Ankylosing Spondylitis
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 ul...
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| Format: | Article |
| Language: | English |
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Knowledge E
2021-07-01
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| Series: | Journal of Ophthalmic & Vision Research |
| Subjects: | |
| Online Access: | https://doi.org/10.18502/jovr.v16i3.9440 |
| _version_ | 1811255628330434560 |
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| author | Nazanin Ebrahimiadib Sahar Berijani Mohammadreza Ghahari Fatemeh Golsoorat Pahlaviani |
| author_facet | Nazanin Ebrahimiadib Sahar Berijani Mohammadreza Ghahari Fatemeh Golsoorat Pahlaviani |
| author_sort | Nazanin Ebrahimiadib |
| collection | DOAJ |
| description | 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 non-granulomatous 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 under-treatment. |
| first_indexed | 2024-04-12T17:26:48Z |
| format | Article |
| id | doaj.art-e0adf1fe54e04b2185dc3a84f534f621 |
| institution | Directory Open Access Journal |
| issn | 2008-2010 2008-322X |
| language | English |
| last_indexed | 2024-04-12T17:26:48Z |
| publishDate | 2021-07-01 |
| publisher | Knowledge E |
| record_format | Article |
| series | Journal of Ophthalmic & Vision Research |
| spelling | doaj.art-e0adf1fe54e04b2185dc3a84f534f6212022-12-22T03:23:16ZengKnowledge EJournal of Ophthalmic & Vision Research2008-20102008-322X2021-07-0116346246910.18502/jovr.v16i3.9440jovr.v16i3.9440Ankylosing SpondylitisNazanin Ebrahimiadib0Sahar Berijani1Mohammadreza Ghahari2Fatemeh Golsoorat Pahlaviani3 Retina Service, Ocular Immunology and Uveitis Foundation, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran Retina Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran Retina Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran Retina Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, IranAbstract 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 non-granulomatous 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 under-treatment.https://doi.org/10.18502/jovr.v16i3.9440ankylosing spondylitisspondyloarthritisuveitis |
| spellingShingle | Nazanin Ebrahimiadib Sahar Berijani Mohammadreza Ghahari Fatemeh Golsoorat Pahlaviani Ankylosing Spondylitis Journal of Ophthalmic & Vision Research ankylosing spondylitis spondyloarthritis uveitis |
| title | Ankylosing Spondylitis |
| title_full | Ankylosing Spondylitis |
| title_fullStr | Ankylosing Spondylitis |
| title_full_unstemmed | Ankylosing Spondylitis |
| title_short | Ankylosing Spondylitis |
| title_sort | ankylosing spondylitis |
| topic | ankylosing spondylitis spondyloarthritis uveitis |
| url | https://doi.org/10.18502/jovr.v16i3.9440 |
| work_keys_str_mv | AT nazaninebrahimiadib ankylosingspondylitis AT saharberijani ankylosingspondylitis AT mohammadrezaghahari ankylosingspondylitis AT fatemehgolsooratpahlaviani ankylosingspondylitis |