Gender and Uveitis in Patients with Multiple Sclerosis

Abstract

Multiple sclerosis (MS), a demyelinating disease of the central nervous system, is more commonly seen in women. It has been associated with both anterior and intermediate uveitis as well as retinal vasculitis. Ocular inflammation may develop concurrent with, prior to, or after the development of neurologic signs and symptoms. Patients with MS have an approximately 1% chance of developing intraocular inflammation. Patients with intermediate uveitis have an 8–12% risk of being diagnosed with MS. This risk is higher in females and in those with bilateral disease. This should be kept in mind when evaluating patients with uveitis, particularly in those patients for whom TNF inhibitor therapy is being considered, as these agents may worsen demyelinating disease.

The Role of Sex in Uveitis and Ocular Inflammation

“…MS is much more prevalent in women, with 78% of patients being female with a mean age of diagnosis around 37 years old. 30, 31 MS varies geographically with a lower incidence in Asia and a higher incidence in countries away from the equator. 32 This suggests a role for genetic, epigenetic, or noninfectious environmental factors.…”

“…32 This suggests a role for genetic, epigenetic, or noninfectious environmental factors. 31 Hormonal changes have been implicated in the disease; it is known that women, though more likely to develop MS, will have fewer relapses during pregnancy, suggesting that changes to the hormonal profile of these women affects the course of the disease. 30, 31 This hypothesis has been supported by further testing in rodent MS models, wherein T lymphocyte transfer from female rats was more effective at instigating disease than from male rats.…”

“…31 Hormonal changes have been implicated in the disease; it is known that women, though more likely to develop MS, will have fewer relapses during pregnancy, suggesting that changes to the hormonal profile of these women affects the course of the disease. 30, 31 This hypothesis has been supported by further testing in rodent MS models, wherein T lymphocyte transfer from female rats was more effective at instigating disease than from male rats. 33 Ocular manifestations of MS range from optic neuritis, internuclear ophthalmoplegia, nystagmus, and uveitis including intermediate uveitis and retinal periphlebitis.…”

Effect of Self-Care Education on Social Adaptability in Patients with Multiple Sclerosis

“…MS commonly affects females approximately 2 or 3 times more than it does males (3,4), and the disease onset usually occurs between the ages of 20 to 40 years (4,5). The number of patients with MS has been increasing, and based on reports of researchers in the 9th International congress on multiple sclerosis that was conducted in 2012, the prevalence of MS was 73 and 60 per 100 000 individuals in the world and in Iran, respectively (4).…”

Quantitative Analysis of Uveitis Macular Edema in Multiple Sclerosis Patients Receiving Deep Posterior Sub-Tenon Triamcinolone Acetonide Injection

“…Systemic therapy may be indicated as the initial treatment for many cases of bilateral intermediate uveitis induced by MS. Interferon-β therapy based only on the indication of uveitis is not recommended [42] . Also, TNF inhibitor therapy is being considered, because these agents may worsen demyelinating disease [43] .…”