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Moonjung Choi, Christopher Seungkyu Lee; Posterior segment involvement in patients with uveitis associated with Ankylosing Spondylitis. Invest. Ophthalmol. Vis. Sci. 2014;55(13):5289.
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To compare clinical characteristics and visual outcome between Ankylosing Spondylitis-associated uveitis patients with and without posterior segment involvement.
Medical records of 91 Ankylosing Spondylitis patients diagnosed with uveitis were retrospectively reviewed. The study population comprised of 33 patients (36.3%) with posterior segment involvement including vitritis, macular edema, retinal vasculitis, papillitis, and pars planar exudates, and 58 patients (63.7%) with inflammation confined to the anterior segment. The gender, age at onset, laterality, HLA-B27 typing, complications, recurrences, treatment administered, and visual outcome were compared between the two groups.
33 patients (36.3%) manifested with posterior segment involvement. Vitritis (54.5%) was most common, followed by retinal vasculitis (27.3%), macular edema (9.1%), pars planar exudates (6.1%) and papillitis (3.0%). Mean age of onset of uveitis was 31.15±10.11 years. Ankylosing spondylitis was diagnosed at a mean age of 33.21±9.94 years. Of 33 patients, 21 (63.6%) had unilateral involvement. Of 12 patients (36.4%) showing bilateral uveitis, 7 (58.3%) showed alternating involvement, while 5 (41.7%) presented with bilateral simultaneous uveitis. All patients were tested positive for HLA-B27. Recurrence was observed in 18 patients (54.5%). Complication occurred in 13 patients (39.4%) including cataract (24.2%), posterior synechiae (18.2%) and secondary glaucoma (9.1%). Final visual acuity was 0.8±0.27 (decimal visual acuity) and 4 patients (12.1%) had final visual acuity of less than 0.5. The clinical characteristics and visual prognosis did not reveal statistically significant difference compared to the patients with anterior uveitis. The necessity for systemic steroid and/or peribulbar steroid injections was significantly higher in patients with posterior involvement (72.7% vs. 37.9%, respectively; P=0.001).
Posterior involvement of uveitis associated with Ankylosing Spondylitis did not reveal significant difference in clinical characteristics compared to those with anterior uveitis, and the visual prognosis was equally favorable despite increased need for systemic and/or peribulbar use of steroid.
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