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Kim, Park, Lee, Lee, and Yoon: Uveitis and Rheumatic Diseases in a Community Based Practice - Korean Population
Original Article

J Rheum Dis 2011;18(4):276-282.

Published online: 31 December 2011

DOI: https://doi.org/10.4078/jrd.2011.18.4.276

Uveitis and Rheumatic Diseases in a Community Based Practice - Korean Population

Na Kyung Kim1, Min Yong Park1, Jong Hyun Lee2, Do Hyung Lee2, Bo Young Yoon1

1Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea

2Department of Ophthalmology, Inje University Ilsan Paik Hospital, Goyang, Korea

Received 27 July 201119 August 2011       Accepted 30 August 2011

Copyright © 2011 The Korean College of Rheumatology

Abstract

Objective

We aimed to investigate the frequency of rheumatic diseases within uveitis patients visiting the department of Ophthalmology and evaluated the clinical value of serological testing and ophthalmologic findings in patients with uveitis in a community-based practice in Korean population.

Methods

On a retrospective basis, we reviewed the medical records of patients with uveitis, who had been treated at the Department of Ophthalmology of Inje University Ilsan Paik Hospital between January 2005 and March 2010. All patients with uveitis were reviewed regarding their ocular histories and findings, rheumatologic medical histories and manifestations, and pelvis anteroposterial view of plain radiographies to identify the sacroilitis. In addition, we tested for rheumatoid factor, antinuclear antibody, and HLA-B27.

Results

A total of 107 patients with uveitis were included in the study. HLA-B27 associated uveitis was present in 64 patients (59.8%) the number of patients with sacroilitis on plain pelvis radiography was 38 patients (37.8%). Fifty-one patients (47.7%) were diagnosed as having systemic rheumatic diseases. The majority of these patients had anklylosing spondylitis (AS) (70.3%) and Bechet's disease (18.9%). The most common type of uveitis was anterior uveitis (90.7%), followed by panuveitis (3.7%) and posterior uveitis (3.7%). The recurrence rate and number of floating cells were greater in patients with rheumatic diseases than patients without rheumatic diseases.

Conclusion

The majority of rheumatic disease related with uveitis were AS and Bechet's disease. HLA-B27 and pelvis plain radiography can be useful tools for screening the spondyloarthropathies with uveitis. Recurrent and severe uveitis might represent an accompanying rheumatic disease.

Keywords: Uveitis, HLA-B27, Spondyloarthropathy, Sacroiliitis

References

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Table 1.
Demographics and serology of uveitis patients with or without rheumatic diseases
Number All patients Uveitis patients with rheumatic diseases n=51 Uveitis patients without rheumatic diseases n=56 p-value
n=107 (%)
Gender         0.008∗
 Female 39 36.4 12 27  
 Male 68 63.6 39 29  
Age (years)          
 Mean age at initial visit 39.5 (12∼74) 39.0 40.1 0.661
 Mean age of 1 st uveitis 37.8 (10∼70) 36.5 39 0.316
Familial history of uveitis 3 2.8 2 1  
Familial history of rheumatic disease 2 1.9 1 1  
HLA B-27         <0.001†
 Positive 64 59.8 43 21  
 Negative 43 40.2 8 35  
Antinuclear antibody         0.100
 Positive 17 15.9 5 12  
 Negative 90 84.1 46 44  
Rheumatoid factor         0.337
 Positive 14 13.1 5 9  
 Negative 93 86.9 46 47  
Sacroiliitis on the pelvis x-ray         <0.001†
 Positive 38 35.5 38 0  
 Negative 64 59.8 11 53  
 Unchecked 5 4.7 2 3  

