Study examines link between MS and uveitis

The findings of a new study will enable clinicians to make more accurate diagnoses of multiple sclerosis (MS) and uveitis while giving people a better understanding of their prognoses, according to its authors.

"Knowing more about the onset [of MS] may enable patients to seek treatment earlier, therefore slowing the progression of the disease and limiting the damage done to the nervous system," said lead researcher Dr Wyatt Messenger. The results of the study were presented at this year's American Academy of Ophthalmology annual meeting.

Almost 60% of people who have both MS and uveitis receive the diagnoses within five years of one another, according to the results of the study, the largest retrospective study of those with MS who have uveitis. It is well established in the medical community that uveitis can be a sign of MS, and it is estimated that 1% to 10% of people with MS have uveitis. This study, however, is the first to provide a detailed description of the relative onset of uveitis and MS and to calculate the likelihood of an MS diagnosis among people with uveitis, according to researchers.

Dr Messenger and other investigators from the Casey Eye Institute at the Oregon Health and Science University as well as investigators from the University of Heidelberg, Germany, conducted a database search of approximately 3,000 patients with uveitis from the Casey Eye Institute and 5,319 patients from the University of Heidelberg between 1985 and 2013. Of these, 24 patients from the Casey Eye Institute and 89 patients from the University of Heidelberg fulfilled the inclusion criteria of diagnoses for both uveitis and MS and were included in the study.

Among their findings:

• Based on the prevalence of MS in American and European populations, MS is 18 times and 21 times more likely in an American and European population with uveitis, respectively, relative to the general population.
• MS was diagnosed before uveitis in 29% of patients, simultaneously in 15% of patients, and after uveitis diagnosis in 54% of patients.
• Traditionally, patients with MS are said to present with intermediate uveitis (pars planitis). Although 80% of people in this study had intermediate uveitis at the time of their MS diagnosis, nearly 1 in 6 of participants presented with anterior uveitis.
• Visual acuity is generally stable in this population. Most patients improved during follow-up.