Anti-TNF therapy for eye involvement in spondyloarthropathy

Approximately 40% of patients with ankylosing spondylitis or reactive arthritis will experience the sudden onset of a unilateral anterior uveitis sometime during the course of their spinal disease. In most instances, this inflammation resolves within several weeks and responds to corticosteroid and mydriatic eye drops without the need for additional therapy. A small percentage of patients with either Crohn's disease or psoriatic arthropathy will have a bilateral, chronic, anterior and/or posterior uveitis that is more refractory to therapy. A similar clinical challenge is occasionally encountered in patients with ankylosing spondylitis or reactive arthritis. In this manuscript, we review briefly the clinical manifestations of the uveitis associated with spondyloarthropathy and discuss several potential novel therapeutic approaches, primarily anti-tumor necrosis factor (TNF) therapy.