Ocular manifestations of systemic diseases: uveitis, Graves ophthalmopathy and Sjögren’s syndrome
DOI:
https://doi.org/10.11606/issn.2176-7262.rmrp.2022.186279Keywords:
ophthalmology, uveitis, Sjögren’s syndrome, Graves ophthalmopathy, diseasesAbstract
Ophthalmology is considered a specialized area within medicine. Ocular manifestations of systemic diseases allow interaction with other specialties, such as rheumatology, endocrinology, infectious diseases, pediatrics and neurology. Decreased visual acuity, pain and ocular hyperemia, or dry eye sensation can be the first manifestation of systemic diseases, and therefore anamnesis can give us clues of undiagnosed diseases. The fundus examination shows blood vessels in a non-invasive way, and detected changes may also be present in other structures, such as kidneys, brain and heart. In this article, we detail the main systemic diseases that affect the eyes and their most common manifestations.
Downloads
References
Bastos TMA, Jorge R. Manifestações oculares de doenças sistêmicas II: diabetes mellitus e hipertensão arterial sistêmica. Medicina (Ribeirão Preto) [Internet]. 2021.
Burkholder BM, Jabs DA. Uveitis for the non-ophthalmologist. BMJ. Published online February 3, 2021. doi:10.1136/bmj.m4979
Gonzalez Fernandez D, Nascimento H, Nascimento C, Muccioli C, Belfort R. Uveitis in São Paulo, Brazil: 1053 New Patients in 15 Months. Ocular Immunology and Inflammation. 2017;25(3). doi:10.3109/09273948.2015.1132741
Montoya J, Liesenfeld O. Toxoplasmosis. The Lancet. 2004;363(9425). doi:10.1016/S0140-6736(04)16412-X
DUBEY JP. The History of Toxoplasma gondii - The First 100 Years. Journal of Eukaryotic Microbiology. 2008;55(6). doi:10.1111/j.1550-7408.2008.00345.x
Furtado JM, Winthrop KL, Butler NJ, Smith JR. Ocular toxoplasmosis I: parasitology, epidemiology and public health. Clinical & Experimental Ophthalmology. 2013;41(1). doi:10.1111/j.1442-9071.2012.02821.x
Furtado J, Smith J, Belfort R, Gattey D, Winthrop K. Toxoplasmosis: A global threat. Journal of Global Infectious Diseases. 2011;3(3). doi:10.4103/0974-777X.83536
Butler NJ, Furtado JM, Winthrop KL, Smith JR. Ocular toxoplasmosis II: clinical features, pathology and management. Clinical & Experimental Ophthalmology. 2013;41(1). doi:10.1111/j.1442-9071.2012.02838.x
de Angelis RE, Veronese Rodrigues M de L, Passos ADC, et al. Frequency and visual outcomes of ocular toxoplasmosis in an adult Brazilian population. Scientific Reports. 2021;11(1). doi:10.1038/s41598-021-83051-0
Morais FB, Arantes TEF e, Muccioli C. Current Practices in Ocular Toxoplasmosis: A Survey of Brazilian Uveitis Specialists. Ocular Immunology and Inflammation. 2018;26(2). doi:10.1080/09273948.2016.1215471
Bosch-Driessen LEH, Berendschot TTJM, Ongkosuwito J v, Rothova A. Ocular toxoplasmosis. Ophthalmology. 2002;109(5). doi:10.1016/S0161-6420(02)00990-9
Arruda S, Vieira BR, Garcia DM, et al. Clinical manifestations and visual outcomes associated with ocular toxoplasmosis in a Brazilian population. Scientific Reports. 2021;11(1). doi:10.1038/s41598-021-82830-z
Hook EW. Syphilis. The Lancet. 2017;389(10078). doi:10.1016/S0140-6736(16)32411-4
https://www.cdc.gov/std/statistics/2019/overview.htm#Syphilis . Acesso em 15 de maio de 2021.
http://indicadoressifilis.aids.gov.br. Acesso em 15 de maio de 2021.
https://wwwn.cdc.gov/nndss/conditions/syphilis/case-definition/2018/. Acesso em 15 de maio de 2021.
Furtado JM, Arantes TE, Nascimento H, et al. Clinical Manifestations and Ophthalmic Outcomes of Ocular Syphilis at a Time of Re-Emergence of the Systemic Infection. Scientific Reports. 2018;8(1). doi:10.1038/s41598-018-30559-7
Northey LC, Skalicky SE, Gurbaxani A, McCluskey PJ. Syphilitic uveitis and optic neuritis in Sydney, Australia. British Journal of Ophthalmology. 2015;99(9). doi:10.1136/bjophthalmol-2014-306168
Vaze A, de Angelis RE, Simões M, et al. Optical Coherence Tomography Findings in Ocular Syphilis Involving the Posterior Segment of the Eye. Ocular Immunology and Inflammation. Published online April 15, 2021. doi:10.1080/09273948.2021.1892152
https://www.cdc.gov/std/tg2015/syphilis.htm . Acesso em 15 de maio de 2021.
