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Demyelinating plaque-associated uveitis.

Alireza Hedayatfar1,2, Pasha Anvari3, C P Herbort4,5

  • 1Eye Research Center, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Sattar khan St., Niayesh Ave, Tehran, 14455-364, Iran. alireza.hedayatfar@gmail.com.

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|October 19, 2023
PubMed
Summary
This summary is machine-generated.

Demyelinating plaque-associated uveitis (DPU) typically affects females, presenting as chronic intermediate uveitis. Patients with DPU show a higher risk of developing multiple sclerosis (MS) and should avoid anti-TNF therapy.

Keywords:
Fluorescein angiographyMultiple sclerosisRetinal vasculitisUveitis, anteriorUveitis, intermediate

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Area of Science:

  • Ophthalmology
  • Neurology
  • Immunology

Background:

  • Demyelinating plaque-associated uveitis (DPU) is a distinct subset of uveitis.
  • DPU patients exhibit central nervous system demyelinating plaques on MRI but do not meet criteria for multiple sclerosis (MS).

Purpose of the Study:

  • To characterize the clinical and fluorescein angiographic (FA) features of DPU.
  • To differentiate DPU from established MS and identify associated risk factors and outcomes.

Main Methods:

  • Retrospective observational study of Persian patients diagnosed with DPU.
  • Inclusion criteria: no MS diagnosis, exclusion of other uveitis etiologies, and minimum 2-year follow-up.
  • Data collection included clinical findings, ocular characteristics, neurological status, and FA imaging.

Main Results:

  • Of 40 initial DPU patients, 8 (20%) later met MS criteria.
  • The remaining 32 patients (93.8% female, mean age 36.3 years) predominantly had bilateral, chronic granulomatous intermediate uveitis (90.6%).
  • Common ocular findings included granulomatous keratic precipitates (97.7%), cystoid macular edema (35.7%), and optic neuritis (8.9%). Fluorescein angiography revealed optic disc leakage (81.5%) and peripheral retinal perivascular leakage (76.9%).

Conclusions:

  • DPU typically manifests as chronic, bilateral, granulomatous intermediate uveitis, predominantly in females, often without neurological symptoms.
  • Visual prognosis is generally favorable, with improvement noted over a 2-year follow-up.
  • DPU patients have an increased risk of developing MS and should not receive anti-TNF treatment.