Background Uveitis is most common extraskeletal manifestation of ankylosing spondylitis (AS). In accordance with traditional views, uveitis within AS characterized by favourable course and rarely leads to impaired vision.
Objectives To assess clinical course and complications of uveitis in AS pts.
Methods Sectional study of 140 AS pts (98 men and 42 women) with at least one episode of uveitis during disease. In addition to standard rheumatological examination, all pts were examined by ophthalmologist using ophtalmoscopy, biomicroscopy, tonometry, computer perimetry, ultrasonic scanning, as needed - fluorescein angiography and electrophysiological studies of the retina for detection of settings and complications of uveitis. Total number of uveitis flares until study and the average number of flares per year were calculated for each pt.
Results 136 (97%) pts had HLA-B27, 43 (30%) - peripheral arthritis, 46 (32%) – other extrasceletal manifestations. Onset of uveitis before manifestation of AS had 37 (26,4%) pts, during first 10 years of AS - 81 (58%), after 10 years of AS – 21 (15%). 33 (24%) had more then 10 episodes of uveitis during diseas and 34 (24,5%) had more then 2 flares per year, 18 (13%) had chronic course of uveitis with persisting of inflammation longer than 3 month. Isolated iridocyclitis was found in 118 (84%)pts, panuveitis – in 12 (8%), separate posterior uveitis – in 2 (0,01%). 122 (87%) pts had unilateral uveitis, 18 (13%) – bilateral, 45 (36%) had alternate eye attacks (D-S).
Complications that led to decrease of vision was found in 41 (29%) pts: synechia – in 26 (18%), vitreous body destruction – in 20 (14%), cataract – in 32 (23%), glaucoma – in 13 (9%), maculopathy - in 6 (4%), band keratopathy - in 6 (4%), optic atrophy –in 3 (2%).
Direct correlation was found between frequency of uveitis flares and development of complications (Table 1).
Conclusions Uveitis within AS characterized by onset predominantly during first 10 year of disease, prevalent unilateral iridocyclitis, recurrent course. Approximately 1|3 of pts have complications with decrese of vision that correlate with frequency of uveitis flares.
Feltkamp T.E.W, Ringrose J. Acute anterior uveitis and spondyloarthropathies. Current Opinion in Rheumatology, 1998, 10: 314-318
Goueia E., Elmann D. Ankylosing spondylitis and uveitis: overview, Bras Rheumatol. 2012; 52: 5
Disclosure of Interest : None declared