Uveitis in Spondyloarthritis: An Overview

Area of Science:

• Ophthalmology
• Rheumatology
• Immunology

Background:

• Autoimmune anterior uveitis (AU) constitutes over half of noninfectious uveitis cases.
• AU occurrence is associated with HLA-B27 positivity, similar to spondyloarthritis (SpA).
• AU is more prevalent in HLA-B27-positive individuals with SpA.

Purpose of the Study:

• To investigate the relationship between autoimmune anterior uveitis and spondyloarthritis.
• To determine the frequency of AU in various subtypes of SpA.
• To explore the impact of SpA treatment on AU.

Main Methods:

• Review of existing literature and epidemiological data.
• Analysis of prevalence rates of AU in SpA patient cohorts.
• Examination of clinical course and treatment outcomes.

Main Results:

• AU occurs in approximately 50% of patients with SpA and is present in at least 30% of AU cases.
• Ankylosing spondylitis shows the highest frequency of AU (33.4%), while psoriatic arthritis and IBD-associated SpA range from 2%-25% and 25%, respectively.
• AU can precede, coincide with, or follow SpA diagnosis, but anti-TNF-α therapy for SpA reduces AU incidence and flares.

Conclusions:

• AU is a significant ocular manifestation associated with SpA, particularly in HLA-B27-positive individuals.
• The prevalence of AU varies across the SpA spectrum, with ankylosing spondylitis being most commonly affected.
• Effective management of SpA, including anti-TNF-α therapy, can positively impact the course of associated AU.