Ocular Microbiology and Immunology Group
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2025 OMIG Abstract

Patients With Neurotrophic Keratopathy with Autoimmune Markers Have Worse Quality of Life Compared to Autoimmune Negative Neurotrophic Keratopathy Patients

Ana Balbuena-Pareja¹, Nabil Ghazal¹, Pedram Hamrah<sup>1,2

1</sup>Center for Translational Ocular Immunology, Department of Ophthalmology, Tufts Medical Center, Tufts Universi-ty School of Medicine, Boston, Massachusetts; ²Cornea Service, New England Eye Center, Tufts Medical Center, Boston, Massachusetts

Purpose: Neurotrophic keratopathy (NK) is a neurodegenerative corneal disease which may lead to visual impairment and corneal perforation. There is growing evidence that NK may have an autoimmune component underlying its development. We aim to compare the quality of life (QoL) in NK patients with and without underlying autoimmune disease, using the Ocular Pain Assessment Survey (OPAS), to assess the impact of autoimmune conditions on NK patients’ QoL.

Methods: This retrospective, cross-sectional study included NK patients who were ≥18 years old and had OPAS available for analysis. QoL questions assessed the extent to which pain interfered with or affected specific activities. Autoimmune serological testing included antinuclear antibody (ANA), rheumatoid factor (RF), anti-Ro, anti-La, anti-neutrophil cytoplasmic antibody (ANCA), and gliadin antibodies.

Results: The autoimmune-positive NK group (n=17, age 60.72±12.87yrs; 22.2% male) and autoimmune-negative group (n=19, age 64.73±12.8yrs, 32% male) did not differ in age or sex (both, p>0.05). In the autoimmune-positive group, the most common positive markers were ANA (89.5%), ANCA (17.6%), and RF (16.7%), with 76.9% of patients reporting pain in this group, compared to 54.5% in the autoimmune-negative group (p=0.09). The autoimmune group reported median scores (scale 0-10) of 5, 7, and 5 for interference with reading/computer use, driving/watching TV, and general activities (such as walking or doing household chores), respectively, whereas the autoimmune-negative group had a median score of 0 for all these activities (p=0.024,p= 0.012, and p=0.039, respectively) Additionally, the autoimmune-positive group reported burning sensation as an associated factor more frequently than the autoimmune-negative group, with a median score of 7 vs 0, respectively (p<0.05).

Conclusions: This study demonstrates that NK patients with positive autoimmune markers experience greater interference of pain with daily activities, compared to NK patients with negative autoimmune markers. These findings suggest that autoimmune conditions may exacerbate the symptoms pain and discomfort in patients with NK and impact patients' quality of life, highlighting the need for tailored management strategies, such as anti-inflammatory therapy for those with underlying autoimmune diseases.