Journal Article

AB0928 COMPARATIVE CHARACTERIZATION OF NON-INFECTIOUS OCULAR INFLAMMATORY PATHOLOGY IN SPONDYLOARTHRITIS

Hidalgo, V., Tornero, C., Schlinker, A., Miguélez, E., Molinari, M., Balsa, A., Peiteado, D.

2024

Overview

Background:Systemic diseases most frequently associated with uveitis are spondyloarthritis (SpA). Differences in the presentation of uveitis have been described in each type of SpA, however, this information is contradictory and scarce in the literature. The differentiation of these associated inflammatory processes has important therapeutic and prognostic implications and may condition the treatment of the underlying disease in Ophthalmology/Rheumatology Ocular Inflammation Interdisciplinary Units.Objectives:The aim of the study is to analyze the characteristics of non-infectious ocular inflammation in the different types of spondyloarthritis in a multidisciplinary ocular inflammation practice.Methods:Descriptive observational study including data from patients with a non-infectious inflammatory ocular process secondary to SpA evaluated in a multidisciplinary ocular inflammation consultation from January 2012 to January 2024. Demographic, ocular involvement, sequelae, and therapy data are comparatively analyzed. Quantitative variables were described as median and interquartile range (IQR) or mean and standard deviation (SD), and frequencies were used for the qualitative variables. Comparative analysis was performed using the IBM SPSS 21.0 program and the comparison of proportions using the chi-square test. P-values <0.05 were considered statistically significant.Results:From our “Inflammatory ocular process Registry” at La Paz University Hospital with a total of 564 patients included, we collected data from 147 patients with SpA (26%). Table 1 shows clinical characteristics in the global sample and in the different types of spondyloarthritis. In the comparative analysis, according to the type of spondyloarthritis, significant differences were found in the percentage of positive HLAB27 (p<0.01); being more frequent in ankylosing spondylitis (AS) and axial spondyloarthritis (AxSpA) than in the rest of the groups. The age of onset was significantly higher in AS and psoriatic arthritis (PsA) than in others (p<0.01). Regarding the ocular involvement, significant differences were found (p<0.01) in the pattern and course. Recurrent acute anterior uveitis (RAAU) pattern and the recurrent acute course were predominant in AS, axSpA and PsA. Bilateral acute anterior uveitis (BAAU) pattern and chronic forms were more frequent in peripheral spondyloarthritis (pSpA) and inflammatory bowel disease associated with spondyloarthritis (IbdSpA). Concerning the ophthalmological examination, significant differences (p<0.05) were found in the presence of keratic precipitates (more frequent in AS, axSpA and PsA), vitritis (higher proportion in PsA) and cataract (more frequent in AS, IbdSpA and PsA). No differences were found in sex, location/laterality of the uveitis (anterior and unilateral involvement are predominant in all cases), neither in complications such as visual impairment, synechiae, cystic macular edema, glaucoma, retinal vasculitis, epiretinian membrane or papilitis. Regarding therapy, there were significant differences (p<0.05) in the use of systemic corticosteroids; most commonly used in pSpA and PsA. The use of disease-modifying anti-rheumatic drugs (DMARDs) was also more frequent in pSpA and PsA without reaching statistical significance (p=0.056). There were no significant differences in the use of biological therapy.Conclusion:This study reveals differences in the inflammatory ocular involvement regarding the type of spondyloarthritis. Bilateral and chronic forms of uveitis were more frequently observed in IbdSpA o pSpA. Additionally, the use of systemic steroids and DMARDs was most common in pSpA and PsA.Table 1.REFERENCES:NIL.Acknowledgements:To the Ophthalmology/Rheumatology Ocular Inflammation Interdisciplinary Unit of La Paz University Hospital.Disclosure of Interests:None declared.

• Publisher: BMJ Publishing Group Ltd and European League Against Rheumatism,Elsevier B.V,Elsevier Limited
• Subject: Ankylosing spondylitis / biological DMARD / Cataracts / Comparative analysis / Complications / Corticosteroids / Disease / Disease-modifying Drugs (DMARDs) / Edema / Eye diseases / Glaucoma / Inflammation / Inflammatory bowel diseases / Inflammatory diseases / Information processing / Interdisciplinary aspects / Interdisciplinary research / Observational studies/registry / Ophthalmology / Patients / Psoriatic arthritis / PspA protein / Rheumatic diseases / Rheumatology / Scientific Abstracts / Statistical analysis / Steroid hormones / Uveitis / Vasculitis