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  • Characteristics of Uveitis in Spondyloarthritis

    By Lynda Seminara
    Selected by Richard K. Parrish II, MD
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    Journal Highlights

    American Journal of Ophthalmology, August 2021

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    Spondyloarthritis denotes a spectrum of diseases with overlapping skeletal and extra-articular features. Although its most common extra-auricular sign is acute anterior uveitis (AAU), spondy­loarthritis goes undiagnosed in nearly 40% of patients with uveitis. Bilge et al. looked at the frequency and fea­tures of AAU in a nationwide cohort of Turkish patients with spondyloarthritis of various subtypes. They found that radiographically observed damage and long duration of disease were linked to elevated uveitis risk.

    The data source for this study was the TReasure registry, which includes detailed information on patients with inflammatory arthritis in regions throughout Turkey. The authors re­corded data for patients with concur­rent spondyloarthritis and uveitis, in­cluding the timing of uveitis diagnosis, the number of attacks, and whether the involvement was unilateral or bilateral. History of uveitis was defined as AAU diagnosed by an ophthalmologist.

    The study cohort included 4,297 patients; of these, 475 (11%) had expe­rienced at least one episode of uveitis. Uveitis was more common in patients older than age 60 years (p < .001) and in those with a smoking history (p = .004), arthritis (p < .001), diagnostic delay (p = .001), disease lasting at least five years (p < .001), HLA-B27 positivity (p < .001), family history of spondyloarthritis (p < .001), or radio­graphic evidence of damage (p < .001). Uveitis was most prevalent in patients with ankylosing spondylitis and was less common in those with psoriasis or psoriatic arthritis.

    Given these results, the authors recommend that eye care providers ask patients with uveitis about back pain and arthritis and refer them to a rheumatologist for a full spondyloar­thritis workup. Collaboration between rheumatology and ophthalmology is crucial for optimal care of patients with uveitis, said the authors. To their knowledge, this study represents the largest cohort of patients with coexist­ing spondyloarthritis and uveitis.

    The original article can be found here.