Autoimmunity in uveitis. Issue 5 (25th January 2018)

• Record Type: Journal Article
• Authors: ten Berge, Josianne C.; Schreurs, Marco W. J.; van Daele, Paul L. A.; Rothova, Aniki
• Is Part Of: Acta ophthalmologica. Volume 96:Issue 5(2018)
• Page Start: 481
• Page End: 485
• Publication Date: 2018-01-25
• Subjects: autoimmune diseases -- autoimmunity -- epidemiology -- inflammation -- scleritis -- uveitis; Ophthalmology -- Periodicals; 617.7005
• DOI: 10.1111/aos.13652
• Languages: English
• ISSNs: 1755-375X

Abstract

Abstract: Purpose: Recent insights into the pathogenesis of immune‐mediated diseases proposed a new classification, which includes autoimmune and auto‐inflammatory diseases. The prevalence of specific autoimmune and auto‐inflammatory diseases in uveitis and/or scleritis is not yet known. In this study, we examine the presence of systemic immune‐mediated diseases in patients with uveitis and/or scleritis and put a special emphasis on autoimmune disorders by reporting on their clinical manifestations and visual prognosis. Methods: In this retrospective study, we reviewed data of 1327 patients presenting with uveitis and/or scleritis between January 2010 and July 2016 at the Erasmus Medical Center, Rotterdam, the Netherlands. All patients with noninfectious uveitis and/or scleritis were classified according to novel criteria for immune‐mediated diseases. Various clinical data, including visual acuity (VA), of patients with uveitis of autoimmune origin were registered during 5‐year follow‐up. Results: The origin of uveitis was in 5% (62/1327) autoimmune, in 15% (197/1327) auto‐inflammatory and in 14% (180/1327) mixed autoimmune/auto‐inflammatory. Patients with classical autoimmune connective tissue disease ( N = 17) suffered mostly from rheumatoid arthritis and granulomatosis with polyangiitis and exhibited predominantly scleritis (53%). After 5 years of follow‐up, none of the eyes of these patients developed legal blindness (VA of <0.1). The VA in patients with uveitis associated with autoimmune neuro‐ophthalmological diseases (multiple sclerosis and neuromyelitis optica; N = 27) remained stable over time. Conclusion: Uveitis and scleritis of autoimmune origin were observed in 5% of the total series. The term autoimmune uveitis should not be used as a synonym for intraocular inflammation of noninfectious origin.