Eye involvement in the spondyloarthropathies

Area of Science:

• Ophthalmology
• Rheumatology
• Immunology

Background:

• Uveitis is a significant manifestation of spondyloarthropathies.
• Ankylosing spondylitis and Reiter's syndrome typically present with acute, unilateral anterior uveitis, prone to recurrence.
• Uveitis linked to inflammatory bowel disease, psoriasis, and undifferentiated spondyloarthropathy may show posterior involvement, bilaterality, and chronicity.

Purpose of the Study:

• To describe the clinical characteristics and management of uveitis in spondyloarthropathies.
• To differentiate uveitis presentations based on associated spondyloarthropathy subtypes.
• To discuss the role of genetic and environmental factors in uveitis pathogenesis.

Main Methods:

• Review of clinical presentations of uveitis in patients with various spondyloarthropathies.
• Analysis of recurrence patterns, laterality, and disease chronicity.
• Consideration of etiological factors including human leukocyte antigen B27, infections, and gut inflammation.

Main Results:

• Acute anterior uveitis is the commonest form, often unilateral and recurrent.
• Posterior segment and chronic uveitis are more frequent in certain spondyloarthropathy subtypes.
• Human leukocyte antigen B27 is associated with acute anterior uveitis, but other factors contribute to pathogenesis.

Conclusions:

• Prognosis for most uveitis cases in spondyloarthropathies is favorable with topical therapy.
• Immunosuppressive therapy may be beneficial for chronic, recurrent, or posterior uveitis.
• Understanding the diverse presentations and etiologies is crucial for effective management.