AAOpt 2022: The latest updates on common autoimmune diseases

Sherrol Reynolds, OD, director of the retina clinic and chief of primary care at Nova Southeastern University College of Optometry, as well as past president of the National Optometric Association, shares highlights from her discussion titled, "The most common autoimmune diseases: latest updates," which she co-presented with Joseph Pizzimenti, OD, during the 2022 American Academy of Optometry meeting held in San Diego.

Editor's note: This transcript has been edited for clarity.

Jackson:

Hi everyone. I'm Kassi Jackson with Optometry Times and I'm joined today by Dr. Sherrol Reynolds, director of the retina clinic and chief of primary care at Nova Southeastern University College of Optometry, as well as past president of the National Optometric Association.

She is here to share highlights from her discussion titled, "The most common autoimmune diseases: Latest updates," which she is co-presenting with Dr. Joseph Pizzimenti during the 2022 American Academy of Optometry meeting this year in San Diego. Thank you for being here, Dr. Reynolds. Will you share with us?

Reynolds:

Yeah, thanks for having me. And you know, my co-presenter, my awesome mentor, Dr. Joseph Pizzimenti cannot be here today. But I would like to offer some highlights of our lecture that we kind of sort of did this lecture last year. But the takeaway the key important takeaway on this lecture on the most common autoimmune diseases, for my colleagues, the optometric community is that we're seeing an increase in patients who have underlying autoimmune disease secondary to the COVID pandemic of 2020.

And so the goal is to discuss those increases in the prevalence of the conditions, such as rheumatoid arthritis and lupus and other autoimmune disease, that are newly diagnosed because of COVID-19. Also sort of discuss, you know, or from my colleagues who appreciate the advanced technologies and methodologies that we can use to analyze in these ocular findings, that include multimodal imaging with spectral domain OCT, and OCT angiography and fundus autofluorescent and widefield imaging.

And as I mentioned earlier, you know, we have over 100 autoimmune conditions, I mean, and new ones that are being shared, or discovered, you know, recently because of COVID-19. But one of the key takeaways is that since the pandemic of 2020, recent research has shown that there's just been an increase in the inflammatory markers in most of our patients. That inflammatory markers, anti-nuclear antibody tests, which is a common biomarker, and we know that this marker is sensitive and nonspecific, when it really indicates that the patients are more inflamed, right? It doesn't tell us which disease.

So we're seeing a lot more conditions linked to COVID-19. We're seeing multisystem inflammatory syndrome in children. We're also seeing a multisystem inflammatory syndrome in adults that's related to COVID-19. And, you know, we're also seeing some ocular complications associated that are inflammatory in nature with COVID-19. We're seeing more patients that have inflammation of the eye, uveitis, inflammation in the back of the eyes, retinitis, because of COVID 19.

And the other thing I wanted to kind of discuss in this presentation with Dr. Pizzimenti is during the height of the pandemic, there was a lot of information about hydroxychloroquine use for COVID-19, or hydroxychloroquine use for COVID-19, right, or Plaquenil as it's known, and how did that impact the eye? What was that emergency use of Plaquenil. And should we still be following those patients yearly to make sure they don't develop Plaquenil-related or hydroxychloroquine-related maculopathy?

And we know that this hydroxychloroquine is used for patients that have autoimmune conditions such as systemic lupus erythematous. We'll provide an overview and the latest update on the diagnosis and the risk factors for that condition. Other conditions such as sarcoid, multiple sclerosis, and we'll touch on a little bit of thyroid-associated eye disease, and some of the newer medications that can help us treat that and get into Tepezza, our patients that have thyroid eye disease. And of course, we'll touch on rheumatoid arthritis and Sjogren's syndrome, especially with all of the new agents that are available, the biologic topical agents that are available for patients that have dry eyes secondary to these underlying conditions.

So we're excited to present this information to our colleagues. And hopefully, our colleagues can learn a little bit more about how COVID-19 has really impacted an increase in the prevalence of underlying inflammatory diseases.

Jackson:

Very important conversation. Dr. Reynolds, thank you so much for your time today.

Reynolds:

Thank you so much for having me.