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At least 145 records · Page 8Linked to original sources
PubMed2000

Tubulointerstitial nephritis and uveitis with bilateral multifocal choroiditis.

PURPOSE: To report a case of bilateral multifocal choroiditis secondary to tubulointerstitial nephritis and uveitis. METHODS: Case report. A 16-year-old women with an 11-month history of tubulointerstitial nephritis and uveitis and bilateral anterior uveitis developed bilateral multifocal choroiditis. After initial unsuccessful treatment with topical steroids, treatment was augmented by a 2-week course of systemic prednisone. RESULTS: Intensive steroid treatment resulted in steroid-induced glaucoma, which required bilateral trabeculectomies, but the uveitis became inactive. Two years after uveitis onset, bilateral intraocular pressure was normal, there were occasional (12+) anterior chamber cells, and inactive depigmented chorioretinal lesions on topical steroid drops. See also pp. 764-768, 798-799. CONCLUSIONS: Tubulointerstitial nephritis and uveitis usually involves only the anterior uvea, although a few cases of posterior uveitis have been described. This article reports a case of multifocal choroiditis associated with tubulointerstitial nephritis and uveitis. It is important for ophthalmologists to be aware of possible posterior uveal involvement in tubulointerstitial nephritis and uveitis so they can choose the most appropriate immunosuppressive therapy for the uveitis.

Adolescent↗
PubMedDate not supplied

[The treatment of recurrent uveitis with TNF-alpha inhibitors].

OBJECTIVE: Uveitis is a severe manifestation of rheumatic diseases since it can lead to visual impairment and even blindness. Ocular involvement is frequently a clinical challenge because its occurrence often requires changes of the therapeutic strategy. There are growing evidence that tumor necrosis factor alpha (TNFalpha) inhibitors may be an effective treatment of refractory uveitis. Purpose of this study was to evaluate the efficacy and safety of TNFalpha blocking agents in patients with seronegative spondylo-arthropathies (SNSA) and Behcet disease (BD) associated relapsing uveitis. METHODS: Five consecutive patients with chronic or relapsing uveitis were prospectively studied. Two patients with SNSA had recurrent anterior uveitis and three patients had BD associated uveitis (one anterior, two posterior uveitis). All of the patients were taking systemic and topical corticosteroids and three of them were also treated with DMARDs (methotrexate, cyclosporine, sulphasalazine) without clinical benefit. Four patients received infliximab, an anti-TNFalpha monoclonal antibody, at a dosage of 5 mg/kg body weight and one patient was treated with etanercept, a TNFalpha receptor p75-Fc fusion protein, at a dosage of 25 mg twice weekly. RESULTS: Both infliximab and etanercept induced a marked improvement in uveitis and none relapse was observed throughout all the study. Systemic corticosteroids were progressively tapered and stopped in all patients. Also methotrexate and sulphasalazine were discontinued, while cyclosporine dose has been reduced by 30%. No side effects were observed. CONCLUSIONS: Therapy with TNFalpha blockers, infliximab and etanercept, was effective and safe in the treatment of rheumatic disease associated uveitis. A complete remission was achieved even in patients with severe steroid resistant uveitis. Further controlled studies on larger number of patients are needed to better define the different forms of ocular involvement that can benefit from the therapy with TNFalpha inhibitors.

Adolescent↗
PubMed1996

Referral patterns of uveitis in a tertiary eye care center.

