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Seronegative spondyloarthropathies and the eye

Ali, Amro; Samson, C Michael

Current Opinion in Ophthalmology: November 2007 - Volume 18 - Issue 6 - p 476–480
doi: 10.1097/ICU.0b013e3282f0fda2
Ocular manifestations of systemic disease: Edited by Russell W. Read
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Purpose of review Ocular inflammation is a common and important manifestation of disease in patients with seronegative spondyloarthropathy.

Recent findings Anterior uveitis is among the most common manifestations of eye disease in patients with seronegative spondyloarthropathies. Additionally, a strong correlation exists among such affected patients and the presence of the HLA-B27 gene. Steroid treatment is often effective for uveitis associated with spondyloarthropathies. Patients with ocular inflammation that is chronic in nature or uncontrolled by steroid treatment have shown good response to immunosuppressive agents known to be effective for articular inflammation, such as methotrexate. Recent studies have shown the possible benefits of tumor necrosis factor-alpha inhibitors, such as infliximab and etanercept.

Summary Uveitis, a leading cause of blindness, is among the most common eye manifestations in patients affected by seronegative spondyloarthropathies. Evidence suggests both genetic and environmental factors in its pathogenesis. Immunomodulator treatments, including the recently popular biologics, may be effective in the control of chronic uveitis in patients with spondyloarthropathy. Ocular surgery is often needed in these patients, and appropriate cautions are required in order to achieve successful vision rehabilitation.

New York Eye and Ear Infirmary, 310 East 14th Street, New York, NY, USA

Correspondence to C. Michael Samson, MD, New York Eye and Ear Infirmary, 310 East 14th Street, New York, New York, USA Tel: (212) 979 4515; fax: (212) 979 4512; e-mail: CSamson@NYEE.EDU

© 2007 Lippincott Williams & Wilkins, Inc.