The Relationship between Ocular Alterations and Alopecia Areata

Background & Aims: Alopecia areata is a chronic inflammatory disorder that affects the hair follicles. The condition most commonly presents with the sudden appearance of non-scarring discrete patches of alopecia on the scalp. Due to being an autoimmune disease, alopecia areata is observed in concomitantly with other diseases. In some studies, ocular alterations were surveyed in these patients. Due to the limited number of studies in this respect and lack of any conclusive results, the present study was performed with the aim to determine ocular alterations in alopecia areata patients. Methods: This case-control study was performed on 106 patients with alopecia areata (20-40 years old) who refer to dermatology clinics in Semnan, Iran, in 2012-2013 and 106 controls. Patients and controls were examined using slit lamp, fundoscopy, and indirect ophthalmoscopy. Results: The two groups were matched in age and sex (P > 0.05). Ocular alterations were observed in 15.1% of patients with alopecia areata and 0.9% of control group subjects; this difference was significant. Thus, the chance of ocular alterations in patients with alopecia areata was 18.7 times that in the control group [odds ratio (OR) = 18.7, 95% confidence interval (CI): 2.4-143.5, P = 0.005]. Increased iris crypt (8.5%) and loss of foveal reflex (4.7%) had the highest prevalence among alterations observed in alopecia areata patients. Conclusion: The findings show that significant ocular alterations in patients with alopecia areata are increased iris crypt and loss of foveal reflex. These alterations are not pathologic, but are based on genetic features and are not important in ocular disease.