Uveitis and Multiple Sclerosis

Overview

Aim:
To evaluate the type of uveitis, the time of the duration between the first ocular signs and establishing of the diagnosis of multiple sclerosis (MS), effect of the treatment, and the final visual acuity (VA).

Methods:
In a retrospective study, medical records of 41 patients (82 eyes) from the total of 1267 patients with uveitis treated at the Center for uveitis diagnosis and treatment at the Department of Ophthalmology of the Faculty Hospital and 1^st Medical faculty, Charles University in Prague, Czech republic, during the period 1986–2003 were evaluated. The cohort consisted of 32 females and 9 males, mean age of 27 years (8–46 years). The mean follow-up period was 8 years (1–17 years).

Results:
The cohort consisted of 41 patients (82 eyes), 32 females and 9 males. The mean age at the beginning of the uveitis was 27 years, at the time of the diagnosis of the MS 29.5 years. In 19 patients the starting of the uveitis preceded the manifestation of the systemic disease. In 23 patients, the uveitis was the first manifestation of MS. The most common type of uveitis in patients with MS was the intermediate uveitis (IMU) and vasculitis of retinal vessels. In 82 % of patients, we were able during the follow-up period to stabilize the VA, or even to improve it. The systemic immunosuppressive treatment was necessary in 83 % of patients.

Summary:
The MS was the second most common systemic disease in uveitis patients. It is necessary to follow-up young patients with unclear etiology of IMU or vasculitis, because the systemic disease may develop even few years after the first sings of uveitis. The collaboration between the neurologist and the ophthalmologist is of a great importance.

Key words:
multiple sclerosis, demyelization, uveitis, vasculitis.