Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disease. Up to one-third of patients suffering from SLE have various ocular manifestations. The ocular findings may represent the initial manifestation of the systemic disease and may lead to severe ocular complications, and even loss of vision. Ocular manifestations are often associated with degree of systemic inflammation, but also can precede the occurrence of systemic symptoms. Early diagnosis and adequate management of patients with SLE are crucial and require cooperation between various specialists. Proper preparation of ophthalmologists can help to differentiate between complication of SLE and other ocular disorders. New therapies for SLE are promising for potential benefits, however, ocular side effects are still unknown.
The eyelid skin represents a unique anatomical and immunological interface between the external environment and the ocular surface. Due to its structural delicacy, dense vascularization, and continuous exposure to microbial and environmental antigens, it is a primary target of inflammatory and autoimmune processes. This review aims to synthesize current molecular insights into eyelid skin inflammation, with particular emphasis on autoimmune mechanisms. We discuss autoimmune diseases such as ocular cicatricial pemphigoid, pemphigus, discoid and systemic lupus erythematosus, and thyroid-associated orbitopathy, focusing on the roles of T helper cell subsets, pro-inflammatory cytokines (IL-1β, IL-6, IL-17, TNF-α), and autoantibody-mediated complement activation. We further address the contribution of the periocular microbiome and meibomian gland dysfunction. Diagnostic advances, including confocal microscopy, in vivo molecular imaging, and tear proteomics, are highlighted alongside emerging targeted therapies such as biologics and small molecules directed at IL-17, TNF-α, and B-cell activity. Finally, we propose future perspectives for precision medicine approaches, integrating omics technologies and microbiome-based therapies to advance personalized management of eyelid skin inflammation.
Dry eye disease (DED) represents one of the most prevalent ocular manifestations associated with systemic lupus erythematosus (SLE), with reported incidence rates ranging from 15% to 35%. DED constitutes a multifactorial condition that significantly impairs both visual function and health-related quality of life. The objective of this study was to assess the impact of DED symptoms on vision-related quality of life in patients diagnosed with SLE, employing the Ocular Surface Disease Index (OSDI) as a disease-specific instrument. Additionally, the study aimed to evaluate correlations between clinical diagnostic tests and OSDI scores, and to determine the frequency of abnormalities affecting individual ocular structures. This study included 35 SLE patients, identifying DED in 37.1%. Common ophthalmic abnormalities included lens opacification (22.9%) and hyaloid degeneration (34.3%). Astigmatism (>0.50 D cyl) was prevalent (60.0%), being significantly higher in DED patients. While visual acuity and intraocular pressure were comparable, DED patients showed significantly lower Schirmer I test values, reduced tear break-up time, and higher van Bijsterveld scores, indicating impaired tear film and surface integrity. OSDI scores were significantly elevated in the DED group, with 51.4% reporting moderate to severe dysfunction. Strong, statistically significant correlations between the OSDI and objective tear film parameters confirmed a robust association between subjective symptoms and clinical signs. These findings highlight the significant impact of DED on visual function in SLE patients, underscoring the importance of routine ophthalmological evaluation and timely intervention.
The aim of this study was to determine the effect of a step load periodisation protocol for the rehabilitation of the anterior cruciate ligament (ACL) based on the variables of both the tempo of movement and time under tension (TUT) in normobaric hypoxia using a case study. Introduction: We verified the influence of variables such as time under tension (TUT) and the tempo of movement in hypoxia on the concentration of insulin-like growth factor 1 (IGF-1), growth hormone (GH), and erythropoietin (EPO). The effectiveness of the protocol also concerned variables such as peak torque of the knee flexors and extensors and maximum oxygen uptake (VO2max), as well as body composition analysis. Methods: The study used a 28-year-old judoka athlete from the national team, competing in the weight category up to 73 kg. Results: The use of short partial rest breaks between series (80s) in combination with six exercises in four series and a hypoxic environment (FiO2 = 15%) significantly increased metabolic stress, resulting in the highest increase in GH and IGF in the main phase of accumulation of the 3:1 step load. During 16 running sessions, the rehabilitated athlete achieved a significant increase in individual variables in the running test. Conclusions: The combination of a hypoxic environment combined with a periodized rehabilitation protocol can induce a number of positive hormonal, circulatory and respiratory reactions as well as positively influence muscle asymmetry, which can ultimately shorten the time it takes for an athlete to return to sport (RTS).
Autoimmune ocular surface diseases represent a complex group of disorders in which systemic immune dysregulation triggers chronic inflammation, epithelial dysfunction, and progressive tissue fibrosis. Systemic lupus erythematosus, primary Sjögren’s syndrome, and ocular cicatricial pemphigoid are the principal entities linking systemic autoimmunity to ocular surface pathology. These conditions share convergent mechanisms—including dysregulated cytokine signaling (IFN-I, IL-6, and IL-17), complement activation, and epithelial–mesenchymal transition—culminating in tear film instability and visual impairment. Recent advances in molecular immunology and omics profiling have elucidated disease-specific pathways and identified actionable therapeutic targets. Conventional immunosuppressants such as corticosteroids and cyclosporine remain fundamental, yet emerging biologics targeting BAFF, IFNAR, and JAK/STAT signaling—alongside regenerative strategies employing mesenchymal and induced pluripotent stem cells—are transforming disease management. Parallel innovations in amniotic membrane transplantation, keratoprosthesis, and bioengineered corneal scaffolds integrate structural reconstruction with immune modulation. Furthermore, the convergence of multi-omics analytics, artificial intelligence-assisted diagnostics, and microbiome-based immunomodulation heralds a new era of precision ophthalmology. This review synthesizes current molecular insights, clinical observations, and translational advances that collectively redefine autoimmune ocular surface diseases—from chronic inflammatory disorders into a targetable, regenerative, and potentially reversible spectrum of conditions.
Dry eye disease (DED) represents one of the most prevalent ocular manifestations associated with systemic lupus erythematosus (SLE), with reported incidence rates ranging from 15% to 35%. DED constitutes a multifactorial condition that significantly impairs both visual function and health-related quality of life. The objective of this study was to assess the impact of DED symptoms on vision-related quality of life in patients diagnosed with SLE, employing the Ocular Surface Disease Index (OSDI) as a disease-specific instrument. Additionally, the study aimed to evaluate correlations between clinical diagnostic tests and OSDI scores, and to determine the frequency of abnormalities affecting individual ocular structures. This study included 35 SLE patients, identifying DED in 37.1%. Common ophthalmic abnormalities included lens opacification (22.9%) and hyaloid degeneration (34.3%). Astigmatism (>0.50 D cyl) was prevalent (60.0%), being significantly higher in DED patients. While visual acuity and intraocular pressure were comparable, DED patients showed significantly lower Schirmer I test values, reduced tear break-up time, and higher van Bijsterveld scores, indicating impaired tear film and surface integrity. OSDI scores were significantly elevated in the DED group, with 51.4% reporting moderate to severe dysfunction. Strong, statistically significant correlations between OSDI and objective tear film parameters confirmed a robust association between subjective symptoms and clinical signs. These findings highlight the significant impact of DED on visual function in SLE patients, underscoring the importance of routine ophthalmological evaluation and timely intervention.