Conference Coverage
CHICAGO—Approximately 60% of patients with multiple sclerosis (MS) and uveitis receive diagnoses of both diseases within a five-year period, according to a large retrospective study presented at the 118th Annual Meeting of the American Academy of Ophthalmology. Although the association between the eye condition and MS has long been known, this study is the first to provide a detailed description of the relative onset of uveitis and that of MS, as well as to calculate the likelihood of an MS diagnosis among patients with uveitis.
Uveitis can be a sign of MS, and between 1% and 10% of people with MS have uveitis. To achieve a better understanding of the association between the two diseases, researchers from Casey Eye Institute at the Oregon Health and Science University in Portland and investigators from the University of Heidelberg in Germany searched a Casey Eye Institute database of approximately 3,000 patients with uveitis and a University of Heidelberg database of 5,319 patients with uveitis who presented between 1985 and 2013. The researchers identified 24 patients from the Casey Eye Institute and 89 patients from the University of Heidelberg who fulfilled the diagnostic criteria for uveitis and MS. Thus, 113 individuals were included in the study.
Compared with the prevalence of MS in American and European populations, MS is 18 times and 21 times more common in American and European populations with uveitis, respectively, according to the researchers. They found that MS was diagnosed before uveitis in 28 (29%) patients, simultaneously in 15 (15%) patients, and after uveitis diagnosis in 54 (56%) patients.
“With a population size four times larger than [that of] any study to date on this topic, our study provides a wealth of clinical information to allow clinicians to make more accurate diagnoses, while giving patients a better understanding of their prognosis,” said Wyatt Messenger, MD, a research fellow at the University of Utah in Salt Lake City and former lead researcher from the Casey Eye Institute. “Knowing more about the onset may enable patients to seek treatment earlier, therefore slowing the progression of the disease and limiting the damage done to the nervous system.”
In addition, this study is the first to estimate the relative frequency of anatomical subtypes of uveitis in patients with MS. Traditionally, patients with MS are thought to present most often with intermediate uveitis, which also is referred to as pars planitis. Although 80% of cases in this study had intermediate uveitis at the time of MS diagnosis, the researchers found that nearly one in six participants presented with anterior uveitis. The investigators also observed that visual acuity is generally stable in this population; the majority of patients improved during follow-up.
A major limitation of the study is the lack of availability of brain MRI for all of the patients, according to the researchers. The study also lacks detailed neurologic studies, which would have allowed investigators to correlate the patients’ uveitis with their neurologic disease.