Agostini FA, Queiroz RP, Azevedo DOM, Henriques JF, Campos WR, Vasconcelos-Santos D v. Intravenous Ceftriaxone for Syphilitic Uveitis. Ocular Immunology and Inflammation. 2018;26(7). doi:10.1080/09273948.2017.1311926
Oliver GF, Stathis RM, Furtado JM, et al. Current ophthalmology practice patterns for syphilitic uveitis. British Journal of Ophthalmology. 2019;103(11). doi:10.1136/bjophthalmol-2018-313207
Queiroz R de P, Inês DV, Diligenti FT, et al. The ghost of the great imitator: prognostic factors for poor outcome in syphilitic uveitis. Journal of Ophthalmic Inflammation and Infection. 2019;9(1). doi:10.1186/s12348-019-0169-8
Cassidy J. Ophthalmologic Examinations in Children With Juvenile Rheumatoid Arthritis. PEDIATRICS. 2006;117(5). doi:10.1542/peds.2006-0421
Kanski JJ. Juvenile arthritis and uveitis. Survey of Ophthalmology. 1990;34(4). doi:10.1016/0039-6257(90)90026-R
Holland GN, Denove CS, Yu F. Chronic Anterior Uveitis in Children: Clinical Characteristics and Complications. American Journal of Ophthalmology. 2009;147(4). doi:10.1016/j.ajo.2008.11.009
MONNET D. Ophthalmic findings and frequency of extraocular manifestations in patients with HLA-B27 uveitis*1A study of 175 cases. Ophthalmology. 2004;111(4). doi:10.1016/j.ophtha.2003.07.011
Chang JH, McCluskey PJ, Wakefield D. Acute Anterior Uveitis and HLA-B27. Survey of Ophthalmology. 2005;50(4). doi:10.1016/j.survophthal.2005.04.003
Gonzalez Fernandez D, Nascimento H, Nascimento C, Muccioli C, Belfort R. Uveitis in São Paulo, Brazil: 1053 New Patients in 15 Months. Ocular Immunology and Inflammation. 2017;25(3). doi:10.3109/09273948.2015.1132741
Holland GN, Vaudaux JD, Jeng SM, et al. Characteristics of Untreated AIDS-related Cytomegalovirus Retinitis. I. Findings before the Era of Highly Active Antiretroviral Therapy (1988 to 1994). American Journal of Ophthalmology. 2008;145(1). doi:10.1016/j.ajo.2007.09.023
Jabs DA, Ahuja A, van Natta M, Dunn JP, Yeh S. Comparison of Treatment Regimens for Cytomegalovirus Retinitis in Patients with AIDS in the Era of Highly Active Antiretroviral Therapy. Ophthalmology. 2013;120(6). doi:10.1016/j.ophtha.2012.11.023
Genere N, Stan MN. Current and Emerging Treatment Strategies for Graves’ Orbitopathy. Drugs. 2019;79(2). doi:10.1007/s40265-018-1045-9
Bahn RS. Graves’ Ophthalmopathy. New England Journal of Medicine. 2010;362(8). doi:10.1056/NEJMra0905750
Taylor PN, Zhang L, Lee RWJ, et al. New insights into the pathogenesis and nonsurgical management of Graves orbitopathy. Nature Reviews Endocrinology. 2020;16(2). doi:10.1038/s41574-019-0305-4
Hiromatsu Y, Eguchi H, Tani J, Kasaoka M, Teshima Y. Graves’ Ophthalmopathy: Epidemiology and Natural History. Internal Medicine. 2014;53(5). doi:10.2169/internalmedicine.53.1518
Nunery WR, Martin RT, Heinz GW, Gavin TJ. The Association of Cigarette Smoking with Clinical Subtypes of Ophthalmic Gravesʼ Disease. Ophthalmic Plastic & Reconstructive Surgery. 1993;9(2). doi:10.1097/00002341-199306000-00001
Bartalena L, Baldeschi L, Dickinson A, et al. Consensus statement of the European Group on Graves’ orbitopathy (EUGOGO) on management of GO. European Journal of Endocrinology. 2008;158(3). doi:10.1530/EJE-07-0666
Stiebel-Kalish H, Robenshtok E, Hasanreisoglu M, Ezrachi D, Shimon I, Leibovici L. Treatment Modalities for Graves’ Ophthalmopathy: Systematic Review and Metaanalysis. The Journal of Clinical Endocrinology & Metabolism. 2009;94(8). doi:10.1210/jc.2009-0376
