Objectives: Uveitis is reported as the most frequent extra articular manifestation in spondylarthritis (SPA) however its prevalence and characteristics are not well established. The objective was to perform a systematic literature review in order to address these issues.
Methods: Data sources: A systematic literature analysis was conducted in the Medline database up to October 2006 and in the abstracts of rheumatology scientific meetings for the years 2004, 2005 and 2006. A hand search of references was also performed. Review methods: Articles were analysed if they reported the prevalence or the characteristics of uveitis in SPA. Data abstraction was standardized. Statistical analysis was mainly descriptive.
Results: Among the 957 articles selected by the search, 126 articles (29,877 patients) allowed a calculation of the prevalence of uveitis in SPA; 36 articles (1,989 patients) described its characteristics. Prevalence of uveitis was 32.7±0.5%; it varied with the type of SPA, e.g. 33.2±0.8% for ankylosing spondylitis versus 25.1±2.3% for psoriatic arthritis. This prevalence increased with mean disease duration and was higher in HLA B27 positive patients with an odds ratio of 4.2. Uveitis was acute in 88.7±2.5%, anterior in 90.5±2.0%, unilateral in 87.3±2.8%. Recurrence concerned 50.6±2.6% and a reduction of visual acuity was observed in 8.3±3.8%.
Conclusion: Prevalence of uveitis varies with disease duration and according to the type of SPA. Reduction of visual acuity is not exceptional. Because of recent promising data concerning the effects of anti tumor necrosis factor therapy on uveitis flares in SPA, it was important to determine this baseline prevalence.