OBJECTIVE: To analyze the referral patterns and diagnosis of uveitis during the past decade in a large tertiary eye center. DESIGN: The records of 1237 patients with uveitis referred to the Immunology Service of the Massachusetts Eye and Ear Infirmary from 1982 to 1992 were classified and analyzed. Data regarding sex, race, nationality, referral site, ages at presentation and onset of uveitis, ocular involvement, clinical characteristics, ocular condition, and systemic disease associations were obtained. RESULTS: The mean age at onset of uveitis was 37.2 years; the male-to-female ratio was 1:1.4. Most patients were white (85.8%), born in the United States (83.1%), and referred from within New England (84.7%). Anterior uveitis was most common (51.6%), followed by posterior uveitis (19.4%), panuveitis (16.0%), and intermediate uveitis (13.0%). Chronic (58.3%), nongranulomatous (77.7%), and noninfectious (83.1%) were the most frequent types of uveitis. The most common entities included idiopathic (34.9%), seronegative spondyloarthropathies (10.4%), sarcoidosis (9.6%), juvenile rheumatoid arthritis (5.6%), systemic lupus erythematosus (4.8%), Behçet's disease (2.5%), and the acquired immunodeficiency syndrome (2.4%). CONCLUSION: The appearance of new uveitic entities, such as the acute retinal necrosis syndrome, multifocal choroiditis and panuveitis, birdshot retinochoroidopathy, and acquired immunodeficiency syndrome-related uveitis, and the reemergence of the classic infectious causes of uveitis, tuberculosis and syphilis, have changed the way we approach the diagnosis and management of posterior and panuveitis at the Massachusetts Eye and Ear Infirmary.

Adolescent↗
PubMed1998

Experimental mucosal induction of uveitis with the 60-kDa heat shock protein-derived peptide 336-351.

Subcutaneous (s.c.) immunization of rats with the human 60-kDa heat shock protein (HSP)-derived peptide 336-351 induced clinical and/or histological uveitis in 80 % of rats. Subsequent experiments to prevent the development of uveitis by oral or nasal administration of the peptide have failed. Instead, uveitis was induced in 74.6 % of rats given the peptide orally (5 times), in 75 % given the peptide nasally (5 times) or 91.7 % of those administered the peptide by both routes (10 times). Histological examination showed that any one route of administration of the peptide elicited iridocyclitis in 42.2 % but loss of photoreceptors only in 4.9 % of rats. In contrast, sequential administrations of the peptide by a combined mucosal-s.c. route resulted in iridocyclitis in only 25 % but loss of photoreceptors in 40 % of animals. Examination of mRNA from CD4-enriched splenic cells by reverse transcription-PCR failed to yield significant differences in Th1 or Th2 cytokines. Treatment with monoclonal antibody (mAb) to CD4 yielded a dose-dependent decrease in uveitis from 82 % to 25 %. Similarly, treatment with IL-4 significantly decreased the development of uveitis from 68 % to 30.4 %. Conversely, treatment of the rats with mAb to CD8 greatly enhanced the onset of uveitis (from about 22 days in the controls to 11 days) and all the rats developed uveitis by day 24. Thus, CD4+ cells mediate, whereas CD8+ cells suppress the development of uveitis. We suggest that this novel experimental mucosal model of induction of uveitis by the human 60-kDa HSP-derived peptide 336-351, which is specific in stimulating T cell responses in Behcet's disease, is consistent with the oro-genital onset of this disease and the development of uveitis.

Administration, Intranasal↗
PubMed2005

Efficacy of infliximab in the treatment of uveitis that is resistant to treatment with the combination of azathioprine, cyclosporine, and corticosteroids in Behçet's disease: an open-label trial.

