Rheumatic diseases detected in patients presenting with uveitis

OBJECTIVE: Uveitis may occur in the course of systemic inflammatory rheumatic diseases (IRD), or it may be the first clinical manifestation of these diseases. The aim of this study was to determine the incidence of IRD in patients whose initial clinical manifestation was non-infectious uveitis.
METHODS: The study included adult patients diagnosed as having noninfectious uveitis in the department of ophthalmology and referred to rheumatology for further investigation of potential rheumatic diseases as underlying etiology of uveitis. The patients’ demographic and clinical features, laboratory, and imaging findings were examined.
RESULTS: One hundred six patients who were diagnosed as having uveitis (42.4% anterior, 2.8% intermediate, 19.8% posterior, and 34.9% panuveitis) were included. Just over half (52.8%) of the patients were male and the mean age was 40.1±14.8 years. The mean age at the uveitis attack was 38.7±15 years. One-third (33%) of the patients were diagnosed as having rheumatologic disease (spondyloarthritis (SpA) n=10, Behcet disease (BD) n=17, vasculitides n=2, sarcoidosis n=2, undifferentiated connective tissue diseases n=3, rheumatoid arthritis n=1). SpA was diagnosed in 20% of patients presenting with anterior uveitis. BD was detected in 27% of patients referred with panuveitis and in 33.3% of patients whose first clinical finding was posterior segment involvement. Bilateral uveitis was detected in two-thirds of patients with posterior uveitis and tended to recur more frequently (p=0.014).
CONCLUSION: Rheumatic diseases have been identified in approximately one-third of patients presenting with different types of uveitis. Investigations addressing systemic rheumatic diseases are of paramount importance in patients with uveitis because they may change diagnosis and treatment processes.

Üveit ile prezente olan hastalarda saptanan romatizmal hastalýklar

Amaç: Üveit, sistemik inflamatuar romatizmal hastalýklarýn seyrinde ortaya çýkabileceði gibi, bu hastalýklarýn ilk klinik bulgusu da olabilir. Bu çalýþmayla, ilk klinik bulgusu non-enfeksiyöz üveit olan hastalarda romatizmal hastalýk insidansýný belirlemeyi amaçladýk.
Metot: Çalýþmaya oftalmoloji bölümünde enfeksiyöz olmayan üveit tanýsý konan ve üveit etiyolojisinin altýnda yatan olasý romatizmal hastalýklarýn daha ayrýntýlý araþtýrýlmasý için romatolojiye sevk edilen yetiþkin hastalar dahil edildi. Hastalarýn demografik ve klinik özellikleri, laboratuvar ve görüntüleme bulgularý incelendi.
Bulgular: Üveit tanýsý alan 106 hasta (%42.4 ön, %2.8 orta, %19.8 arka ve %34.9 panüveit) çalýþmaya dahil edildi. Hastalarýn yarýsýndan fazlasý (%52.8) erkekti ve yaþ ortalamasý 40.1±14.8 idi. Ortalama üveit atak yaþý 38.7±15 idi. Hastalarýn üçte birine (%33) romatolojik hastalýk [spondiloartrit (SpA) n=10, Behçet hastalýðý (BH) n=17, vaskülitler n=2, sarkoidoz n=2, farklýlaþmamýþ bað dokusu hastalýklarý n= 3, romatoid artrit n=1].) tanýsý konuldu. Anterior üveit ile baþvuran hastalarýn %20'sinde SpA saptandý. Panüveit ile baþvuran hastalarýn %27'sinde ve ilk klinik bulgusu arka segment tutulumu olan hastalarýn %33.3'ünde BH saptandý. Arka üveitli hastalarýn üçte ikisinde bilateral üveit saptandý ve daha sýk tekrarlama eðilimi gösterdi (p=0.014).
Sonuç: Farklý üveit tipleri ile baþvuran hastalarýn yaklaþýk üçte birinde romatizmal hastalýklar saptanmýþtýr. Üveitli hastalarda sistemik romatizmal hastalýklara yönelik araþtýrmalar taný ve tedavi sürecini deðiþtirebileceði için büyük önem taþýmaktadýr. (NCI-2023-8-11)