To describe the clinical findings and outcomes in patients who presented with uveitis associated with multiple sclerosis.
Methods:
Retrospective review of 20 patients (38 eyes).
Results:
The most frequent ocular finding was multifocal elongated retinal perivenous “sheathing” with focal vascular leakage on fundus fluorescein angiography in 29 eyes followed by vitreous snowballs and debris in 26 eyes, anterior chamber inflammation in 15 eyes, mutton-fat keratic precipitates in 14 eyes, posterior synechiae in 13 eyes, cystoid macular edema in 9 eyes, iris nodules in 4 eyes, and optic neuritis in 3 eyes. Patients with cystoid macular edema were treated successfully with systemic corticosteroids combined with mycophenolate mofetil. Ocular complications were cataract in 6 eyes, glaucoma in 2 eyes and vitreous hemorrhage in 1 eye.
Conclusions:
Multifocal elongated retinal perivenous “sheathing” with focal vascular leakage on fundus fluorescein angiography is the most frequent finding in uveitis associated with multiple sclerosis.
GordonLKGoldsteinDA.Gender and uveitis in patients with multiple sclerosis. J Ophthalmol2014; 2014: 565262.
2.
ForooghianF.Uveitis and the diagnosis of multiple sclerosis. Can J Neurol Sci2017; 44(3): 334–335.
3.
GilHFery-BlancoCSchwartzC, et al. Contribution of cerebral magnetic resonance imaging to etiological investigation of uveitis. Rev Med Interne2014; 35: 790–793.
4.
PetrushkinHKiddDPavesioC.Intermediate uveitis and Multiple Sclerosis: to scan or not to scan. Br J Ophthalmol2015; 99: 1591–1593.
5.
OlsenTGFrederiksenJ.The association between multiple sclerosis and uveitis. Surv Ophthalmol2017; 62: 89–95.
BarnesDMcDonaldWI. The ocular manifestations of multiple sclerosis. 2. Abnormalities of eye movements. J Neurol Neurosurg Psychiatry1992; 55: 863–868.
8.
TiliketeCJasseLVukusicS, et al. Persistent ocular motor manifestations and related visual consequences in multiple sclerosis. Ann N Y Acad Sci2011; 1233: 327–334.
9.
BiousseVTrichetCBloch-MichelE, et al. Multiple sclerosis associated with uveitis in two large clinic-based series. Neurology1999; 52: 179–181.
10.
SmithJRRosenbaumJT.Neurological concomitants of uveitis. Br J Ophthalmol2004; 88: 1498–1499.
11.
AlBloushiAFAlfawazAMAl-DahmashSA, et al. Incidence, risk factors and surgical outcomes of cataract among patients with uveitis in a University Referral Hospital in Riyadh, Saudi Arabia. Ocul Immunol Inflamm2019; 27: 1105–1113.
12.
Bloch-MichelENussenblattRB.International uveitis study group recommendations for the evaluation of intraocular inflammatory disease. Am J Ophthalmol1987; 103: 234–235.
13.
MalinowskiSMPulidoJSFolkJC.Long-term visual outcome and complications associated with pars planitis. Ophthalmology1993; 100: 818–824.
14.
MarrieRACutterGTyryT.Substantial adverse association of visual and vascular comorbidities on visual disability in multiple sclerosis. Mult Scler2011; 17: 1464–1471.
15.
CaponeAAabergTM.Intermediate uveitis. In: AlbertDMJakobiecFA (eds) Principles and practice of ophthalmology. Philadelphia, PA: WB Saunders, 1994, pp. 423–442.
16.
JabsDANussenblattRBRosenbaumJT.Standardization of Uveitis Nomenclature (SUN) Working Group. Standardization of uveitis nomenclature for reporting clinical data. Results of the first international workshop. Am J Ophthalmol2005; 140: 509–516.
17.
PolmanCHReingoldSCBanwellB, et al. Diagnostic criteria for multiple sclerosis: 2010 revisions to the McDonald criteria. Ann Neurol2011; 69: 292–302.
18.
MessengerWHildebrandtLMackensenF, et al. Characterisation of uveitis in association with multiple sclerosis. Br J Ophthalmol2015; 99: 205–209.
ShugaivETüzünEKürtüncüM, et al. Uveitis as a prognostic factor in multiple sclerosis. Mult Scler2015; 21: 105–107.
21.
HedayatfarAFalavarjaniKGSoheilianM, et al. Mycophenolate mofetil for the treatment of multiple sclerosis-associated uveitis. Ocul Immunol Inflamm2017; 25: 308–314.
22.
JouveLBenrabahRHéronE, et al. Multiple sclerosis-related uveitis: does MS treatment affect uveitis course. Ocul Immunol Inflamm2017; 25: 302–307.
23.
RuckerCW.Sheathing of the retinal veins in multiple sclerosis: review of pertinent literature. Mayo Clin Proc1972; 47: 335–340.
24.
PrineasJWWrightRG.Macrophages, lymphocytes, and plasma cells in the perivascular compartment in chronic multiple sclerosis. Lab Invest1978; 38: 409–421.
25.
HadjadjJDechartresAChapronT, et al. Relevance of diagnostic investigations in patients with uveitis: retrospective cohort study on 300 patients. Autoimmun Rev2017; 16: 504–511.
26.
ZierhutMFosterCS.Multiple sclerosis, sarcoidosis and other diseases in patients with pars planitis. Dev Ophthalmol1992; 23: 41–47.
27.
BregerBCLeopoldIH.The incidence of uveitis in multiple sclerosis. Am J Ophthalmol1966; 62: 540–545.
28.
PorterR.Uveitis in association with multiple sclerosis. Br J Ophthalmol1972; 56: 478–481.
29.
BachmanDMRosenthalARBeckingsaleAB.Granulomatous uveitis in neurological disease. Br J Ophthalmol1985; 69: 192–196.
30.
LimJITesslerHHGoodwinJA.Anterior granulomatous uveitis in patients with multiple sclerosis. Ophthalmology1991; 98: 142–145.
31.
SaitoWKatokeSSasamotoY, et al. A case of granulomatous panuveitis associated with multiple sclerosis. Nippon Ganka Gakkai Zasshi2002; 106: 99–102.
32.
KayaDKayaMÖzakbaşS, et al. Uveitis associated with multiple sclerosis: complications and visual prognosis. Int J Ophthalmol2014; 7: 1010–1013.
