Ocular findings in patients with psoriasis as A systemic disease

Psoriasis is a chronic, inflammatory skin disease; characterized by white squam located on sharp erythematous plaques or papules with increased epidermal proliferation and also involving the nails and joints. The lesions are often located symmetrically on the extensor surfaces of the knee, elbow, sacral region, scalp and joints. It is known that psoriasis is more than a skin disease and can also affect other systems. Blepharitis, inferior punctate corneal opacity, conjunctivitis, dry eye, punctate epitheliopathy, superficial punctate keratitis, iritis, chronic iridocyclitis, uveitis, pigment dispersion, trichiasis, symlepharone, cataract, episcleritis, and peripheral corneal melt syndrome are eye findings reported in psoriasis. In this study, we aimed to investigate eye findings and examination results in psoriatic patients and their relationship with age, sex, disease duration, disease severity, scalp, joint and nail involvement. Seventy-seven patients over 18 years of age diagnosed as psoriasis clinically and histopathologically and 75 healthy control groups were included in the study. Information about age, occupation, smoking habit and duration, family history, duration of illness was questioned. Nail, hair and joint involvement were evaluated. PASI score was calculated. Those with a PASI score of 1-10 were considered as 'mild' and those with a score of more than 10 were considered as 'severe' 'psoriasis. Biomicroscopic examination, fundus examination, tear break-up time, Schirmer test, visual acuity, intraocular pressure and eye movements were evaluated in all cases. Specular microscopy and optical coherence tomography (OCT) were performed. Corneal meniscus parameters were calculated. OSDI score was calculated for dry eye symptoms. In our study, the PASI score was significantly higher in patients with nail and hair involvement than those without. Blepharitis was observed in 5.19%, nuclear cataract was 2,59% and pterygium was found in 1,29% of the patients. Retinal epithelial pigment changes were observed in 2,59% of the patients and asteroid hyelosis was found in 1,29% of the patients. According to the results of the BUT test, 79,2% of the patients with psoriasis and 2,6% of the control group had a tear break-up time of less than 10 s. Blepharitis was more common in female patients, whereas dry eye was common in men. In specular microscopy, CV (coefficient of variability) and HEX (hexagonal cell ratio) were statistically significant. Central, temporal, superior and inferior corneal epithelial thicknesses were found to be statistically significant in AS-OCT (anterior segment optical coherence tomography). When tear meniscus findings were evaluated, it was observed that tear meniscus area was significant in psoriasis group. All patients with psoriasis should be screened regularly for eye diseases such as dry eye, blepharitis, conjunctivitis and uveitis during follow-up visits. Patients should be questioned for routine discomfort (pain / irritation / foreign body sensation / dry eye / photophobia), loss of eyelash, swollen / painful eyelids, redness of the eyes, periocular or eyelid lesions and visual changes; if necessary, it should be recommended to see an opthalmologist.