OBJECTIVE: To investigate the effect of infliximab on the frequency of uveitis attacks and the visual prognosis in male patients with Behçet's disease in whom uveitis was resistant to combination therapy with corticosteroids, azathioprine, and cyclosporine. METHODS: The study group comprised patients who were receiving combination therapy but experienced at least 2 attacks of posterior uveitis/panuveitis or retinal vasculitis during the 6-month period prior to enrollment. Infliximab infusions (5 mg/kg) were administered at weeks 0, 2, 6, and 14. Weeks 0-22 were defined as the infusion period, and weeks 23-54 were defined as the observation period. Patients continued to receive azathioprine and corticosteroids, but cyclosporine was discontinued after the screening visit. The primary outcome measures were the absence of uveitis attacks during the infusion period (remission), and the absence of uveitis attacks throughout the study period (sustained remission). RESULTS: Thirteen patients were enrolled in the study. Thirty-two uveitis attacks involving the posterior segment occurred during the previous-treatment period. During the infusion period, 4 patients (30.8%) remained attack-free, and 9 patients had a total of 13 uveitis attacks. Ten of these attacks (76.9%) occurred at either week 14 or week 22. One of 13 patients fulfilled the definition of sustained remission, and the remaining 12 patients had a total of 36 uveitis attacks during the observation period. The mean number of uveitis attacks and daily corticosteroid doses were significantly lower during the infusion period than during the previous-treatment period or the observation period. Although potential visual acuity was regained following infliximab infusion, this beneficial effect was not preserved until week 54. None of the patients experienced a serious adverse event. CONCLUSION: The results of this trial suggest that infliximab is effective in suppressing the occurrence of uveitis attacks, has a corticosteroid-sparing effect, and has favorable implications for the visual prognosis of patients with resistant Behçet's uveitis.

Adrenal Cortex Hormones↗
PubMed2006

High incidence of antibodies to lens proteins in sera from patients with uveitis.

BACKGROUND: Uveitis is an intraocular inflammatory disease in which autoimmune reactions have been discussed in playing an important role. Many data in this respect derived from the animal model of "experimental autoimmune uveitis", where several organ-specific autoantigens have been described such as the retinal S-antigen and the interphotoreceptor retinoid-binding protein. However, their diagnostic and pathogenic role in humans has been controversially discussed. In recent studies, the possible relevance of betaB1-crystallin, present in lens and ciliary body, has been outlined. We, therefore, wanted to analyse whether sera from patients with uveitis might contain antibodies to lens proteins METHODS: Human lenses from cadaveric eyes were shock frozen, homogenized, and resuspended. The resulting suspension (human lens protein fraction--HLPF) was analyzed for antigenicity by ELISA and Western blotting with patients' sera. A total of 165 patients with uveitis, 54 patients with scleritis and episcleritis, 56 patients with other eye diseases, and 112 healthy blood donors were studied. RESULTS: Twenty-six (49%) of the 53 patients with anterior uveitis, 17 (32%) of the 53 patients with intermediate uveitis and 7 (22%) of 32 patients with posterior uveitis reacted in the ELISA with the HLPF. Antibodies to lens antigens were detected in one-third of patients with panuveitis and retinal vasculitis. In contrast, only 12% of the healthy blood donors were positive in the ELISA. The number of patients with an autoimmune response to alpha-crystallins in Western blot predominated in all investigated groups. CONCLUSIONS: These data indicate that antibodies to lens proteins occur in a high incidence in sera from patients with uveitis. Forty-nine percent of the patients with anterior uveitis and only 12% of healthy controls were positive in the ELISA. In our groups of patients and controls the autoantibodies reacted in the Western blot predominantly with alpha-crystallin. Further studies are required to analyze in more detail the clinical and etiopathogenetic relevance of the antilens antibodies in uveitis.

Autoantibodies↗
PubMed2005

The development of complications in patients with chronic anterior uveitis.

PURPOSE: This study aimed to identify the factors determining the ocular complications and visual outcome in patients with chronic anterior uveitis. DESIGN: Retrospective, noncomparative case study. METHODS: Ninety-one eyes of 68 patients with anterior uveitis that lasted longer than 3 months were assessed. Patients were divided into idiopathic and nonidiopathic chronic anterior uveitis and Fuchs' heterochromic uveitis. Visual acuity and complications such as posterior synechiae, cataract formation, raised intraocular pressure (IOP), and posterior segment complications (i.e., cystoid macular edema and optic nerve involvement) were evaluated. Poor visual outcome measured by life-table analysis was considered when logMAR (log of the reciprocal of Snellen visual acuity) visual acuity was 0.3 or worse. RESULTS: No statistically significant differences in the visual outcome were found between the three groups of patients with chronic anterior uveitis. Posterior synechiae formation was, as expected, significantly increased in patients with chronic anterior uveitis compared with those with Fuchs' heterochromic uveitis. There was a trend for patients with nonidiopathic chronic anterior uveitis to have an increased risk of cystoid macular edema compared with those with idiopathic disease. There were no significant differences in visual outcome between any of the groups with time. CONCLUSIONS: The visual prognosis for patients with chronic anterior uveitis is generally good. Posterior segment complications appear to be more likely to occur if there is an underlying associated disease. However, the presence of complications does not seem to affect the visual outcome in patients with chronic anterior uveitis.

