Ocular involvement is a common manifestation of many rheumatic diseases. Anterior uveitis, peripheral ulcerative keratitis and scleritis are often associated with autoimmunity. This study in particular correlated ankylosing spondylitis with glaucoma. Photo: MyHealth Alberta. Click image to enlarge.

There are dozens of rheumatic diseases affecting nearly every body system, from joints and bones to organs and muscles. These autoimmune and inflammatory conditions are among the most common causes of adult disability in the United States. Notably, glaucoma is also related to autoimmunity and inflammation. To learn more about this relationship, researchers investigated the possible association between rheumatic diseases and glaucoma using Mendelian randomization studies. Of the six rheumatic diseases they explored, only one increased the risk for glaucoma.

The diseases in the study were ankylosing spondylitis, rheumatoid arthritis, systemic lupus erythematosus, Sjogren’s syndrome, dermatomyositis and gout; with primary open-angle glaucoma (POAG) and primary angle-closure glaucoma (PACG). The researchers extracted associated genetic variants from genome-wide association studies before performing multiple types of Mendelian randomization to identify potential causal associations, verify findings and analyze sensitivity.

The researchers reported that only ankylosing spondylitis was significantly related to a higher risk of either glaucoma subtype. While the underlying mechanisms remain unclear, the researchers speculate that since ankylosing spondylitis is a type of collagen connective tissue disorder, the biomechanical integrity of the corneal stroma, which is composed of collagen fibrils, may be compromised, leading to a higher risk for glaucoma.

The researchers concluded in their paper for Frontiers in Immunology that they “stress the importance of glaucoma screening for ankylosing spondylitis patients, which would help in early diagnosis and prevention of irreversible vision loss.”