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S. Agnani, D. Choi, J. T. Rosenbaum; Does Acute Anterior Uveitis Preferentially Affect the Right or Left Eye?. Invest. Ophthalmol. Vis. Sci. 2009;50(13):281.
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Acute anterior uveitis (AAU) associated with ankylosing spondylitis or reactive arthritis is often unilateral and recurrent. We tested the hypotheses that one eye is preferentially affected in this disease and that recurrences are predictable.
We retrospectively studied case charts of 207 individuals, recording first documented episode of AAU, the eye in which it occurred, and the episode duration. Additionally, the time between documented attacks of AAU or disease free period was noted. Information on risk factors including age, sex, history of ankylosing spondylitis, and reactive arthritis was also recorded.
One hundred and twenty-six patients had a diagnosis of ankylosing spondylitis (60.9%) and six patients had a history of reactive arthritis (2.9%). The initial episode of AAU occurred 52.7% in the right eye, 44.0% in the left eye, and 3.3% were bilateral. Interestingly, 69.4% of recurrent episodes occur in the same eye previously affected and its 95% CI is (59.3%, 78.3%). This tendency was not significantly associated with a history of ankylosing spondylitis (p> 0.05). With a previous history of AAU, the probability of being disease-free for one year was 0.69 and its 95% CI is (0.59 , 0.81 ) using Kaplan-Meier estimates. Univariate analyses showed that male sex, (p=0.037) and history of AAU in the same eye (p=0.037) were significantly associated with a shorter time interval between attacks of acute anterior uveitis. Multivariate analysis by the Cox proportional hazards model showed similar results.
The initial episode of unilateral acute anterior uveitis randomly affects the right or left eye. However, subsequent episodes of AAU are likely to occur in the same eye previously affected. Male sex and previous history of unilateral AAU are associated with a shortened time interval between relapses of AAU in the same eye.
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