<p>Psoriasis and uveitis: links and risks</p>

Abstract

Uveitis, an inflammatory disorder of the mid-portion of the eye, is considered a relatively rare but very serious ocular complication of psoriasis. Data on the specific characteristics of uveitis in the background of psoriasis are extremely limited. The presence of uveitis in the context of psoriasis has been estimated to occur in 7–20% of the psoriasis cases. This incidence tends to be higher in patients suffering from psoriasis and psoriatic arthritis (PsA) or PSA alone. Psoriatic uveitis is usually bilateral, chronic, and severe. In term of pathogenesis, both psoriasis and uveitis are considered as paradigms of T-helper 1/T-helper 17 (Th1/Th17) inflammatory reactions. Certain cytokines such as tumor necrosis factor-α (TNF- α), Interleukin-17 (IL-17), IL-23, and IL-6 play a significant role in the pathogenesis of both psoriasis and uveitis. As uveitis shares common pathogenetic mechanisms with psoriasis in certain circumstances, both diseases may benefit from the same targeted biologic therapies. Undiagnosed and under-treated cases of psoriatic uveitis may cause significant morbidity and even vision loss. Larger prospective studies are needed in order to further investigate the association between these two entities.

Psoriatic Arthritis and Diabetes Mellitus: A Narrative Review

“…The clinical manifestations of PsA include peripheral arthritis, axial involvement, enthesitis, or dactylitis [9]. Patients with PsA could also present nail disease and more rarely uveitis [10]. PsA generally presents as tendon and/or joint inflammation and swelling.…”

The Incidence and Prevalence of Uveitis in Psoriasis: A Systematic Review and Meta-Analysis

“…Previously, a few reviews have reported on the association between uveitis and psoriasis. 8,25 A previous systematic review on a related topic explored 2 case-control and 1 cross-sectional study, as well as 1 case series. 26 However, our systematic review explores a more narrowed scope in our methodological process and focus on prevalence and incidence, as opposed to a broader association between the 2 disorders.…”

“…Anterior uveitis is more common with psoriasis-related uveitis, and while symptoms of uveitis tend to vary depending on the affected area of the uveal tract, dry eyes have been reported as a main symptom. 25 Other symptoms of anterior uveitis include red or painful eyes, distinguishing it from intermediate and posterior uveitis, which tend to present with altered vision including floaters and vision loss. 5 It has been suggested that the presentation of uveitis might indicate systemic inflammation and could act as a precursor of PsA.…”

“…5 It has been suggested that the presentation of uveitis might indicate systemic inflammation and could act as a precursor of PsA. 4,25,26 Ocular complications occur in about 10% of psoriasis patients, where PsA and pustular psoriasis have the highest frequency. 27 The contributory role of psoriasis in the pathogenesis of ocular changes has been suggested given tear film changes and other subclinical ocular pathologies found in patients with psoriasis vulgaris.…”

“…33 Some studies propose that inflammation from psoriasis can lead to increased permeability of the barrier between the blood and aqueous humor, allowing activated neutrophils to enter and cause bouts of anterior uveitis or subclinical inflammation. 11,16,25 As such, it has been reported that uveitis tends to occur more often in PsA or pustular psoriasis patients. 35 Given the common pathogenetic mechanisms shared between uveitis and psoriasis, the same targeted immunomodulating biological treatments have been demonstrated to have benefits for both diseases.…”