Adult↗
PubMed2006

Risk of new-onset uveitis in patients with juvenile idiopathic arthritis treated with anti-TNFalpha agents.

OBJECTIVE: To determine whether treatment with tumor necrosis factor alpha (TNFalpha)-blocking agents alters the incidence of new-onset uveitis in patients with juvenile idiopathic arthritis (JIA). STUDY DESIGN: Cohort study based on retrospective chart review. The charts of all 1109 patients with a diagnosis of JIA seen between January 1, 1996, and June 30, 2003, at our clinic were reviewed for diagnosis of uveitis and treatment with TNFalpha inhibitors. Cox regression analysis was performed with anti-TNFalpha treatment as a time-dependent covariate for risk of development of uveitis. RESULTS: We identified 70 patients treated with anti-TNFalpha without a prior diagnosis of uveitis. Two of these 70 patients (2.9%), both treated with etanercept, had development of new-onset uveitis during anti-TNFalpha therapy. One had juvenile psoriatic arthritis diagnosed 4.1 years before onset of uveitis. The other had extended oligoarticular JIA diagnosed 6.4 years before onset of uveitis. We found no statistically significant difference in the risk for development of uveitis between patients with or without anti-TNFalpha treatment. CONCLUSIONS: In our patients with JIA, anti-TNFalpha treatment did not alter the risk for development of new-onset uveitis. However, anti-TNFalpha therapy with etanercept did not prevent the development of uveitis in 2 patients.

Adolescent↗
PubMed2006

Impact of macular edema on visual acuity in uveitis.

OBJECTIVE: To investigate the impact of cystoid macular edema (CME) on visual acuity in patients with uveitis. DESIGN: Cross-sectional study. PARTICIPANTS: The data from 529 patients (842 eyes) with uveitis were analyzed. MAIN OUTCOME MEASURES: We recorded gender and age of the patients, anatomic site and diagnosis of uveitis, associations with systemic diseases, onset and duration of uveitis, presence of CME, best-corrected visual acuity, and the causes of decrease in visual acuity. RESULTS: Cystoid macular edema was noted in 175 (33%) of all uveitis patients, of whom 77 (44%) had visual acuity of 20/60 or less in at least 1 eye. The mean visual acuity for eyes with CME was significantly worse than for eyes without CME (0.25 vs. 0.4; P = 0.003). Of all uveitis patients, 185 (35%) had visual acuity of 20/60 or less in at least 1 eye, which was caused by CME in 77 (42%) patients. Poor visual acuity in patients with CME was associated with the advanced age of the patients, chronic inflammation, and various specific uveitis entities. The development of visually impaired or blind eyes in patients with panuveitis and intermediate uveitis was caused in most cases by CME (59% and 85%, respectively). CONCLUSIONS: Cystoid macular edema was a major cause of visual loss in patients with uveitis. The unsatisfactory visual acuity in patients with uveitis underlines the need for improved management of this complication.

Adolescent↗
PubMed1991

Anterior uveitis and hypopyon.

