Triggering factors associated with a new episode of recurrent acute anterior uveitis

Abstract

To identify triggering factors for the next inflammatory episode of recurrent acute anterior uveitis (RAAU), a 1:1 case–control study was conducted. We interviewed RAAU patients with recent acute anterior uveitis attack and quiescent controls for their information during a previous month using Srithanya Stress Test (ST-5) and questionnaires about potential triggering factors. Asymptomatic controls were matched for age (± 5 years), sex, and HLA-B27. There were 39 pairs of cases and controls. Patients who recently experienced a uveitis attack demonstrated higher mean ST-5 scores (3.7 ± 2.9 vs 0.7 ± 1.1) and shorter sleep time (6.3 ± 1.4 vs 7.4 ± 0.7 h per day) compared with their controls. In the multivariate conditional logistic regression analysis, ST-5 score ≥ 3 (OR 9.07, 95% CI 1.14–72.16, p = 0.037) and sleep time < 7 h per day (OR 12.12, 95% CI 1.37–107.17, p = 0.025) were more likely to trigger a uveitis attack in RAAU accounted for patients’ age, sex, HLA- B27 positivity, and presence of concurrent anti-inflammatory drugs for co-existing diseases. Other suspected triggering factors were not found to have any significant association. In short, stress and inadequate sleep may lead to the future episode of acute anterior uveitis in RAAU. Both physical and emotional stress management should be advised to RAAU patients to minimize recurrences and further complications.

Sleep loss potentiates Th17‐cell pathogenicity and promotes autoimmune uveitis

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The HLA-G Immune Checkpoint Plays a Pivotal Role in the Regulation of Immune Response in Autoimmune Diseases

“…Ocular inflammation is a disease that is quite rare in the population (115-204 cases per 100,000 population) but poses a serious threat to vision loss. As reported in the literature, one of the etiopathological factors of the development of this disease are infections that can directly or indirectly (by activating innate immune processes against infection) cause tissue damage [166][167][168]. This type of disease is recognized by specialists as an infectious type of eye inflammation.…”

Drug delivery to the anterior segment of the eye: A review of current and future treatment strategies

“…When topical steroids do not control the inflammation, systemic immunotherapy is required, such as, high-dose prednisone (e.g., 1 mg/kg/day) (Thorne and Jabs, 2015). Repeated episodes of intraocular inflammation within the eye can lead to tissue damage as well as glaucoma, cataract, cystoid macula edema and irreversible loss of vision (Neti et al, 2021) (Martin et al, 2002).…”

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