Association of acute anterior uveitis with disease activity, functional ability and physical mobility in patients with ankylosing spondylitis: a cross-sectional study of Chinese patients in Taiwan

Abstract

Acute anterior uveitis (AAU) is the most frequently extra-articular manifestation of ankylosing spondylitis (AS). To investigate whether AAU has an association with disease activity, functional ability and physical mobility in AS patients, 146 Chinese AS patients in Taiwan were enrolled in a cross-sectional study. These patients fulfilled the 1984 modified New York criteria and visited the Outpatient Department of the Veterans General Hospital-Taipei from April 2004 to July 2005. Patients completed questionnaires assessing disease activity [Bath Ankylosing Spondylitis Disease Activity Index (BASDAI)], functional ability [Bath Ankylosing Spondylitis Functional Index (BASFI)] and patient's global assessment [Bath Ankylosing Spondylitis Patient Global Score (BAS-G)]. Meanwhile, physical examinations were performed, including Schober test, finger-to-floor, lateral spinal flexion, occiput-to-wall and chest expansion. The history of AAU was accepted only if diagnosed by an ophthalmologist. The prevalence of AAU in this Chinese AS cohort was 15.8% (23/146). Patients with AAU had a significantly higher BASDAI than those without [absolute differences=0.96, 95% confidence intervals (CI): 0.35-1.88]. Additionally, patients with AAU had significantly increased BASFI than those without (absolute differences=1.46, 95% CI: 0.33-2.59). Moreover, there was advanced limitation of physical motility in patients with AAU, including finger-to-floor, occiput-to-wall distances and Schober test, (95% CI: 3.89-16.95 and p=0.046, respectively). Disease duration mildly correlated with BASFI (r=0.24, p=0.003) but not with BASDAI (p=0.838). There was no difference of disease duration between patients with and without AAU (p=0.343). These results suggested that the presence of AAU in AS patients may be associated with higher disease activity, poor functional ability and advanced physical impairment.

Abnormalities in soluble CD147 / MMPs / TIMPs axis in Ankylosing Spondylitis patients with and without a history of Acute Anterior Uveitis / Anomalii ale axei CD147 solubil / MMPs / TIMPs la pacienții cu spondilită anchilozantă cu sau fără uveită acută anterioară

“…Consistent with the results of other groups of investigators (9,38,39,48), our data emphasize the existence of elevated values of BASDAI and BASFI in AAU AS patients suggesting that these patients develop a more aggressive disease than wAAU AS patients. For the first time, we identified MMP-2/sCD147 ratio as a new variable to better characterize AAU AS patients.…”

“…This idea was generated by the observation that AAU AS patients seem to have a more rapid evolution of the disease (9). The results of Chen et al, on 146 Chinese AS patients in Taiwan, suggested that the presence of AAU in AS patients is associated with higher disease activity (BASDAI), poor functional ability and advanced physical impairment (BASFI) (38). Recently, another group of investigators showed on 159 patients with AS a relationship between the history of uveitis and AS disease activity (BASDAI) (not statistically significant) and functional impairment (BAS-FI) (statistically significant) (39).…”

Prevalence of extra-articular manifestations in patients with ankylosing spondylitis: a systematic review and meta-analysis

“…A possible explanation could be that patients in trials were selected based on higher disease activity and that this may coincide with a higher prevalence of AAU. 24 Some limitations of the present study should be recognised. First, the prevalence of EAMs used in this review was usually not the main objective of the primary studies included, and therefore, not always indexed in the electronic article databases.…”

Demographic, clinical, laboratory and treatment characteristics of spondyloarthritis patients with and without acute anterior uveitis

“…Chen et al 13 found an association between AAU and BAS-DAI. In the present study, no significant relationship between higher disease activity in AAU and SpA could be demonstrated statistically although a trend was found (P = 0.06).…”