Objective: To check the ability of microperimetry to detect early retinal damage in rheumatic patients taking hydroxychloroquine (HCQ) and/or chloroquine (CQ). To describe the microperimetric alterations attributable to these drugs and their correlation with some clinical variables. Results: Significant differences in microperimetry indexes were detected between cases and controls, between patients of different age groups, and between patients taking CQ and HCQ. Significant differences were also detected in retinal sensitivity between patients overdosed for CQ but not for those overdosed for HCQ. Daily overdosing per ideal weight alone cannot explain retinal toxicity, although the effect of cumulative dose in macular sensibility is significant to explain both AT and MI. Conclusions:Microperimetry is an accurate tool for detecting early macular hyposensibility caused by CQ and HCQ. Microperimetry indexes of retinal sensibility are worse in elderly patients taking these drugs, and in 2 short stature patients taking CQ. A high cumulative dose is an important factor in explaining retinal hyposensibility on microperimetry.3

To develop a disease activity index for patients with uveitis (UVEDAI) encompassing the relevant domains of disease activity considered important among experts in this field. The steps for designing UVEDAI were: (a) Defining the construct and establishing the domains through a formal judgment of experts, (b) A two-round Delphi study with a panel of 15 experts to determine the relevant items, (c) Selection of items: A logistic regression model was developed that set ocular inflammatory activity as the dependent variable. The construct “uveitis inflammatory activity” was defined as any intraocular inflammation that included external structures (cornea) in addition to uvea. Seven domains and 15 items were identified: best-corrected visual acuity, inflammation of the anterior chamber (anterior chamber cells, hypopyon, the presence of fibrin, active posterior keratic precipitates and iris nodules), intraocular pressure, inflammation of the vitreous cavity (vitreous haze, snowballs and snowbanks), central macular edema, inflammation of the posterior pole (the presence and number of choroidal/retinal lesions, vascular inflammation and papillitis), and global assessment from both (patient and physician). From all the variables studied in the multivariate model, anterior chamber cell grade, vitreous haze, central macular edema, inflammatory vessel sheathing, papillitis, choroidal/retinal lesions and patient evaluation were included in UVEDAI. UVEDAI is an index designed to assess the global ocular inflammatory activity in patients with uveitis. It might prove worthwhile to motorize the activity of this extraarticular manifestation of some rheumatic diseases.Electronic supplementary materialThe online version of this article (doi:10.1007/s00296-016-3593-1) contains supplementary material, which is available to authorized users.

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ObjectivesTo evaluate effectiveness and safety of certolizumab pegol (CZP) in uveitis due to immune-mediated inflammatory diseases (IMID).MethodsMulticentre study of CZP-treated patients with IMID uveitis refractory to conventional immunosuppressant. Effectiveness was assessed through the following ocular parameters: best-corrected visual acuity, anterior chamber cells, vitritis, macular thickness and retinal vasculitis. These variables were compared between the baseline, and first week, first, third, sixth months, first and second year.ResultsWe studied 80 (33 men/47 women) patients (111 affected eyes) with a mean age of 41.6±11.7 years. The IMID included were: spondyloarthritis (n=43), Behçet’s disease (n=10), psoriatic arthritis (n=8), Crohn’s disease (n=4), sarcoidosis (n=2), juvenile idiopathic arthritis (n=1), reactive arthritis (n=1), rheumatoid arthritis (n=1), relapsing polychondritis (n=1),ConclusionsCZP seems to be effective and safe in uveitis related to different IMID, even in patients refractory to previous biological drugs.

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