We undertook a study to determine the incidence of hypopyon, as well as the most common anterior uveitis entities with which hypopyon is associated. A total of 216 patients with anterior uveitis were studied. The uveitis was acute in 155. Of the 155 patients, 11 (7.1%) had hypopyon. Nine of the 11 patients with hypopyon were positive for HLA B27. Of these nine, two had Reiter's syndrome and one had ankylosing spondylitis; the other six had no confirmed systemic disease. Of the two patients with hypopyon who were HLA B27-negative, one had mixed connective-tissue vascular disease, and one had idiopathic anterior uveitis. Of the 155 patients with acute anterior uveitis, 62 were HLA B27-positive. Thus, the incidence of hypopyon uveitis among HLA B27-positive patients was 14.5% (nine of 62 patients), whereas the incidence among HLA B27-negative patients was only 2.2% (two of 93 patients). These results suggest that HLA B27-related anterior uveitis is the most common cause of hypopyon uveitis, and that most patients with anterior uveitis associated with hypopyon will test positive for HLA B27. Although these results reflect a referral population, they should be of benefit in the treatment of patients with anterior uveitis.

Acute Disease↗
PubMedDate not supplied

A clinical evaluation of uveitis-associated secondary glaucoma.

PURPOSE: To investigate the clinical features of secondary glaucoma associated with uveitis. METHODS: The subjects of the study were 1,099 patients with uveitis (1,604 eyes) treated at the Miyata Eye Hospital, Miyakonojo, Miyazaki, between October 1974 and January 2000. The intraocular pressure (IOP) and clinical data were analyzed retrospectively. Secondary glaucoma was diagnosed in the patients when IOP was higher than 21 mm Hg at two consecutive visits and they needed treatment with medication to control the high IOP. RESULTS: Secondary glaucoma was found in 293 eyes (18.3%) of 217 patients (19.7%) among the uveitis patients. The clinical entity with the highest incidence of secondary glaucoma was Posner-Schlossman syndrome in 100%, followed by sarcoidosis in 34.1%, herpetic anterior uveitis in 30.4%, Behçet's disease in 20.8%, human leukocyte antigen-B27-related acute anterior uveitis in 20.0%, Vogt-Koyanagi-Harada's disease in 16.4%, and human T-lymphotropic virus type 1 uveitis in 16.2%. Among these 293 eyes with secondary glaucoma, the majority (72%) had active anterior uveitis at the time of high IOP. Only 7.5% of the secondary glaucoma eyes had peripheral anterior synechia wider than 180 degrees of the trabecular meshwork. Steroid-induced glaucoma was found in only 8.9% of the secondary glaucoma eyes. Surgical therapy, mainly trabeculectomy with anti-metabolites, was performed in 38 eyes and the post-surgical IOP was controlled under 20 mm Hg in 34 eyes. Despite the medical and surgical therapy for secondary glaucoma, visual field defect was found in 39% of the secondary glaucoma eyes. CONCLUSIONS: The incidence of secondary glaucoma in the 1,604 eyes with uveitis was 18.3%, but it differed depending upon the clinical entity of the uveitis. The evaluation and the management of IOP are very important in the treatment of patients with uveitis, in addition to the management of intraocular inflammation.

Adult↗
PubMed1997

Posterior capsule opacification after cataract surgery in patients with uveitis.

PURPOSE: To compare the incidence rate of posterior capsule opacification (PCO) after phacoemulsification and standard extracapsular cataract extraction (P/ECCE) in eyes with antecedent uveitis with the incidence rate in eyes without any history of intraocular inflammation. DESIGN: Review of records of 108 eyes of 78 patients with uveitis and 122 eyes of 106 patients with no uveitis who underwent P/ECCE. Rates of PCO were compared by the log-rank test of differences in the Kaplan-Meier survival curves. Proportional hazards regression models provided estimates of the relative risks of PCO among uveitic compared to nonuveitic eyes. MAIN OUTCOME MEASURES: Performance of neodymium: YAG laser posterior capsulotomy was used as a proxy measure for the main outcome of visually significant PCO. RESULTS: Study patients ranged in age from 6 to 81 years (median, 44.5 years) among those with uveitis and 27 to 96 years (median, 68.5 years) among those without uveitis (P = 0.0001). Crude incidence rates for visually significant PCO were 54% over a mean follow-up of 4.3 years in uveitic cases and 40% over a mean follow-up of 3.9 years among nonuveitic cases (P = 0.02). Estimates of PCO incidence (95% confidence interval) in uveitic eyes derived from the Kaplan-Meier models were 38.5% (range, 28.9%-48.2%) at 1 year and 56% (range, 45.8%-66.3%) at 3 years, and estimates among nonuveitic eyes were 11.5% (range, 6.2%-16.8%) at 1 year and 38.4% (range, 29%-47.8%) at 3 years. These rates of PCO among patients with uveitis and those patients without uveitis differed significantly by the log-rank test (P = 0.004). However, after adjusting for the younger age of patients with uveitis, the rates of PCO were no longer statistically different. CONCLUSIONS: The apparent higher rate of PCO in patients with uveitis is primarily due to their younger age at the time of surgery. A moderately increased independent risk of PCO from uveitis cannot, however, be ruled out by this study.

