Uveitis & inflammatory rheumatic diseases

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Uveitis as a cause of visual loss in arthritides and comparable

conditions.

J Rheumatol 2001 Feb;28(2):309-12 (ISSN: 0315-162X)

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Kotaniemi K; Aho K; Kotaniemi A

Rheumatism Foundation Hospital, Heinola, Finland.

OBJECTIVE: To examine the role of inflammatory rheumatic diseases and

comparable conditions in the etiology of severe uveitis leading to

visual impairment and blindness.

METHODS: A retrospective study based on the Finnish Register of Visual

Impairment. At the end of 1996, the Finnish Register of Visual

Impairment included 296 uveitis patients in whom uveitis was the main

cause of visual impairment. The patient records were examined

retrospectively to investigate the etiology of severe uveitis. Due to

the incompleteness of data obtained of the patients blinded a long time

ago, we included only 174 uveitis patients whose visual handicap (best

corrected visual acuity in the better eye < 20/60 or severe visual field

loss) was stated during 1980-1996.

RESULTS: A total of 174 uveitis patients were found, 72 male and 102

female. A diagnosed or presumed inflammatory rheumatic disease or

comparable condition was found in 38/174 (22%) patients: juvenile

rheumatoid arthritis in 14 (8%), spondyloarthropathy (ankylosing

spondylitis or reactive arthritis) in 10 (6%), sarcoidosis in 5 (3%),

seronegative rheumatoid arthritis in 4 (2%); Behcet's disease was

diagnosed in 2 (1%), 1 patient had polymyositis, 1 polyarteritis nodosa,

and 1 juvenile systemic lupus erythematosus. In addition to the above,

10 (6%) patients had chronic back pain and 5 (3%) patients various

noninflammatory joint problems. Diverse other ophthalmologic or systemic

disease was detected in 38 (22%) cases. Trauma or surgery caused uveitis

in 9 (5%) patients. For 74/174 (43%) uveitis patients no specific

associating condition could be shown. Legal blindness was documented in

65/174 (37%) patients, including 8 totally blind persons.

CONCLUSION: This study provides first data on the relative importance of

inflammatory rheumatic diseases and comparable conditions in the

etiology of severe uveitis leading to visual handicap and blindness.