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Anterior uveitis linked to reduced physical QoL, particularly with underlying SpA
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Anterior uveitis was associated with reduced physical quality of life, particularly in patients with underlying spondyloarthritis before diagnosis of this condition, according to findings.
esearchers developed and validated the Dublin Uveitis Evaluation tool (DUET), an algorithm designed to improve the efficiency of referrals between ophthalmologists and rheumatologists. The algorithm was developed and validated on 173 consecutive adult patients who presented to the eye casualty unit at Royal Victoria Eye and Ear Hospital in Dublin. Patients were presumed to have immune-mediated acute anterior uveitis (AU).
After examination, patients self-administered the SF-36 and completed a vision-related quality of life tool, the Vision Core Measure 1 (VCM1). These questionnaires were completed at the first examination at the research clinic (“baseline”) and upon the final examination prior to discharge (“resolution”).
Researchers found the mean of the VCM1 score of the patients at baseline was 1.06 ±1.02 and was 0.81 ±0.92 at resolution.
There was a significant improvement in VCM1 scores from active AU to AU resolution, with a standard response mean of 0.32, suggesting a small VCM1 score change in response to uveitis resolution. At baseline, 14.6% of patients had a VCM1 score of more than 2 (“more than a little” concern about vision) and 11% had a score of 2 or greater on resolution. No association was seen between VCM1 score and the visual acuity of the affected eye at baseline, but a weak correlation was observed between VCM1 score and the visual acuity of the affected eye at resolution.
An improvement was seen in all SF-36 scores on resolution of ocular inflammation. This improvement was significant for pain, social functioning, and energy and vitality scores, as well as the composite physical component summary (PCS) and mental component summary scores.
mparison of patients with newly diagnosed spondyloarthritis (SpA) vs. patients with idiopathic AU, researchers found patients with SpA had significantly worse physical function, role physical, pain and PCS during active AU. Although the SpA group continued to have lower SF-36 scores on resolution of AU, only physical function continued to be statistically lower at this point in the SpA group.
“AU affects physical aspects of quality of life more than is appreciated by clinical variables, especially in those with pre-existing, undiagnosed SpA,” the researchers wrote. “This study is unique in examining the effect of SpA on patients prior to diagnosis. These results highlight the role of the ophthalmologist in identifying patients with SpA who present with AU using the DUET algorithm.” -by Jennifer Byrne
Disclosures: The researchers report no relevant disclosures.
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