Wiersinga WM. Smoking and thyroid. Clinical Endocrinology. 2013;79(2). doi:10.1111/cen.12222
Murube J. Criteria for Diagnosis of Sjogren-Jones Syndromes. The Ocular Surface. 2011;9(2). doi:10.1016/S1542-0124(11)70013-1
Murube J. Henrik Sjögren, 1899–1986. The Ocular Surface. 2010;8(1). doi:10.1016/S1542-0124(12)70212-4
Murube J. The First Definition of Sjögren’s Syndrome. The Ocular Surface. 2010;8(3). doi:10.1016/S1542-0124(12)70221-5
Shiboski CH, Shiboski SC, Seror R, et al. 2016 American College of Rheumatology/European League Against Rheumatism Classification Criteria for Primary Sjögren’s Syndrome: A Consensus and Data‐Driven Methodology Involving Three International Patient Cohorts. Arthritis & Rheumatology. 2017;69(1). doi:10.1002/art.39859
Vitali C. Classification criteria for Sjogren’s syndrome: a revised version of the European criteria proposed by the American-European Consensus Group. Annals of the Rheumatic Diseases. 2002;61(6). doi:10.1136/ard.61.6.554
Valim V, Trevisani VFM, Pasoto SG, et al. Recomendações para o tratamento da síndrome de Sjögren. Revista Brasileira de Reumatologia. 2015;55(5). doi:10.1016/j.rbr.2015.07.004
Binard A D-PVFBJSYPSA. Epidemiology of Sjögren’s syndrome: where are we now? Clin Exp Rheumatol. 2007;Jan-Feb;25(1):1-4.
Fox RI, Chan EK, Ho-Il K. Laboratory evaluation of patients with Sjögren’s syndrome. Clinical Biochemistry. 1992;25(3). doi:10.1016/0009-9120(92)90341-O
Flores-Chávez A, Kostov B, Solans R, et al. Severe, life-threatening phenotype of primary Sjögren’s syndrome: clinical characterisation and outcomes in 1580 patients (the GEAS-SS Registry). Clin Exp Rheumatol. 2018;May-Jun;36(Suppl 112(3):121-129).
Hall JC, Baer AN, Shah AA, et al. Molecular Subsetting of Interferon Pathways in Sjögren’s Syndrome. Arthritis & Rheumatology. 2015;67(9). doi:10.1002/art.39204
de Oliveira F, Fantucci M, Adriano L, et al. Neurological and Inflammatory Manifestations in Sjögren’s Syndrome: The Role of the Kynurenine Metabolic Pathway. International Journal of Molecular Sciences. 2018;19(12). doi:10.3390/ijms19123953
Chisholm DM, Mason DK. Labial salivary gland biopsy in Sjogren’s disease. Journal of Clinical Pathology. 1968;21(5). doi:10.1136/jcp.21.5.656
Horvath IF, Szanto A, Papp G, Zeher M. Clinical Course, Prognosis, and Cause of Death in Primary Sjögren’s Syndrome. Journal of Immunology Research. 2014;2014. doi:10.1155/2014/647507
Rocha EM, Paula JS, Reinach PS. Punctal occlusion in Sjögren’s syndrome needs clarification. Nature Reviews Rheumatology. 2012;8(12). doi:10.1038/nrrheum.2012.53-c1
Fife RS, Chase WF, Dore RK, et al. Cevimeline for the Treatment of Xerostomia in Patients With Sjögren Syndrome. Archives of Internal Medicine. 2002;162(11). doi:10.1001/archinte.162.11.1293
Vivino FB. Pilocarpine Tablets for the Treatment of Dry Mouth and Dry Eye Symptoms in Patients With Sjögren Syndrome<subtitle>A Randomized, Placebo-Controlled, Fixed-Dose, Multicenter Trial</subtitle> Archives of Internal Medicine. 1999;159(2). doi:10.1001/archinte.159.2.174
Downloads
Published
Issue
Section
License
Copyright (c) 2022 João M. Furtado, Italo Pena de Oliveira, Barbara Regina Vieira , Barbara Maria Guedes Marcusso, Juliana Maia Farias, Anna Flora Teixeira Soto Pelinson, Bárbara Salomão de Almeida Cunha, Fabíola Reis Oliveira, Antônio Augusto Velasco Cruz, Eduardo Melani Rocha
This work is licensed under a Creative Commons Attribution 4.0 International License.
