Anterior uveitis in patients with spondyloarthropathies in a single US academic center: a retrospective study

Rheumatol Int. 2019 Sep;39(9):1607-1614. doi: 10.1007/s00296-019-04386-6. Epub 2019 Jul 24.


Uveitis may represent an opportunity to diagnose spondyloarthropathies (SpA) earlier and influence treatment decisions. We describe the percentage of acute anterior uveitis (AAU) in a diverse group of SpA patients seen at one academic setting and compare demographic and clinical characteristics according to the presence of uveitis. We conducted a retrospective study of patients with SpA and AAU (January 2016-June 2017). Patients were identified using ICD-10 and administrative claim codes, diagnoses were confirmed through chart review. Extracted data included demographics, laboratory, clinical data, treatment and Routine Assessment of Patient Index Data 3 (RAPID3) scores based on Multidimensional Health Assessment Questionnaire (MDHAQ). Baseline description and comparison between the two groups were performed. We included 190 patients, mostly men (59.5%), with a mean age of 45.9 years: 48% with ankylosing spondylitis (AS), 26% with psoriatic arthritis (PsA), 22% with undifferentiated SpA, and 4% with SpA associated with inflammatory bowel disease (IBD). Uveitis was identified in 17% of patients, ranging from 25% in AS to 4% in PsA. Time from symptom onset to SpA diagnosis was longer in patients with uveitis (10.9 versus 5.9 years, p < 0.001). A higher percentage of patients with uveitis were HLA-B27 positive (85% versus 67%, p = 0.02). The prevalence of uveitis in our population was 17%, slightly lower than previously reported in the literature. There was a diagnostic delay of about 7 years, significantly longer in patients with uveitis. New screening strategies in collaboration with ophthalmology may lead to earlier diagnosis and better outcomes.

Keywords: Ankylosing spondylitis; Anterior uveitis; Diagnosis delay; HLA-B27; Patient-reported outcomes; Spondyloarthropathies.

Publication types

  • Comparative Study

MeSH terms

  • Academic Medical Centers*
  • Adult
  • Chicago / epidemiology
  • Databases, Factual
  • Delayed Diagnosis
  • Electronic Health Records
  • Female
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prevalence
  • Prognosis
  • Retrospective Studies
  • Risk Factors
  • Spondylarthropathies / diagnosis*
  • Spondylarthropathies / epidemiology*
  • Spondylarthropathies / immunology
  • Spondylarthropathies / therapy
  • Time Factors
  • Uveitis, Anterior / diagnosis*
  • Uveitis, Anterior / epidemiology*
  • Uveitis, Anterior / immunology
  • Uveitis, Anterior / therapy