Insights into multiple sclerosis‐associated uveitis: a scoping review

Abstract

Purpose This paper is a scoping review of research on multiple sclerosis (MS)‐associated uveitis to determine its epidemiology, pathophysiology, clinical features and treatment. Methods A comprehensive search of the medical databases MEDLINE (PubMed), EMBASE, Web of Science and Cochrane was carried out on 25 November 2019, to identify papers published between 1980 and 2019 that focus on patients with MS‐associated uveitis. Results Based on large cohort studies (n ≥ 1000), the prevalence of uveitis in patients with MS is estimated to be 0.53–1.34% (mean = 0.83%), and MS is diagnosed in 0.52–3.20% (mean = 1.30%) of patients with uveitis. The condition is most frequent among middle‐aged women. Patients usually complain of floaters and/or blurred vision, with bilateral intermediate uveitis (with retinal vasculitis) as the most frequent ophthalmological finding. Both MS and intermediate uveitis are associated with HLA‐DRB1*15:01 and IL‐2RA gene polymorphism rs2104286 A > G, suggesting a common genetic background. T cells, and possibly B cells, play an important role in both autoimmune disorders. Multiple sclerosis (MS)‐related uveitis is classically treated as non‐infectious uveitis, with corticosteroids as the first treatment step. Other treatments include immunosuppressants, cryotherapy, laser photocoagulation and vitrectomy. These treatment options have a limited, if any, effect on the course of MS and can be complicated by side‐effects. As treatment strategies for MS have increased in the last decade, it would be interesting to evaluate the efficacy of these new treatments during the course of uveitis. Moreover, the correlation between retinal periphlebitis and MS could be established more accurately with the recently developed techniques of wide‐field fluorescein angiography in a large cohort of MS patients. Conclusion MS‐associated uveitis is a rare, highly discussed pathology about which much is still unknown. Large epidemiological studies and extrapolation of new MS treatments to this condition are warranted.

Retinal Periphlebitis May Be a Marker for Subphenotype in Multiple Sclerosis

“…Retinale Periphlebitis -Marker eines Subphänotyps der Multiplen Sklerose ity and bigger contrast-enhancing parenchymal lesions in the brain [7,8]. A recently published scoping review about MS-associated uveitis concluded that due to new examination modalities with more possibilities to examine the retinal periphery, RPP should be further investigated [9].…”

Intermediäre und posteriore Uveitis – Teil 2

“…Vor allem bei jungen Frauen kann bei der Erstmanifestation einer IU auch eine MS vorliegen, die bei Diagnosestellung der Uveitis durch den Augenarzt oft noch nicht bekannt ist. Etwa 1% aller MS Patienten zeigen eine intermediäre Uveitis, und etwa 1% aller IU-Patienten haben auch eine MS 3 . Es zeigen sich dann im Rahmen der zerebralen MRT-Untersuchung Demyelinisierungsherde.…”

Juvenile Idiopathic Arthritis, Uveitis and Multiple Sclerosis: Description of Two Patients and Literature Review

“…Moreover, MS and intermediate uveitis are both associated with HLA-DRB1*15:01. T and B lymphocytes may have a crucial role in both diseases, but further research is needed to establish the exact pathogenic mechanism [ 63 ].…”