Uveitis in spondyloarthritis including psoriatic arthritis, ankylosing spondylitis, and inflammatory bowel disease


Uveitis is a common complication of spondyloarthritis. The “phenotype” of the uveitis characteristic of ankylosing spondylitis (sudden onset, anterior, unilateral, recurrent, more often male) may differ from the phenotype often seen with either psoriatic arthritis or inflammatory bowel disease (insidious onset, anterior and intermediate, bilateral, chronic, and/or more often female). The frequency of uveitis is also much greater in association with ankylosing spondylitis than with either inflammatory bowel disease or psoriasis. Uveitis may affect the choice of therapy and can rarely be a complication of therapy. Uveitis and arthritis also co-exist in several animal models.

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  1. 1.

    Rosenbaum J, Chandran V (2012) Management of comorbidities in ankylosing spondylitis. Am J Med Sci 343(5):364–366

    Article  PubMed  Google Scholar 

  2. 2.

    Paiva ES, Macaluso DC, Edwards A, Rosenbaum JT (2000) Characterisation of uveitis in patients with psoriatic arthritis. Ann Rheum Dis 59(1):67–70

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  3. 3.

    Lyons JL, Rosenbaum JT (1997) Uveitis associated with inflammatory bowel disease compared with uveitis associated with spondyloarthropathy. Arch Ophthalmol 115:61–64

    Article  CAS  PubMed  Google Scholar 

  4. 4.

    Jabs DA, Nussenblatt RB, Rosenbaum JT (2005) Standardization of uveitis nomenclature for reporting clinical data. Results of the First International Workshop. Am J Ophthalmol 140(3):509–516

    Article  PubMed  Google Scholar 

  5. 5.

    Rosenbaum JT (1989) Characterization of uveitis associated with spondyloarthritis. J Rheumatol 16(6):792–796

    CAS  PubMed  Google Scholar 

  6. 6.

    Sampaio-Barros PD, Conde RA, Bonfiglioli R, Bertolo MB, Samara AM (2006) Characterization and outcome of uveitis in 350 patients with spondyloarthropathies. Rheumatol Int 26(12):1143–1146

    Article  PubMed  Google Scholar 

  7. 7.

    D'Alessandro LP, Forster DJ, Rao NA (1991) Anterior uveitis and hypopyon. Am J Ophthalmol 112:317–321

    Article  PubMed  Google Scholar 

  8. 8.

    Zeboulon N, Dougados M, Gossec L (2008) Prevalence and characteristics of uveitis in the spondyloarthropathies: a systematic literature review. Ann Rheum Dis 67(7):955–959

    Article  CAS  PubMed  Google Scholar 

  9. 9.

    Wright R, Lumsden K, Luntz MH, Sevel D, Truelove SC (1965) Abnormalities of the sacro-iliac joints and uveitis in ulcerative colitis. Q J Med 34:229–236

    CAS  PubMed  Google Scholar 

  10. 10.

    Greenstein AJ, Janowitz HD, Sachar DB (1976) The extra-intestinal complications of Crohn's disease and ulcerative colitis: a study of 700 patients. Medicine (Baltimore) 55(5):401–412

    Article  CAS  Google Scholar 

  11. 11.

    Yilmaz S, Aydemir E, Maden A, Unsal B (2007) The prevalence of ocular involvement in patients with inflammatory bowel disease. Int J Colorectal Dis 22(9):1027–1030

    Article  PubMed  Google Scholar 

  12. 12.

    Lanna CC, Ferrari Mde L, Rocha SL, Nascimento E, de Carvalho MA, da Cunha AS (2008) A cross-sectional study of 130 Brazilian patients with Crohn's disease and ulcerative colitis: analysis of articular and ophthalmologic manifestations. Clin Rheumatol 27(4):503–509

    Article  PubMed  Google Scholar 

  13. 13.

    Felekis T, Katsanos K, Kitsanou M et al (2009) Spectrum and frequency of ophthalmologic manifestations in patients with inflammatory bowel disease: a prospective single-center study. Inflamm Bowel Dis 15(1):29–34

    Article  PubMed  Google Scholar 

  14. 14.

    Niccoli L, Nannini C, Cassara E et al (2012) Frequency of iridocyclitis in patients with early psoriatic arthritis: a prospective, follow up study. Int J Rheum Dis 15(4):414–418

    Article  PubMed  Google Scholar 

  15. 15.

    Lambert JR, Wright V (1976) Eye inflammation in psoriatic arthritis. Ann Rheum Dis 35:354–356

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  16. 16.

    Robinson PC, Claushuis TA, Cortes A et al (2015) Genetic dissection of acute anterior uveitis reveals similarities and differences in associations observed with ankylosing spondylitis. Arthritis Rheum 67(1):140–151

    Article  CAS  Google Scholar 

  17. 17.

