Characterisation of uveitis in association with multiple sclerosis

Messenger, Wyatt; Hildebrandt, Lena; Mackensen, Friederike; Suhler, Eric B.; Becker, Matthias; Rosenbaum, James T.

doi:10.1136/bjophthalmol-2014-305518

Cited by 66 publications

(36 citation statements)

References 23 publications

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“…On the other hand, MS is a frequent underlying disease in IU in our patients and in the US [14]. The proportion of MS in IU patients varies from 7 to 30.4% [1, 21, 25–31]. In our cohort, MS was very significantly associated with periphlebitis, a particular indication of IU.…”

Section: Discussionmentioning

confidence: 66%

Intermediate uveitis: pattern of etiology, complications, treatment and outcome in a tertiary academic center

Neß

Boehringer

Heinzelmann

2017

Orphanet J Rare Dis

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BackgroundPatients with intermediate uveitis (IU) represent a heterogenous group characterized by a wide spectrum of etiologies and regional differences. Aim of the study was to analyze the characteristics of patients with IU examined in an academic center in Germany.MethodsWe conducted a retrospective analysis of the clinical records of all patients with intermediate uveitis referred to the Eye Center, University of Freiburg from 2007 to 2014. Diagnosis followed the Standardization in Uveitis Nomenclature (SUN) criteria. Data analysis included: etiology of IU, demographics, complications, treatment and visual acuity.ResultsWe identified 159 patients with intermediate uveitis during that period. Mean age at diagnosis was 35 years. Most are female (64%), and the mean duration of IU was 6.1 years (range 1 month – 35 years). Etiology of IU was idiopathic in 59%. Multiple sclerosis (MS) (20%) and sarcoidosis (10%) were frequent systemic causes of IU. Other etiologies including infectious diseases (tuberculosis, borreliosis) or immune-mediated conditions (eg, after vaccination) were present in 11%. The pattern of complications included macular edema (CME) (36%), cataract (24%), secondary glaucoma (7%), and epiretinal membrane formation (19%). Periphlebitis and optic neuritis were more frequent in conjunction with MS. Treatment comprised local and systemic steroids, immunosuppressive agents, biologics, and surgery. Best corrected visual acuity was better than 20/25 in 60% of the eyes after more than 10 years of follow-up.ConclusionsIn our German academic center, most IU cases were idiopathic or associated with MS or sarcoidosis. In contrast to other countries, infectious cases were rare. Patients’ overall visual prognosis is favorable even when the duration of IU has been long and and despite numerous complications.

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Section: Discussionmentioning

confidence: 66%

Intermediate uveitis: pattern of etiology, complications, treatment and outcome in a tertiary academic center

Neß

Boehringer

Heinzelmann

2017

Orphanet J Rare Dis

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“…The prevalence of MS among patients with uveitis and conversely of uveitis in MS is 1% [7,8]. Patients with MS with intermediate uveitis [7,9] do not differ in clinical course and disability compared with those with MS alone [10]. To date, there is no literature regarding aquaporin 4 (AQP4) or MOG antibodies being associated with uveitis.…”

Section: Discussionmentioning

confidence: 99%

Uveitis and optic perineuritis in the context of myelin oligodendrocyte glycoprotein antibody seropositivity

Ramanathan

Fraser

Curnow

et al. 2019

Euro J of Neurology

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Background and purpose Antibodies to myelin oligodendrocyte glycoprotein (MOG) have been identified in both children and adults with demyelination, with a strong association with bilateral or recurrent optic neuritis (ON). However, the full clinical spectrum of this newly described condition is unknown. We sought to describe non‐ON inflammatory ophthalmological presentations such as uveitis and optic perineuritis in the context of MOG antibody seropositivity. Methods Using a live cell‐based assay analysed by flow cytometry, we identified seropositive patients referred for MOG antibody testing in Australasia between 2014 and 2017. We identified four MOG antibody‐positive patients with non‐ON inflammatory ophthalmological presentations and present their detailed clinical information in this case series. Results Three patients had uveitis either in association with, or remote from, ON. One patient had optic perineuritis and peripheral ulcerative keratitis. We describe the presentation, examination, investigation findings and clinical course of these four patients. Conclusions Recognition of these novel clinical associations may expand the clinical spectrum of MOG antibody‐associated presentations. An expedited diagnosis may guide the management of these complex patients.

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“…The most renowned ocular manifestation of MS is optic neuritis, albeit intermediate uveitis is also highly associated with MS [19]. The incidence of uveitis in MS is, however, less than 1%, while its prevalence ranges from 0-9.3% [20].…”

Section: Non-infectious Uveitismentioning

confidence: 99%

Diagnosis and treatment of uveitis; not restricted to the ophthalmologist

Laar

Rothová

Missotten

et al. 2015

JCTRes

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A B S T R A C T uveitis ethiology anti-TNF immunosuppressive therapy multidisciplinary managementUveitis is associated with a wide range of underlying causes. Familiarity with its clinical manifestations, referral indications, and treatment strategies are required for the optimal use of current therapeutic options. Uveitis can be caused by infectious and non-infectious factors, resulting in differing prognoses and treatments. The treatment of chronic, non-infectious uveitis has profoundly changed in the last years due to the advent of biologicals, but also of intraocular therapies. In severe uveitis, treatment of the underlying cause, whether ocular or systemic, is required to prevent severe loss of vision. For these purposes, a multidisciplinary clinical approach is important, which is addressed in this review. Relevance for patients: A broad understanding of the different causes of uveitis and the implementation of disease-tailored, multidisciplinary management of uveitis is expected to improve treatment outcomes for patients with different types of uveitis.

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Characterisation of uveitis in association with multiple sclerosis

Abstract: Uveitis with MS generally presents as intermediate uveitis with a minority presenting with anterior uveitis. Patients are significantly older and more likely to be women than patients with idiopathic intermediate uveitis. The visual prognosis is generally favourable.

Cited by 66 publications

References 23 publications

Intermediate uveitis: pattern of etiology, complications, treatment and outcome in a tertiary academic center

Intermediate uveitis: pattern of etiology, complications, treatment and outcome in a tertiary academic center

Uveitis and optic perineuritis in the context of myelin oligodendrocyte glycoprotein antibody seropositivity

Diagnosis and treatment of uveitis; not restricted to the ophthalmologist

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