An assessment of ocular elasticity using real time ultrasound and ocular response analyzer in active or remission rheumatoid arthritis



To investigate the elasticity of ocular structures in patients with rheumatoid arthritis (RA) without ocular involvement.


The study included 56 RA patients (study group) and 24 healthy volunteers as the control group. The rheumatoid arthritis patients were divided into two subgroups as those in active phase (Group 1, n = 25) or in remission phase (Group 2, n = 31) according to the disease activity index (DAS 28) score. The elastography values of the ratio of orbital fat-sclera (ROF/S) were measured with real-time US elastography, and corneal mechanical values were measured with the Reichert Ocular Response Analyzer in each eye.


The mean ROF/S value was 5.2 ± 1.8 in Group 1, 0.7 ± 0.4 Group 2, and 0.6 ± 0.1 in the control group. There was a significant difference between the Group 1 and control group with regard to ROF/S (p < 0.001), but no significant difference was determined between Group 2 and control group (p > 0.05). The mean ROF/S value was a significant difference between the Group 1 and 2 (p < 0.001). ROF/S was significantly correlated with DAS-28 and C-reactive protein (CRP) (r = 0.816, p < 0.001 and r = 0.259, p = 0.006).


ROF/S was significantly increased in patients in the active phase of RA. Findings revealed that ocular tissue structural changes may occur in the active phase and these could be related to ocular complications as a prognostic factor.

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Correspondence to Mehmet Erol Can.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Can, M.E., Unal, Ö., Kars, M.E. et al. An assessment of ocular elasticity using real time ultrasound and ocular response analyzer in active or remission rheumatoid arthritis. Int Ophthalmol 39, 2187–2194 (2019).

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  • Rheumatoid arthritis
  • Ocular elasticity
  • Ultrasound elastography
  • DAS 28