Clinical Features of Patients with Diabetes Mellitus Presenting with Their First Episode of Uveitis

Oswal, K. S.; Sivaraj, R.; Stavrou, P; Murray, Philip I.

doi:10.3109/09273940903200309

Cited by 10 publications

(9 citation statements)

References 8 publications

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“…This severe fibrinous reaction was likely to be responsible for the large number of eyes with posterior synechiae (50%) and the eyes with raised IOP (29%). In four patients the uveitis was likely to be related to DM as investigations failed to reveal any underlying cause, the uveitis resolved with better glycaemic control, and all had a severe fibrinous reaction in the AC in line with previous reports [5-10,12]. It is interesting that severe inflammation was also noted in the eyes where DM was not suspected as a cause of the uveitis.…”

Section: Discussionsupporting

confidence: 84%

“…We have previously published the presenting features of uveitis in most of these patients [12]. Our study suggests that patients with pre-existing DM presenting with uveitis may exhibit increased intraocular inflammation that does not appear to be related to the type of uveitis and subsequently had on average three recurrences.…”

Section: Discussionmentioning

confidence: 76%

“…We have previously shown that HbA1c is raised in DM patients at presentation with uveitis [12]. We attempted to correlate glycaemic control with episodes of uveitis.…”

Section: Discussionmentioning

confidence: 99%

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Clinical course and visual outcome in patients with diabetes mellitus and uveitis

et al. 2013

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PurposeWe report the clinical course and visual outcome of patients with diabetes mellitus (DM) who subsequently developed uveitis from any cause.MethodsLongitudinal, retrospective case note review.ResultsA total of 36 patients (M/F: 18/18, 58 eyes) were included, Of the 36 patients, 35 had Type 2 DM and one had Type 1 DM. Mean age of onset of DM was 49 years and uveitis 55 years. The uveitis was bilateral in 22 (61%) patients. There were 19 patients with anterior uveitis, 12 with panuveitis and 5 with intermediate uveitis. Mean follow up was 4.4 years (range 1-18). Mean number of uveitis recurrences was 3 (range 1-7). Causes of vision of 6/18 or worse appeared related to the uveitis in 9 eyes and diabetes in 4 eyes. Cataract occurred in 22 eyes, glaucoma in 17 eyes, and cystoid macular oedema in 10 eyes. Diabetic retinopathy was detected in 38 (65.5%) eyes (29 non-proliferative including 6 with clinically significant macular oedema, and 9 proliferative). Progression of diabetic retinopathy to proliferative stage occurred in 7 eyes of 4 patients over a mean duration of 4.4 years. In 10 patients with active uveitis the mean HbA1c was 80 mmol/mol [9.5%], (range 49-137 [6.6-14.7]), and 67 mmol/mol [8.3%] (range 46-105 [6.4-11.8]) when the uveitis was quiescent, p = 0.01. Better glycaemic control was required in 10 patients during episodes of uveitis.ConclusionsPatients with DM who develop uveitis may have a high complication rate, reduced vision and poor glycaemic control. Checking blood glucose during episodes of uveitis is important.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionmentioning

confidence: 76%

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Clinical course and visual outcome in patients with diabetes mellitus and uveitis

et al. 2013

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“…There have been reports that diabetic retinopathy can exacerbate uveitis and uveitis can accelerate diabetic retinopathy . While the HFD model we used only achieved moderate diabetes, it did exacerbate the uveitis.…”

Section: Discussionmentioning

confidence: 88%

Exacerbation of autoimmune uveitis by obesity occurs through the melanocortin 5 receptor

Muhammad

Peters

Wang

et al. 2019

Journal of Leukocyte Biology

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Autoimmune uveitis is a leading cause of blindness with a complex etiology. Obesity is considered a chronic disease with a connection with autoimmune diseases through systemic inflammation.However, an obesity and autoimmune disease connection is not consistently true in rodent models of autoimmune disease. A mouse model of human autoimmune uveitis, experimental autoimmune uveitis (EAU) has been used to better understand the immunobiology of uveitis. In this study, we assessed EAU in a high-fat diet (HFD) obesity model and found that the EAU severity is significantly higher in wild-type mice, but not in HFD melanocortin 5 receptor deficient mice. We find a decrease in CD11b + F4/80 + Ly-6C lo Ly-6G + M s, previously shown to be suppressive, and an enhancement of a Th1 response at the onset of EAU in obese mice. We further demonstrate that at recovery of EAU, obese mice lack regulatory immunity that provides protection from EAU. This report demonstrates that obesity exacerbates autoimmune uveitis and inhibits the promotion of post-EAU regulatory immunity through the melanocortin 5 receptor. The implication of this work is that obesity may contribute to the prevalence of autoimmune uveitis. K E Y W O R D Sautoimmune uveitis, melanocortin 5 receptor, obesity, ocular inflammation 1

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“…These patients presented with severe fibrinous uveitis (one patient was referred for suspicion of endophthalmitis, as in our case 2) in the setting of poor diabetes control and no other systemic association or aetiological cause for their uveitis; better glycaemic control was believed to have contributed to the resolution of uveitis 4 5. Interestingly, there were a large number of South Asian and African-Caribbean patients in their study, which they attributed merely to the demographics of the population they served in Birmingham in addition to the increased prevalence of type 2 DM in the South Asian ethnic group 4. On the other hand, ‘diabetic iritis’ was the diagnosis given in 1.2%–1.4% of patients in nationwide surveys of uveitis specialty clinics in Japan,6 7 and thus diabetic anterior uveitis may be more common in certain ethnicities such as Asians.…”

Section: Discussionmentioning

confidence: 93%

Clinical features of patients with diabetic anterior uveitis

et al. 2018

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Clinical Features of Patients with Diabetes Mellitus Presenting with Their First Episode of Uveitis

Abstract: Diabetic patients presenting with uveitis, whatever the aetiology, may have severe inflammation, reduced vision, and poor glycaemic control.

Cited by 10 publications

References 8 publications

Clinical course and visual outcome in patients with diabetes mellitus and uveitis

Clinical course and visual outcome in patients with diabetes mellitus and uveitis

Exacerbation of autoimmune uveitis by obesity occurs through the melanocortin 5 receptor

Clinical features of patients with diabetic anterior uveitis

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