May 2008
Volume 49, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2008
Autoimmune Hepatitis and Uveitis: A Possible Association
Author Affiliations & Notes
  • L. L. Lim
    Ophthalmology, Centre for Eye Research, Melbourne Uni, East Melbourne, Australia
  • J. D. Scarborough
    Ophthalmology, Casey Eye Institute, OHSU, Portland, Oregon
  • J. M. Schwartz
    Medicine, Oregon Health & Science University, Portland, Oregon
  • J. R. Smith
    Ophthalmology, Casey Eye Institute, OHSU, Portland, Oregon
  • Footnotes
    Commercial Relationships  L.L. Lim, None; J.D. Scarborough, None; J.M. Schwartz, None; J.R. Smith, None.
  • Footnotes
    Support  Research to Prevent Blindness, New York, NY through career development grant to JRS and an unrestricted award to the CEI. LL is supported by the Crock-Mankiewicz-Zelkin Fellowship
Investigative Ophthalmology & Visual Science May 2008, Vol.49, 3237. doi:https://doi.org/
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    • Get Citation

      L. L. Lim, J. D. Scarborough, J. M. Schwartz, J. R. Smith; Autoimmune Hepatitis and Uveitis: A Possible Association. Invest. Ophthalmol. Vis. Sci. 2008;49(13):3237. doi: https://doi.org/.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : Autoimmune hepatitis (AIH) is a chronic progressive hepatitis of unknown cause that has been associated with other autoimmune diseases such as thyroiditis and rheumatoid arthritis. Uveitis is also a rare autoimmune condition that may be associated with systemic autoimmune disease. The type of uveitis often fits a specific pattern that is typical for that disease. Here we report 9 cases of AIH and uveitis, raising the possibility that uveitis may be an extra-hepatic feature of AIH.

Methods: : Medical records of patients with AIH and uveitis were reviewed retrospectively. One index case was identified from the Uveitis Clinic of the Casey Eye Institute of the Oregon Health & Science University. Further cases were identified by a web-based survey of members of the American Uveitis Society, the International Uveitis Study Group, the Proctor Foundation chat room and the SUN International Workshop. All respondents were sent a clinical data collection sheet requesting clinical information about uveitis phenotype, treatment and AIH features.

Results: : Clinical information was obtained for 9 individuals (4 females and 5 males; age range 20-70 years) who suffered from AIH and uveitis. The average duration of follow up was 49 months (range 11 months - 9 years). All patients had chronic, persistent, bilateral non-granulomatous uveitis that was anterior (n=3), intermediate (n=1) or pan (n=5) in location. In those with anterior uveitis, the onset was sudden, whereas the onset in the others was insidious. In 6 patients the diagnosis of uveitis preceded that of AIH by an average of 8 years (range <1 - 26 years), whereas the diagnosis of AIH preceded the diagnosis of uveitis by an average of 3 years (range 1 - 5 years) in 3 patients. Every patient had one or more complications arising from their uveitis. Cataract was the most common (N=7), followed by glaucoma (N=5), hypotony (N=4), cystoid macular edema (N=3), band keratopathy (N=3) and posterior synechiae (N=3). Less common were peripheral anterior synechiae (N=2), epiretinal membrane (N=1) and pthisis (N=1). Final visual acuities varied from 20/16 to light perception. To treat the uveitis and/or AIH, all patients required oral prednisone and 6 of 9 were treated with systemic immunosuppression.

Keywords: autoimmune disease • uveitis-clinical/animal model • inflammation 
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