Adolescent↗
PubMed1999

Latanoprost 0.005% and anterior segment uveitis.

PURPOSE: To evaluate the association of latanoprost with anterior chamber uveitis in glaucoma patients. METHODS: We retrospectively reviewed 527 charts in latanoprost treated patients with: no prior uveitis (Group 1); prior uveitis but were inactive at the time of the study (Group 2); and active uveitis (Group 3). RESULTS: In Group 1 five (1.0%) of 505 patients developed uveitis after beginning latanoprost. The uveitis was trace to 1+ cell in severity and delayed in onset 99.8+/-73.9 days In Group 2 three of 13 (23.1%) patients developed delayed uveitis (trace to 1+ cell). In Group 3 zero of nine (0%) patients had worsened inflammation and the intraocular pressure remained unchanged (22.8+/-7.8 mmHg to 22.0+/-7.3 mmHg) after beginning latanoprost (p=0.38). CONCLUSION: In patients without a prior history a mild delayed uveitis with latanoprost treatment may develop rarely. In patients with a uveitis history, a mild delayed exacerbation potentially may occur and the intraocular pressure may not be decreased in active uveitis.

Aged↗
PubMed2000

Uveitis in children: population-based study in Finland.

PURPOSE: To investigate the incidence and prevalence rates of different types of uveitis in children, and to compare them with the rates in adults. SUBJECTS AND METHODS: For this population-based retrospective study the medical records of all residents of the district of Turku University Hospital with a diagnosis of uveitis seen at the Eye Clinic of Turku University Hospital during the years 1980-1982 and 1988 were reviewed. RESULTS: A total of 1122 uveitis cases were identified, and 55 (4.9%) of them were children under 16 years. The incidence per 100 000 population per year for all uveitis cases in children was 4.3 (95% confidence interval [CI], 2.2 to 6.4), and the prevalence was 27.9 (95% CI, 17.1 to 38.6), which was significantly lower compared with the rates in adults (p=0.001 for incidence and prevalence). The vast majority of children, 50 (90.9%), had anterior uveitis (AU), and the incidence and prevalence rates of AU were significantly lower than in adults (p=0.001 for incidence and prevalence). Three (5.5%) children had posterior uveitis (PU), but there was no significant difference in the incidence and only marginally significant difference in the prevalence rate of PU in children compared with the rates in adults (p=0.33 for incidence, and p=0.07 for prevalence). Only one case (1.8%) was found with intermediate and one with panuveitis, but no new cases. The commonest diagnostic groups in children were AU associated with juvenile rheumatoid arthritis, idiopathic acute anterior uveitis, and idiopathic chronic anterior uveitis. Toxoplasmic retinochoroiditis was found in all of the PU cases with the incidence 0.3, and the prevalence 1.1, which did not differ significantly from the rates in adults (p=1.0 for incidence, and p= 0.48 for prevalence). CONCLUSION: Uveitis is rarer in children than in adults. However, in contrast to studies from tertiary referral centers, the distribution of different forms of uveitis in children in this population-based study seems to resemble the distribution in adults.

