Anterior Scleral Thickness in Rheumatoid Arthritis and Sjögren's Syndrome: A Comparative Analysis

This study aimed to investigate anterior scleral stromal thickness (AST) in patients with rheumatoid arthritis (RA) and primary Sjögren's Syndrome (SjS) compared with healthy controls and to explore its relationship with disease duration.

The study included 156 participants: 58 with RA, 42 with SjS and 56 healthy controls. The majority of participants were women (n = 130), with a mean age of 51.1 ± 9.38 years. All patients were receiving immunosuppressive therapy and had no history of scleritis. AST and conjunctiva-tenon-episcleral complex thickness (CTEC) were measured using anterior segment OCT at distances of 0, 1, 2 and 3 mm from the scleral spur in the medial-inferior-lateral-superior quadrants. Statistical analyses, including group comparisons and correlation analyses, were performed to assess intergroup differences and associations with disease duration.

The proportion of women was significantly higher and the disease duration was significantly shorter in the SjS group. Compared with controls, the RA group showed significantly thinner medial CTEC at 1, 2, and 3 mm from the scleral spur, whereas inferior AST at the scleral spur was thicker. No significant differences in AST or CTEC parameters were observed in the SjS group relative to controls.

RA is associated with localized alterations in anterior scleral morphology, while SjS does not appear to significantly affect these parameters. These findings may reflect the impact of timely diagnosisand effective immunosuppressive therapy in limiting ocular tissue involvement. However, the absence of a standardized anatomical reference point for scleral thickness measurements complicates direct comparison among scientific studies.