Background While the diagnosis of many SpA is usually made in rheumatology units based on other clinical findings as the inflammatory low back pain or arthritis (1,2), it has been described that there could be patients with AU with an undiagnosed SpA (3). Therefore, an early recognition of a possible SpA in patients attending the ophthalmology units with uveitis is vital in order to improve these patient's management
Objectives To describe and analyse the prevalence of spondyloarthritis (SpA) in patients with anterior uveitis (AU).
Methods In a multicentric prospective study, consecutive patients with AU HLA-B27 positive or HLA-B27 negative with more than one episode of AU separated by at least 3 months were selected and evaluated by an ophthalmologist and a rheumatologist following a pre-defined visits schedule. Patients with previous diagnosis of SpA were excluded. Sociodemographic and clinical variables including the diagnosis of SpA according to ASAS criteria and an exhaustive ophtalmological examination were collected. Baseline descriptive, bivariate and concordance analyses were performed.
Results We included 798 patients, most men (59%) with a mean age of 45 years, 60% with AU HLA-B27 positive, 40% with recurrent AU HLA-B27 negative. A total of 50.2% and 17.5% presented axial and peripheral SpA according to ASAS criteria respectively. Patients with AU and HLA-B27 were more frequently diagnosed of axial (69.8% vs 27.3%, p<0.0001) and peripheral SpA (21.9% vs 11.1%, p<0.0001) than patients with recurrent AU with HLA-B27 negative. In general, we did not detect important differences between groups in the ophthalmologic variables.
Conclusions A high rate of patients with clinically significant AU have an undiagnosed SpA, higher if HLA-B27 was positive.
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Disclosure of Interest None declared