Adolescent↗
PubMed2002

Clinical features and predictive factors in psoriatic arthritis-related uveitis.

OBJECTIVES: To analyze the clinical features of uveitis in psoriatic arthritis (PsA) and to investigate the factors predicting its appearance. PATIENTS AND METHODS: Retrospective cohort study (1991-2000) of 71 patients diagnosed with PsA according to the criteria of Moll and Wright. All patients were studied according to a standard protocol. The group was divided into 3 articular categories: axial, oligoarticular, and polyarticular. Human leukocyte antigen (HLA)-Cw typing was performed by the polymerase chain reaction-sequence specific oligonucleotide probes (PCR-SSOP) method in 65 patients and in 177 healthy donors. HLA-DR typing was done by serologic methods in the 71 patients and in 82 healthy donors from the same racial and geographic origin. The HLA-B27 allele also was tested among the study population. All subjects with possible inflammatory ocular disease received a complete ophthalmologic examination at the Ophthalmology Department of our hospital. Only patients with uveitis were analyzed. Univariate and multivariate analyses were applied. RESULTS: Thirteen patients had uveitis (18% of this series), 4 (31%) had an insidious onset, and the remaining had acute-onset uveitis. Five cases (39%) had bilateral-simultaneous uveitis. Ten (77%) presented with anterior uveitis only, 2 with anterior and posterior pole involvement, and only 1 case with isolated posterior pole involvement. Four patients needed oral corticosteroids; 2 of them also used immunosuppresive drugs. None of our patients developed sequelae or complications. In univariate analysis, uveitis was associated with inflammatory back pain (P =.02), sacroiliac pain (P =.001), syndesmophytes (P =.001), bilateral sacroileitis (P =.0001), HLA-DR13 (P =.002), and HLA-B27 (P =.026). In multivariate analysis, the predictive factors for uveitis were bilateral sacroileitis (OR 17, 95% CI: 3.7-76, P =.0002), HLA-DR13 (OR 24, 95% CI: 3.78-150, P =.0056), and syndesmophytes (OR 9.7, 95% CI: 0.97-97, P =.05). CONCLUSIONS: Insidious onset, bilaterality, posterior pole involvement, and chronicity are common in PsA patients with uveitis. In this study, extensive axial involvement (bilateral sacroileitis and syndesmophytes), and the HLA-DR13 antigen were the best predictors for the appearance of uveitis.

Arthritis, Psoriatic↗
PubMed2002

Causes of uveitis at The Eye Center in Saudi Arabia: a retrospective review.

AIMS AND BACKGROUND: The main objective of this study was to determine the causes of uveitis at a referral center in Riyadh, Saudi Arabia. METHODS: We carried out a retrospective review of clinical records of 200 uveitis cases referred to The Eye Center, a referral center in Riyadh, Saudi Arabia. There were 120 (60%) males and 80 (40%) females with an age range of 7 to 91 years and a mean age of 35 (SD +/- 17). Patients had complete ophthalmic and medical examinations. Laboratory studies were requested whenever indicated. Patients were followed up for a minimum of 12 months. RESULTS: In the period 1995-2000, we encountered 200 cases of uveitis among a total of 20,191 consecutive new cases, yielding a prevalence of 1%. Acute anterior uveitis of undetermined origin was found in 58 (29%) of 200 patients. There were 13 (6.5%) cases of Behçet's disease, 7 (3.5%) of Fuchs' heterochromic iridocyclitis, 6 (3%) of sarcoidosis, and 5 (2.5%) patients had Vogt-Koyanagi-Harada syndrome (VKH). Among the infectious causes, herpetic uveitis was found in 32 (16%) patients, tuberculosis in 21 (10.5%), and toxoplasmosis in 13 (6.5%) cases. Seventeen (8.5%) cases were of miscellaneous origin and in 28 (14%) cases the etiologic diagnosis was undetermined. CONCLUSION: Acute anterior uveitis of undetermined origin was the most common cause of uveitis, followed by Behçet's disease. Herpetic uveitis was the most common infectious cause of uveitis. Ocular tuberculosis and toxoplasmosis were found to be common causes of infectious uveitis at this referral center in Saudi Arabia.

