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Friederike Mackensen, Lena Hildebrandt, Wyatt Messenger, Phoebe Lin, Eric B Suhler, James T Rosenbaum; Findings in Multiple Sclerosis associated Uveitis. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5322.
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About 1% of patients with Multiple Sclerosis (MS) have uveitis and about 10% of patients with intermediate uveitis have MS. Uveitis subtypes associated with MS are variable and not restricted to intermediate uveitis. We describe the largest reported series of patients with uveitis in association with MS in order to characterize the uveitis subtypes and to determine if a diagnosis of uveitis has clinical implications in MS.
Retrospective chart review of patients with a diagnosis of MS and uveitis identified in the electronic database of 2 uveitis centers (Heidelberg, Germany and Portland, OR, USA).
We identified 167 patients with MS and uveitis; charts were available of 162. Among them 122 (75%) were female and the mean age at first presentation for uveitis was 42 years (range 13 -70). Anatomic localization was anterior or anterior to intermediate in 21 and 19 respectively, resulting in 22.5% anterior uveitis (AU). Intermediate uveitis (IU) was seen in 109 (65%) of patients. There were patients with scleritis, panuveitis and no location given (each n=3) and 4 with posterior uveitis. Information on the subtype of MS was available for 55 patients: 38 (69%) with relapsing remitting MS (RRMS), 12 (22%) with secondary progressive MS (SPMS), 4 (7%) with primary progressive MS (PPMS). Of the AU patients 9 had RRMS (81%), 2 SPMS (17%) and 1 PPMS (8%), while among the IU patients 26 had RRMS (68%), 9 SPMS (24%) and 3 PPMS (8%).
A relevant proportion of the patients had anterior uveitis associated with MS instead of the more common intermediate uveitis. We found no apparent correlation between uveitis subtype and MS diagnosis. MS subtypes were of similar frequencies as found in MS clinics. This database is roughly 5 times larger than any previous report on this association and thus it should provide new information on the clinical implications of the co-existence of uveitis and MS.
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