Uveitis associated with multiple sclerosis: complications and visual prognosis.

AIM

To determine the frequency, subtype, complications, treatment and visual prognosis of uveitis in patients with multiple sclerosis (MS).

METHODS

A total of 1702 MS patients' medical records were reviewed for a history of uveitis both with a neurologist and an ophthalmologist.

RESULTS

Nine patients (0.52%) with uveitis were detected. Eight of them were female, one was male. The mean age was 42.0±14.1y (range 22-66). Seven patients were relapsing remitting MS, two were secondary progressive MS. The mean duration of MS was 10.8±10.3y, and the mean duration of uveitis 10.3±9.9y. The onset of uveitis preceded that of MS (four patients) by a mean of 5.0±4.3y (range 1-11). MS diagnosed prior to the onset of uveitis (five patients) by an interval of 0.75-16y (mean 4.95±6.24y). There were 16 affected eyes of nine patients. The most common types of uveitis were panuveitis and intermediate uveitis. Uveitis was bilateral in most patients. The most common complications were cataract and glaucoma, and patients with such complications were surgically treated. The range of visual acuity of affected eyes was 20/800 to 20/22, with only six of 16 affected eyes better than 20/40. After treatment, the visual acuity of the affected eyes was better than 20/40 in 11 of 16 eyes.

CONCLUSION

Uveitis should be considered when assessing an MS patient with visual loss, as surgical interventions other than medical treatments may be needed to improve visual function. Complications could be seen more often when posterior segment is involved.