Risk factors for developing Polyautoimmunity in patients with non-infectious uveitis and their impact on visual outcomes.

Abstract

Objectives To identify the risk factors for PolyA development in NIU patients and determine if PolyA may be related to worse visual outcomes.Methods We investigated immune-mediated diseases in a cross-sectional study of 218 consecutive NIU patients. Univariate logistic regression and Kaplan-Meier analysis with Cox regression were performed for losing two lines of vision on the Snellen between patients with PolyA and without PolyA.Results PolyA was present in 45.9% of NIU patients. Median age at diagnosis was 44 (IQR 24–57) years, with a predominance of women (PolyA 71% vs. without PolyA 68%). Uveitis etiology shows a difference between patients with PolyA and without PolyA (autoimmune disease represents 54% PolyA vs. 0.8% without PolyA (P < 0.001)). Clinical features of PolyA uveitis included mainly bilateral, anterior, and non-granulomatous, with insidious onset and a recurrent course. The most common immunomarkers were HLA-B27 and antinuclear antibodies (ANAs), that was also significantly more frequent in PolyA patients (25% vs. 9.3% (P = 0.002)). Risk factors for developing PolyA included ages 30–64, anterior uveitis, positive ANAs, and familial autoimmunity. Kaplan-Meier analysis revealed a statistically significant increased risk of losing two lines of vision on the Snellen chart for visual acuity (HR = 2.51, 95% CI = 1.00-6.29, P = 0.049).Conclusion The development of PolyA in NIU can lead to a more rapid loss of two or more lines of vision. NIU patients aged 30–64 with anterior uveitis, familial autoimmunity, and positive ANAs require frequent follow-up to identify and manage it promptly.