[Uveitis in spondyloarthritis]

Area of Science:

• Ophthalmology
• Rheumatology
• Immunogenetics

Background:

• Acute anterior uveitis (AAU) is the most common form of uveitis.
• AAU is frequently associated with HLA-B27 and inflammatory rheumatic diseases, particularly spondyloarthritis (SpA).
• Approximately 40-60% of AAU patients have associated SpA, and 20-40% of SpA patients experience uveitis.

Purpose of the Study:

• To highlight the strong association between AAU and SpA.
• To emphasize the importance of early diagnosis and management of AAU.
• To guide ophthalmologists on when to suspect SpA and refer patients to rheumatology.

Main Methods:

• Review of existing literature on AAU and its association with SpA.
• Analysis of clinical presentation, diagnostic criteria, and treatment outcomes for AAU.
• Correlation of AAU incidence with SpA disease duration.

Main Results:

• AAU incidence in SpA patients correlates with disease duration.
• AAU typically presents with acute onset, unilateral involvement, and recurrent episodes.
• Effective management involves early topical steroid therapy (6-8 weeks minimum) to prevent recurrence and ensure good visual outcomes.

Conclusions:

• Early ophthalmological diagnosis of AAU warrants rheumatology referral for suspected SpA, especially with concurrent rheumatic symptoms.
• Management of refractory AAU or frequent recurrences may involve disease-modifying antirheumatic drugs (DMARDs) and biologics like TNF-alpha inhibitors.
• Prompt and adequate treatment of AAU is crucial for preserving visual function and preventing long-term complications.