Clinical findings and outcomes of uveitis associated with multiple sclerosis

AlBloushi, Abdulrahman F; Dheyab, Abdulsalam M; Alswaina, Nayef Fahad; Al-Obailan, Majed; Daif, Abdulkader; El‐Asrar, Ahmed M. Abu

doi:10.1177/1120672120904667

Cited by 14 publications

(6 citation statements)

References 29 publications

(43 reference statements)

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“…All of the former patients had presented with intermediate uveitis along with a range of signs, including anterior uveitis, posterior uveitis, and vasculitis. These findings correlate with the reports in the literature that the most common type of uveitis in MS is intermediate uveitis that primarily involves the vitreous, peripheral retina, and pars plana [ 8 , 10 , 11 ]. The ocular inflammation may develop concurrently, prior to, or after the development of the neurological signs and symptoms, but none of the earlier studies had identified any major difference in the clinical features of MS patients with and without uveitis [ 12 ].…”

Section: Discussionsupporting

confidence: 90%

Uveitis prior to clinical presentation of Multiple Sclerosis (MS) is associated with better MS prognosis

et al. 2022

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Objective An association between uveitis and multiple sclerosis (MS) is well-established, but the actual nature of that association remains poorly understood. We sought to determine the association between the presence of a uveitis diagnosis prior to an MS diagnosis compared to no pre-existing uveitis diagnosis in MS patients. Methods Patients in whom the presentation of uveitis preceded the presentation of MS (study group) and patients with MS and no uveitis (control group) were randomly selected at a ratio of 1:3 from the Sheba Multiple Sclerosis Center computerized database. Results Eleven patients presented with uveitis prior to MS diagnosis (study group), and 31 randomly selected patients had MS without uveitis (control group). Only one patient in the study group deteriorated to EDSS 3 during the follow-up period, compared to 15 patients in the control group (9.1% vs 48.4%, P = 0.049). None of the patients in the study group reached EDSS 6 during the 10 years of follow-up compared to 6 (19.4%) patients in the control group (P = 0.194). Conclusions MS patients who presented with uveitis that preceded their neurological symptoms of MS demonstrated a clinically significant better neurological prognosis, than our MS patients with no uveitis.

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Section: Discussionsupporting

confidence: 90%

Uveitis prior to clinical presentation of Multiple Sclerosis (MS) is associated with better MS prognosis

et al. 2022

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“…Patients with SS experience BRAO, which is not a characteristic feature of MS; thus, this is a differentiating symptom which should be sought for in FA when the diagnosis of SS is suspected, even in patients without visual symptoms, or when the examination of the fundus of the eye seems normal [2,12]. In the case of uveitis during MS, the change most frequently observed in FA is multifocal elongated retinal perivenous 'sheathing' with focal vascular leakage [62]. AWH at the site of BRAO is non-specific for SS, and should also be an incentive for the consideration of the presence of other factors responsible for the development of vessel inflammation.…”

Section: Ss or Ms-differentiationmentioning

confidence: 99%

Susac’s syndrome – the crucial role of imaging tests for proper diagnosis

Roskal-Wałek¹,

Mackiewicz²,

Wypchło³

et al. 2022

Ann Agric Environ Med.

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Introduction. Susac's syndrome (SS) is a rare, autoimmune-mediated endoteliopathy characterized by a clinical triad of encephalopathy, branch retinal artery occlusion, and sensorineural hearing loss. SS is also characterized by a neuroimaging triad consisting of white matter lesions, grey matter lesions, and leptomeningeal enhancement on magnetic resonance imaging (MRI). Considering the rarity of SS, as well as certain similarity to other, more frequent neurological diseases, such as multiple sclerosis (MS), this syndrome is sometimes incorrectly diagnosed and treated.Objective. The aim of the study is to present the current state of knowledge on SS, with particular consideration for the differential diagnostics between SS and MS, using the latest available imaging techniques, such as brain MRI, optical coherence tomography (OCT), OCT angiography (OCTA) and fluorescein angiography (FA). Review methods. The major electronic databases (PubMed, Google Scholar) were searched manually in order to identify the relevant studies published on SS. Brief description of the state of knowledge. Distinguishing SS from MS is a diagnostic challenge. In the majority of cases, patients with SS do not present the complete clinical or neuroimaging triad, and a delay in making the correct diagnosis exposes the patient to the occurrence of complications, resulting from the development of the underlying disease, or/and the application of improper treatment. In the case of SS the results of brain MRI and FA are essential for making the correct diagnosis as they may reveal pathognomonic changes. Sumary. Imaging examinations, such as brain MRI, FA, and OCT complement each other, due to which the diagnosis of SS may be simpler, irrespective of the stage of the disease.

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“…1 ). Enhanced-depth imaging OCT (OCT-EDI) better visualises choroidal structures, [ 18 ] and changes in choroidal thickness can relate to posterior uveitis [ 19 , 20 ]. OCT angiography (OCT-A), non-invasively images perfused retinal and choroidal vessels of the central macula [ 21 , 22 ].…”

Section: Introductionmentioning

confidence: 99%

A systematic review of OCT and OCT angiography in retinal vasculitis

Dhirachaikulpanich

Chanthongdee

Zheng

et al. 2023

J Ophthal Inflamm Infect

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Background Retinal vasculitis is a component of uveitis for which the Standardisation of Uveitis Nomenclature (SUN) working group has no standard diagnostic criteria or severity grading. Fluorescein angiography is the gold standard test to assess retinal vasculitis, but is invasive and time-consuming. Optical coherence tomography (OCT) provides non-invasive detailed imaging of retinal structures and abnormalities, including blood vessel architecture and flow with OCT angiography (OCT-A). However, use of OCT in retinal vasculitis beyond assessing macular oedema, is not well established. We conducted a systematic review to understand the features of retinal vasculitis in OCT, Enhanced-depth imaging OCT (OCT-EDI) and OCT-A imaging. Methods The systematic search was done in March 2022 and updated in January 2023, through PubMed, EMBASE and the Web of Science database for studies related to OCT, OCT-EDI and OCT-A findings and retinal vasculitis. Bias assessment was assessed using JBI Critical Appraisal Checklist, and any findings associated with retinal vasculitis were extracted by qualitative analysis. Results We identified 20 studies, including 8 articles on OCT, 6 on OCT-EDI and 6 on OCT-A. The studies included analytical retrospective studies, case-series, and a case–control study. Five OCT studies reported secondary complications could be detected, and four reported retinal thickness alteration in retinal vasculitis. Five studies explored choroidal thickness alteration in OCT-EDI, and four explored capillary density alterations in retinal vasculitis using OCT-A. The heterogeneity in the studies’ analysis and design precluded a meta-analysis. Discussion There were no clear OCT, OCT-EDI or OCT-A findings that demonstrated potential to supersede fluorescein angiography for assessing retinal vasculitis. Some signs of macular structural effects secondary to retinal vasculitis may help prognostication for vision. The OCT signs of inflamed retinal vessels and perivascular tissue is an unexplored area.

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Clinical findings and outcomes of uveitis associated with multiple sclerosis

Cited by 14 publications

References 29 publications

Uveitis prior to clinical presentation of Multiple Sclerosis (MS) is associated with better MS prognosis

Uveitis prior to clinical presentation of Multiple Sclerosis (MS) is associated with better MS prognosis

Susac’s syndrome – the crucial role of imaging tests for proper diagnosis

A systematic review of OCT and OCT angiography in retinal vasculitis

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