Adolescent↗
PubMed2006

Extended oligoarthritis and other risk factors for developing JIA-associated uveitis under ILAR classification and its implication for current screening guideline.

PURPOSE: To investigate the risk factors for developing uveitis in a regional cohort of patients with juvenile idiopathic arthritis (JIA) as classified under ILAR criteria. PATIENTS AND METHODS: The clinical factors for developing uveitis and its visual outcome were studied retrospectively for all children diagnosed with JIA at Nottingham University Hospital, England from 1974 to 2001. RESULTS: A total of 202 patients with juvenile idiopathic arthritis were identified. Twenty-three patients (11.4%) were found to have uveitis. The mean age of arthritis onset in those with uveitis was 4.9 (95% CI 3.4-6.4) and in those without uveitis was 7.6 (95% CI 7.0-8.3), p = 0.002. Both the persistent and extended oligoarthritis groups are at significant risk of developing uveitis on Kaplan-Meier analysis with p = 0.001 and 0.013, respectively, compared to other ILAR subtypes. Extended oligoarthritis (1 to 4 joints affected in first 6 months of disease but 5 or more cumulative joints after first 6 months) had the highest prevalence of uveitis (25%) among the ILAR subtypes. Patients with extended oligoarthritis also developed uveitis earlier than persistent group, p = 0.017. Gender, race, and antinuclear antibody (ANA) status were not significant risk factors. The visual outcome was favorable, with 90% achieving acuity of 6/12 or better. CONCLUSION: Patients with extended oligoarthritis are at higher risk and have a shorter interval from diagnosis of arthritis to development of uveitis and need to be monitored more closely. Screening guideline for JIA-associated uveitis based on ILAR classification is called for.

Adolescent↗
PubMed1996

HTLV-I uveitis.

Human T-cell lymphotropic virus type I (HTLV-I) is known to cause adult T-cell leukemia/T-cell lymphoma and tropical spastic paraparesis/HTLV-I-associated myelopathy. Recent seroepidemiologic, clinical, and virologic studies indicate that the virus is also related to a certain type of uveitis, which has been classified as uveitis without defined etiologies or idiopathic uveitis. According to the seroepidemiologic survey, the seroprevalence of HTLV-I in patients with idiopathic uveitis was significantly higher than that of two control groups, that is, patients with uveitis with defined etiologies and patients with nonuveitic ocular diseases. Clinically, the uveitis seen in HTLV-I carriers is characterized by moderate to severe cellular infiltration in the eye and by moderate retinal vasculitis, and the intraocular inflammation responds well to corticosteroid therapy. Interestingly, 25% of female patients with the disease had a previous history of Graves disease with hyperthyroidisms. The following virologic, molecular biologic findings suggest that cytokines produced by HTLV-I-infected T cells in the eye play the central role in the pathogenic mechanisms of the uveitis: (a) the virus load in the peripheral blood monocytes analyzed by the quantitative polymerase chain reaction methods was significantly greater in patients with the uveitis than in asymptomatic carriers, (b) the proviral DNA of HTLV-I and the gene expression of the virus at the mRNA level was detected in the infiltrating cells from the eyes of the patients, (c) the virus particles were detected by electron-microscopic examination in the T-cell clones established from the intraocular fluid of the patients, and (d) the HTLV-I-infected T cells produced a variety of cytokines without any stimuli, such as interleukin (IL)-1 alpha, IL-2, IL-3, IL-6, IL-8, IL-10, tumor necrosis factor alpha, interferon-gamma, and granulocyte-macrophage colony-stimulating factor. Based on the seroepidemiologic, clinical, and virologic data, the uveitis seen in HTLV-I carriers is considered to be a distinct clinical entity related to HTLV-I infection, and the disease is designated as HTLV-I uveitis.

Adolescent↗