Characterization of uveitis in association with multiple sclerosis

Abstract

Purpose Characterize uveitis in association withmultiple sclerosis (MS) including anatomic presentations, age, gender, and outcome. Methods Retrospective chart review of patients with uveitis and MS at two uveitis centers (Portland, Oregon, USA and Heidelberg, Germany). Baseline characteristics and ophthalmic data were collected at the patient’s first and last visits. Additionally, neurologic records were obtained when possible. In a sub‐analysis, controls with idiopathic intermediate uveitis were compared to cases with intermediate uveitis and MS. Results We identified 113 patients (196 eyes), 83 (73%) female and a mean age of presentation of 41 years (range 13‐64). Vision was fair with mean visual acuity of 20/39. After classifying anatomically, intermediate, anterior, posterior and pan‐uveitis comprised 80%, 15%, 3%, and 2%, respectively. Fifty‐four patients (56%) were diagnosed with uveitis before MS, 15 patients (15%) simultaneously, and 28 patients (29%)after having MS. Optic neuritis was present in 33% of our patients. During an average follow‐up of 4.2 years (range 0.04 – 21), visual acuity improved ‐0.09 logMar/year. Compared to our location‐matched controls with idiopathic intermediate uveitis(n=16), patients with MS and intermediate uveitis were significantly older when diagnosed with uveitis (p=0.027) and more likely to be female (p=0.01). There was no statistical difference in visual acuity or rate of vision change between our cases and controls. Conclusion Uveitis with MS generally presents as intermediate uveitis with a minority presenting with anterior uveitis. Patients are significantly older and more likely to be female than patients with idiopathic intermediate uveitis. The visual prognosis is generally favorable. Commercial interest