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T Zhao, S Kiss, E Letko, S Qamruddin, CS Foster; Long-Term Follow Up of Patients With Ocular Involvement Associated With Reiter’s Syndrome . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4253.
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Purpose: To investigate the spectrum of ocular involvement in patients diagnosed with Reiter’s syndrome during a follow up of one year or longer. Methods: Charts of patients with ocular inflammatory diseases treated by the Immunology and Uveitis Service at the Massachusetts Eye and Ear Infirmary in Boston, MA were reviewed. Data on age, sex, follow-up time, ocular symptoms, extraocular involvement, ocular complications, therapy, initial and final visual acuity (VA) were recorded. Results: Twenty-five patients diagnosed with Reiter’s syndrome were identified. The mean age at the time of diagnosis was 29 years. Male to female ratio was 4:1. The mean follow-up time was 48 months. Eighty-one percent of patients were positive for the HLA-B27 gene; 19% were HLA-B27 negative. Ocular involvement was recorded in 68% of the cases, and bilateral in 32%. Conjunctivitis was the most common ocular finding present in 96% of patients, followed by anterior uveitis (92%), posterior uveitis (64%), keratitis (64%), intermediate uveitis (40%), and scleritis (28%). The most common extraocular symptom during the follow-up period was oligoarthritis, present in 100% of patients, with lower back being the most frequently affected (56% of patients), followed by Achilles tendon (52%), knee (44%) and sacroiliac joints 28%. Skin lesions were present in 24% of patients, and mucous membrane lesions in 36%. Ocular involvement was complicated with cataract in 56%, cystoid macular edema (28%), glaucoma (16%), and papillitis (16%). Ninety-six percent of patients were treated with non-steroidal anti-inflammatory agents, 88% with steroids, and 52% with immunosuppressive agents. The average VA at the time of initial visit was 0.67. The average final VA was 0.82. Conclusion: Reiter’s syndrome may be associated with chronic recurrent ocular inflammation. Systemic therapy is typically required to control the ocular inflammation and prevent progressive loss of vision.
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