Uveitis prior to clinical presentation of Multiple Sclerosis (MS) is associated with better MS prognosis

Abstract

Objective An association between uveitis and multiple sclerosis (MS) is well-established, but the actual nature of that association remains poorly understood. We sought to determine the association between the presence of a uveitis diagnosis prior to an MS diagnosis compared to no pre-existing uveitis diagnosis in MS patients. Methods Patients in whom the presentation of uveitis preceded the presentation of MS (study group) and patients with MS and no uveitis (control group) were randomly selected at a ratio of 1:3 from the Sheba Multiple Sclerosis Center computerized database. Results Eleven patients presented with uveitis prior to MS diagnosis (study group), and 31 randomly selected patients had MS without uveitis (control group). Only one patient in the study group deteriorated to EDSS 3 during the follow-up period, compared to 15 patients in the control group (9.1% vs 48.4%, P = 0.049). None of the patients in the study group reached EDSS 6 during the 10 years of follow-up compared to 6 (19.4%) patients in the control group (P = 0.194). Conclusions MS patients who presented with uveitis that preceded their neurological symptoms of MS demonstrated a clinically significant better neurological prognosis, than our MS patients with no uveitis.

Multiple sclerosis-associated uveitis – A series from South India

“…The oligoclonal bands in CSF, produced by intrathecal B-cells in the CSF (contribute to inflammation and destruction of myelin sheath) and meningeal-based ectopic B-cell follicles adjacent to areas of focal cortical demyelination, suggest a central role for B-cells in MS. B-cells also host Epstein–Barr virus (EBV), which is strongly related to MS in epidemiological analyses. [ 15 16 17 ] In our series, rituximab was used in three cases. In all the three cases, there were no relapses in MS flares and near improvement in intra-ocular inflammation.…”

Case Series on Autosomal Recessive Non-Syndromic Retinitis Pigmentosa Caused by POMGNT1 Mutations with a Report of a New Variant

“…It was not until genetic testing was completed that RP was included in the differential. The association between multiple sclerosis and uveitis is well documented, and the incidence of uveitis in multiple sclerosis patients ranges from 0.4 to 26.9% [9]. However, common findings of RP are also seen in various forms of uveitis, and these cases reiterate the importance of considering RP when creating a differential for uveitis masquerade syndromes.…”