Tear Proteins, Conjunctival Cells and Imaging Eyes in Rheumatoid Arthritis and Systemic Lupus Erythematosus Patients

Rheumatoid Arthritis (RA) and Systemic Lupus Erythematosus (SLE) are chronic systemic autoimmune diseases that have been reported to affect the ocular surface of patients \[1,2\]. However, the nature of the disturbances of the ocular surface immunity and their relationship to systemic disease severity are poorly understood. This study aims to profile the ocular surface inflammation of RA and SLE patients by a., analysing levels of tear cytokine, and b., investigating conjunctival cells, and c. clinical imaging for conjunctival redness and tear stability. 20 consecutive RA patients and 20 consecutive SLE patients will be recruited from the Singapore General Hospital Rheumatology clinic. 20 age matched controls for SLE and another 20 age matched controls for RA will be recruited. All participants will undergo 1. Tear collection with Schirmer strips 2. EyePRIMTM (Opia Technologies) Impression Cytology Device for conjunctival sampling 3. Clinical ocular surface assessment with Oculus Keratograph 5M 4. Collection of blood via venipuncture (optional) 5. Retrieval of Clinical Information of participants The association of cytokines in the tears with various cellular and immune markers, as well as clinical signs of inflammation and tear stability will be investigated. This will be useful for further longitudinal studies of treatment in autoimmmune disease patients.