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Tear film and ocular surface assessment in psoriasis
  1. Emanuela Aragona1,
  2. Laura Rania1,
  3. Elisa Imelde Postorino1,
  4. Alberto Interdonato1,
  5. Roberta Giuffrida2,
  6. Serafinella Patrizia Cannavò2,
  7. Domenico Puzzolo3,
  8. Pasquale Aragona1
  1. 1 Department of Biomedical Sciences, Regional Referral Center for the Ocular Surface Diseases, University of Messina, Messina, Italy
  2. 2 Department of Clinical and Experimental Medicine, Section of Dermatology, University of Messina, Messina, Italy
  3. 3 Department of Biomedical Sciences, Section of Histology and Embriology, University of Messina, Messina, Italy
  1. Correspondence to Professor Pasquale Aragona, Department of Biomedical Sciences, Regional Referral Center for the Ocular Surface Diseases, University of Messina, Via Consolare Valeria 1, I-98125, Messina, Italy; paragona{at}


Background Psoriasis is a skin disease with also systemic involvement: its impact on the eye is not well established and often clinically underestimated. Aim of this study was to investigate the presence of ocular discomfort symptoms and of ocular surface changes in a population of patients with psoriasis.

Methods For this cross-sectional, comparative study, 66 patients with psoriasis were subdivided according to the presence of arthritis and to the use of biological therapy. All patients underwent clinical evaluation with the following tests: Ocular Surface Disease Index Questionnaire, Tearscope examination, meibometry, tear film breakup time, corneal and conjunctival fluorescein staining, Schirmer I test, corneal aesthesiometry, meibomian gland dysfunction (MGD) assessment and conjunctival impression cytology. 28 healthy subjects were also enrolled and treated with the same clinical tests. A statistical analysis of the results was performed.

Results Patients with psoriasis showed a significant deterioration of the ocular surface tests, if compared with healthy subjects, demonstrated by tear film lipid layer alteration, tear film instability, corneal and conjunctival epithelial suffering and mild squamous metaplasia at impression cytology. No differences were found in ocular surface test results of the psoriatic group when patients were divided according to the presence of arthritis, whereas the anti-inflammatory treatment with biological drugs demonstrated a significant improvement of corneal stain and MGD.

Conclusions Our findings suggest that the ocular surface involvement in patients with psoriasis indicates the need of periodic ophthalmological examinations to diagnose the condition and allow a proper treatment, so contributing to the amelioration of patients’ quality of life.

  • Tears
  • Ocular surface
  • Conjuctiva
  • Cornea

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  • Contributors EA designed the study, performed clinical tests and wrote the paper; LR, EIP and AI performed the tests; RG evaluated patients with psoriasis; SPC contributed to study design and selection of patients with psoriasis; DP contributed to study design and evaluated cytological specimens; PA contributed to the study design, wrote the paper and evaluated all data.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Ethics approval The Institutional Review Board of the Department of Biomedical Sciences of the University of Messina, Messina, Italy.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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