    Martin TM, Zhang G, Luo J et al (2005) A locus on chromosome 9p predisposes to a specific disease manifestation, acute anterior uveitis, in ankylosing spondylitis, a genetically complex, multisystem, inflammatory disease. Arthritis Rheum 52(1):269–274

    Article  CAS  PubMed  Google Scholar 

  18. 18.

    Braun J, Baraliakos X, Listing J, Sieper J (2005) Decreased incidence of anterior uveitis in patients with ankylosing spondylitis treated with the anti-tumor necrosis factor agents infliximab and etanercept. Arthritis Rheum 52(8):2447–2451

    Article  CAS  PubMed  Google Scholar 

  19. 19.

    Wendling D, Paccou J, Berthelot JM et al (2011) New onset of uveitis during anti-tumor necrosis factor treatment for rheumatic diseases. Semin Arthritis Rheum 41(3):503–510

    Article  PubMed  Google Scholar 

  20. 20.

    Rudwaleit M, Rodevand E, Holck P et al (2009) Adalimumab effectively reduces the rate of anterior uveitis flares in patients with active ankylosing spondylitis: results of a prospective open-label study. Ann Rheum Dis 68(5):696–701

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  21. 21.

    Galor A, Perez V, Hammel J, Lowder C (2006) Differential effectiveness of etanercept and infliximab in the treatment of ocular inflammation. Ophthalmology 113(12):2137–2323

    Article  Google Scholar 

  22. 22.

    Munoz-Fernandez S, Hidalgo V, Fernandez-Melon J et al (2003) Sulfasalazine reduces the number of flares of acute anterior uveitis over a one-year period. J Rheumatol 30(6):1277–1279

    CAS  PubMed  Google Scholar 

  23. 23.

    Dougados M, Berenbaum F, Maetzel A, Amor B (1993) Prevention of acute anterior uveitis associated with spondyloarthropathy induced by salazosulfapyridine. Rev Rhum 60:81–83

    CAS  Google Scholar 

  24. 24.

    Munoz-Fernandez S, Garcia-Aparicio AM, Hidalgo MV et al (2009) Methotrexate: an option for preventing the recurrence of acute anterior uveitis. Eye (Lond) 23(5):1130–1133

    Article  CAS  Google Scholar 

  25. 25.

    Levinson RD, Rosenbaum JT (2010) Nonsteroidal anti-inflammatory drugs for prophylaxis of acute anterior uveitis. Ocul Immunol Inflamm 18(2):69–71

    Article  PubMed  Google Scholar 

  26. 26.

    Lim LL, Fraunfelder FW, Rosenbaum JT (2007) Do tumor necrosis factor inhibitors cause uveitis? A registry-based study. Arthritis Rheum 56(10):3248–3252

    Article  CAS  PubMed  Google Scholar 

  27. 27.

    Kezic JM, Glant TT, Rosenbaum JT, Rosenzweig HL (2012) Neutralization of IL-17 ameliorates uveitis but damages photoreceptors in a murine model of spondyloarthritis. Arthritis Res Ther 14(1):R18

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  28. 28.

    Kezic JM, Davey MP, Glant TT, Rosenbaum JT, Rosenzweig HL (2012) Interferon-gamma regulates discordant mechanisms of uveitis versus joint and axial disease in a murine model resembling spondylarthritis. Arthritis Rheum 64(3):762–771

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  29. 29.

    Petty RE, Johnston W, McCormick AQ, Hunt DWC, Rootman J, Rollins DF (1989) Uveitis and arthritis induced by adjuvant: clinical, immunologic and histologic characteristics. J Rheumatol 16:499–505

    CAS  PubMed  Google Scholar 

  30. 30.

    Ruutu M, Thomas G, Steck R et al (2012) Beta-glucan triggers spondylarthritis and Crohn's disease-like ileitis in SKG mice. Arthritis Rheum 64(7):2211–2222

    Article  CAS  PubMed  Google Scholar 

  31. 31.

    Baggia S, Lyons J, Angell E et al (1997) A novel model of bacterially-induced acute anterior uveitis in rats and the lack of effect from HLA B27 expression. J Investig Med 45:295–301

    CAS  PubMed  Google Scholar 

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The author has consulted for Abbvie, UCB, Allergan, EMD Serono, Novartis, Regeneron, Xoma, Santen, Genentech, and Sanofi.

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Correspondence to James T. Rosenbaum.

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Rosenbaum, J.T. Uveitis in spondyloarthritis including psoriatic arthritis, ankylosing spondylitis, and inflammatory bowel disease. Clin Rheumatol 34, 999–1002 (2015). https://doi.org/10.1007/s10067-015-2960-8

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  • Ankylosing spondylitis
  • Crohn’s disease
  • HLA B27
  • Iritis
  • Psoriatic arthritis
  • Ulcerative colitis
  • Uveitis