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Ebrahimiadib N, Berijani S, Ghahari M, Golsoorat Pahlaviani F. Ankylosing Spondylitis. JOVR [Internet]. 2021Jul.29 [cited 2024Apr.20];16(3):462–469. Available from: https://knepublishing.com/index.php/JOVR/article/view/9440

https://doi.org/10.18502/jovr.v16i3.9440

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  • Cited by 14 articles

authors

  • Nazanin Ebrahimiadib

    Nazanin Ebrahimiadib

    Retina Service, Ocular Immunology and Uveitis Foundation, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
  • Sahar Berijani

    Sahar Berijani

    Retina Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
  • Mohammadreza Ghahari

    Mohammadreza Ghahari

    Retina Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
  • Fatemeh Golsoorat Pahlaviani

    Fatemeh Golsoorat Pahlaviani

    Retina Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
    https://orcid.org/0000-0002-5792-295X

Published Date

  • Jul 29, 2021
This journal is publishing all the articles under Creative Commons Attribution License CC BY 4.0.

Ankylosing Spondylitis

Journal of Ophthalmic and Vision Research (JOVR) / July–September 2021, Volume 16, Issue 3 / Pages 462–469

Abstract

The seronegative spondyloarthropathies are a group of autoimmune inflammatory diseases lacking rheumatoid factor or antinuclear antibody in their serum. They include ankylosing spondylitis (AS), reactive arthritis, psoriatic arthritis, spondylitis associated with Crohn’s disease and ulcerative colitis, and undifferentiated spondyloarthropathies. Inflammation mostly affects the axial joints, entheses, and extra-articular structures such as uveal tract, gastrointestinal tract, mucocutaneous tissue, and heart. Uveitis is the most common extra-articular manifestation. Spondyloarthropathies, especially AS, have a strong association with the presence of Human Leukocyte Antigen (HLA)-B27 gene. AS happens earlier in HLA-B27 patients and men are more prone to the disease. Uveitis, typically unilateral nongranulomatous acute anterior uveitis, occurs in up to 50% of the patients with AS. HLA-B27 positivity correlates with more frequent flare-ups. Conjunctivitis and scleritis are rare ocular manifestations of AS. To establish the diagnosis of AS, at least one clinical and one radiologic parameter are required for definitive diagnosis. Magnetic resonance imaging (MRI) or bone scan can help early detection of the axial skeleton inflammation. The course of eye and joint involvement are not correlated. Short-term treatment with topical corticosteroids and cycloplegic agents control the uveitis attack. In resistant cases, local or systemic therapy with corticosteroids are recommended. NSAIDs, disease-modifying anti-rheumatic drugs (DMARDs), methotrexate, azathioprine, anti-IL-17A monoclonal antibodies, and TNF- α antagonists are effective treatments for ocular and systemic manifestations of AS. If not treated adequately, uveitis may become recalcitrant and extend posteriorly. Functional impairment due to joint destruction can also occur as a result of undertreatment.

Keywords:

Ankylosing Spondylitis, Spondyloarthritis, Uveitis

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