Multiple Sclerosis-Associated Uveitis in Persian Population, a Multicenter Study Publisher Pubmed



Anvari P¹ ; Fekri S² ; Hedayatfar A^{1, 3} ; Heidari H⁴ ; Hosseini S⁵ ; Khamesi S¹ ; Kohandel K⁴ ; Mahdizad Z⁶ ; Soheilian M² ; Zarei M⁶ ; Niktinat H⁶ ; Ebrahimiadib N⁷ Show Affiliations
Source: Multiple Sclerosis and Related Disorders Published:2024

Abstract

Purpose: To report the characteristics of multiple sclerosis-associated uveitis (MSU) among the Persian population. Patients and methods: Retrospective, nonrandomized, multicenter study. Epidemiological characteristics, ocular and neurologic findings, angiographic features, and visual outcomes in MSU were studied. Results: 92 patients (173 eyes) were included; the mean age at the time of uveitis onset was 35.9 ± 10.9 years (range; 10–60 years), 84.8 % were female, and 88.0 % had bilateral involvement. The anatomical subgroups were isolated anterior uveitis (AU) in 12.0 %, intermediate uveitis (IU) with or without AU in 84.8 % and pure retinal vasculitis in 3.3 % of patients. None of the patients were defined as having posterior or panuveitis. Uveitis had an insidious onset and chronic course in 89.1 % patients and was of granulomatous type in 81.9 %. The diagnosis of MS precedes uveitis onset in 48.8 % patients (range 1 to 35 years, median: 7 years) and was concurrent or after the uveitis onset in 52.2 % patients (range; 1 to 12 years; median: 2 years). Undifferentiated intermediate uveitis was the most common initial diagnosis (30.4 %) before MS establishment. 89.1 % of patients received at least one conventional immunotherapy agent. Peripheral retinal perivascular leakage (81.4 %) and optic disc hyperfluorescence (74.4 %) were the two most common fluorescein angiography (FA) findings The major causes of visual impairment were cataracts (52.7 %), cystoid macular edema (CME) (31.5 %), and optic neuritis (29.2 %). During an average follow-up time of 4.76 ± 3.18 years (range: 1–12 years), visual acuity improved –0.09 logMar/year and most eyes maintain relatively good visual acuity. Conclusion: MSU usually presents as chronic granulomatous bilateral IU and less often isolated AU, especially in females. Retinal vasculitis can be a prominent feature. Clinically, it may resemble Undifferentiated intermediate uveitis . In geographical areas where MS is prevalent, the indication of neuroimaging should be expanded and include patients presenting with chronic granulomatous IU or AU especially if accompanied by retinal vasculitis. © 2024 Elsevier B.V.