∗ p<0.05,

† p<0.01

Table 2.
Frequency of the rheumatic diseases associated with uveitis
Association of rheumatic diseases N (%)
Anklylosing spondylitis 40 78.43
Bechet's disease 7 13.73
Psoriatic arthritis 1 1.96
Undifferentiated spondyloathropathy 1 1.96
Rheumatoid arthritis 1 1.96
Sjogren syndrome 1 1.96
Total 51 100
Table 3.
Ophthalmic characteristics of uveitis patients with or without rheumatic diseases
Number All patients Uveitis patients with rheumatic diseases Uveitis patients without rheumatic diseases p-value
n=107 (%) n=51 (%) n=56 (%)
Type             0.635
 Unilateral 90 84.1 41 80.4 48 85.7  
 Bilateral 17 15.9 10 19.6 8 14.3  
Location             0.188
 Anterior 97 90.7 49 96.1 48 85.7 0.066
 Posterior 4 3.7 1 2.0 3 5.4 0.355
 Intermediate 2 1.9 1 2.0 1 1.8 0.947
 Panuveitis 4 3.7 0 0.0 4 7.1 0.052
Episode recurrence             0.048∗
 1st attack 63 58.9 25 49.0 38 67.9  
 More than 2 times 44 41.1 26 51.0 18 32.1  
Number of Floating cells             0.039∗
 0 4 3.7 1 2.0 3 5.4  
 1 20 18.7 7 13.7 13 23.2  
 2 31 29.0 11 21.6 20 35.7  
 3 17 15.9 8 15.7 9 16.1  
 4 35 32.7 24 47.1 11 19.6  
 Mean   2.6   2.9   2.2 0.003†
Fibrin 11 10.3 8 15.7 3 5.4 0.079
Hypopyon 8 7.5 6 11.8 2 3.6 0.108
Keratic precipitate 24 22.4 10 19.6 14 25.0 0.504
Treatment              
 Topical steroid 104 97.2 51 100.0 53 94.6 0.094
 Systemic steroid 76 71.0 39 76.5 37 66.1 0.288
 Immunosuppressant 2 1.9 2 3.9 0 0.0 0.135

∗ p<0.05,

† p<0.01

Supplement Table 1.
Demographics of uveitis patients with or without HLA-B27
Number Uveitis patients with HLA-B27 n=64 Uveitis patients without HLA-B27n=43 p-value
Gender      0.683
 Female 22 17  
 Male 42 26  
Age (years)      
 Mean age at initial visit 41.4 42.9 0.028∗
 Mean age of 1 st uveitis 35.4 37.3 0.017∗
Familial history of uveitis 3 0 0.272
Familial history of rheumatic disease 2 0 0.515
Antinuclear antibody     0.594
 Positive 5 12  
 Negative 46 44  
Rheumatoid factor     0.242
 Positive 9 8  
 Negative 55 35  
Sacroiliitis on the pelvis x-ray     <0.001†
 Positive 36 2  
 Negative 27 39  
 Unchecked 1 2  

∗ p<0.05,

† p<0.01

Supplement Table 2.
Ophthalmic characteristics of uveitis patients with or without HLA-B27
Number Uveitis patients with HLA-B27 Uveitis patients Without HLA-B27 p-value
n=64 (%) n=43 (%)
Type         0.002†
 Unilateral 60 30.2 30 69.8  
 Bilateral 4 6.3 13 30.2  
Location         0.021∗
 Anterior 62 96.9 35 81.4  
 Posterior 0 0.0 4 9.3  
 Intermediate 0 0.0 2 4.7  
 Panuveitis 2 3.1 2 4.7  
Episode recurrence         0.164
 1st attack 34 53.1 29 67.4  
 more than 2 times 30 46.9 14 32.6  
Number of Floating cells Mean   3.0 1.9   <0.001†
Fibrin 10 15.6 1 2.3 0.047∗
Hypopyon 7 10.9 7 2.3 0.140
Keratic precipitate 15 23.4 9 20.9 0.817
Treatment          
 Topical steroid 63 98.4 41 95.3 0.563
 Systemic steroid 50 78.1 26 60.5 0.054
 Immunosuppressant 2 3.1 0 0.0 0.515

∗ p<0.05,

† p<0.01

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