Ocular findings in patients with vitiligo: A single-center experience

Purpose: We sought to evaluate ocular abnormalities in patients with nonsegmental vitiligo.

Methods: This was a case-control study in which patients with vitiligo were evaluated in terms of ocular findings. Vitiligo patients were classified into acrofacial and generalized groups. Duration and periocular involvement of the vitiligo were recorded. Vitiligo Area Scoring Index (VASI) and Vitiligo Disease Activity Score (VIDA) were calculated. All patients and control subjects underwent uncorrected and corrected visual acuity, keratometry, central corneal thickness, Schirmer's testing, tear film break-up time (TBUT), intraocular pressure, biomicroscopic examination, and anterior segment tomography.

Results: A total of 244 subjects (130 vitiligo and 114 controls) were included in the study. Most of the vitiligo patients (87.7%) had vitiligo vulgaris. One-third of all vitiligo patients had periocular involvement. Fundus hypopigmentation was found in 42.6% of the vitiligo patients. Thirty-five vitiligo patients (27.3%) and 23 vitiligo patients (18%) had moderately severe and very severe dry eyes, respectively. Based on TBUT, 48 vitiligo patients (44.4%) had a poor tear film. Median scores on Schirmer's testing were 5mm in vitiligo patients with periocular involvement and 11mm in vitiligo patients without periocular involvement (P<0.001). Mean intraocular pressure was 14.4±3.2mmHg in vitiligo patients and was no different from that of the control subjects. Six patients (4.6%) had increased IOP. None of the control subjects had increased IOP. Corneal keratometry showed a significantly higher vertical measurement in vitiligo patients. Astigmatism was significantly higher and peripheral iris atrophy was significantly more frequent in vitiligo patients compared to controls.

Conclusion: Periocular involvement was associated with an increased risk of dry eye in vitiligo patients.