Beyond the joints: mechanistic insights and multidisciplinary strategies for spondyloarthritis-associated uveitis

Spondyloarthritis (SpA) is a group of diseases characterized by chronic inflammation and extra-articular involvement of tissues and organs. Acute anterior uveitis (AAU), the most common extra-articular manifestation of SpA, typically presents as a unilateral acute disruption of the blood-aqueous barrier, characterized by photophobia, redness of the eye, pain, and blurred vision. The underlying pathogenesis is not fully understood but is thought to involve genetic factors, gut microbiota, and dysregulation of the immune system. Corticosteroids remain the cornerstone of AAU treatment. However, alternative therapies such as nonsteroidal anti-inflammatory drugs (NSAIDs), disease modifying antirheumatic drugs (DMARDs), and biologics have also demonstrated utility. In recent years, biologics have gained increasing attention due to their efficacy and safety. This review summarizes recent research findings and advancements in the diagnosis and management of spondyloarthritis-associated uveitis.