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Uveitis in spondyloarthritis
Uveitis is the most frequent extra-articular manifestation of axial spondyloarthritis (SpA), occurring in up to one-third of the patients. In the majority of patients, uveitis is acute, anterior and unilateral and presents with photosensitivity, sudden onset of pain and blurred vision. Topical stero...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7488890/ https://www.ncbi.nlm.nih.gov/pubmed/32963592 http://dx.doi.org/10.1177/1759720X20951733 |
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author | Rademacher, Judith Poddubnyy, Denis Pleyer, Uwe |
author_facet | Rademacher, Judith Poddubnyy, Denis Pleyer, Uwe |
author_sort | Rademacher, Judith |
collection | PubMed |
description | Uveitis is the most frequent extra-articular manifestation of axial spondyloarthritis (SpA), occurring in up to one-third of the patients. In the majority of patients, uveitis is acute, anterior and unilateral and presents with photosensitivity, sudden onset of pain and blurred vision. Topical steroids are an effective treatment; however, recurrent or refractory cases may need conventional disease-modifying antirheumatic drugs or biological treatment with monoclonal tumor necrosis factor (TNF) inhibitors, thus also influencing treatment strategy of the underlying SpA. Though the exact pathogenesis of SpA and uveitis remains unknown, both seem to result from the interaction of a specific, mostly shared genetical background (among other HLA-B27 positivity), external influences such as microbiome, bacterial infection or mechanical stress and activation of the immune system resulting in inflammation. Up to 40% of patients presenting with acute anterior uveitis (AAU) have an undiagnosed SpA. Therefore, an effective referral strategy for AAU patients is needed to shorten the diagnostic delay of SpA and enable an early effective treatment. Further, the risk for ophthalmological manifestations increases with the disease duration in SpA; and patients presenting with ocular symptoms should be referred to an ophthalmologist. Thus, a close collaboration between patient, rheumatologist and ophthalmologist is needed to optimally manage ocular inflammation in SpA. |
format | Online Article Text |
id | pubmed-7488890 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-74888902020-09-21 Uveitis in spondyloarthritis Rademacher, Judith Poddubnyy, Denis Pleyer, Uwe Ther Adv Musculoskelet Dis Extra-Articular Manifestations and Comorbidities in Spondyloarthritis Uveitis is the most frequent extra-articular manifestation of axial spondyloarthritis (SpA), occurring in up to one-third of the patients. In the majority of patients, uveitis is acute, anterior and unilateral and presents with photosensitivity, sudden onset of pain and blurred vision. Topical steroids are an effective treatment; however, recurrent or refractory cases may need conventional disease-modifying antirheumatic drugs or biological treatment with monoclonal tumor necrosis factor (TNF) inhibitors, thus also influencing treatment strategy of the underlying SpA. Though the exact pathogenesis of SpA and uveitis remains unknown, both seem to result from the interaction of a specific, mostly shared genetical background (among other HLA-B27 positivity), external influences such as microbiome, bacterial infection or mechanical stress and activation of the immune system resulting in inflammation. Up to 40% of patients presenting with acute anterior uveitis (AAU) have an undiagnosed SpA. Therefore, an effective referral strategy for AAU patients is needed to shorten the diagnostic delay of SpA and enable an early effective treatment. Further, the risk for ophthalmological manifestations increases with the disease duration in SpA; and patients presenting with ocular symptoms should be referred to an ophthalmologist. Thus, a close collaboration between patient, rheumatologist and ophthalmologist is needed to optimally manage ocular inflammation in SpA. SAGE Publications 2020-09-12 /pmc/articles/PMC7488890/ /pubmed/32963592 http://dx.doi.org/10.1177/1759720X20951733 Text en © The Author(s), 2020 https://creativecommons.org/licenses/by/4.0/ This article is distributed under the terms of the Creative Commons Attribution 4.0 License (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Extra-Articular Manifestations and Comorbidities in Spondyloarthritis Rademacher, Judith Poddubnyy, Denis Pleyer, Uwe Uveitis in spondyloarthritis |
title | Uveitis in spondyloarthritis |
title_full | Uveitis in spondyloarthritis |
title_fullStr | Uveitis in spondyloarthritis |
title_full_unstemmed | Uveitis in spondyloarthritis |
title_short | Uveitis in spondyloarthritis |
title_sort | uveitis in spondyloarthritis |
topic | Extra-Articular Manifestations and Comorbidities in Spondyloarthritis |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7488890/ https://www.ncbi.nlm.nih.gov/pubmed/32963592 http://dx.doi.org/10.1177/1759720X20951733 |
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