Anterior uveitis impacted physical QoL, particularly with underlying SpA

In patients with anterior uveitis, the impact on physical quality of life has been underestimated, particularly in patients with pre-existing, previously undiagnosed spondyloarthritis, according to recently published findings.
Researchers tested the Dublin Uveitis Evaluation Tool (DUET) algorithm, which was designed to improve and simplify referrals between ophthalmologists and rheumatologists, in patients with anterior uveitis (AU). They recruited 173 adults who presented to the eye casualty unit at Royal Victoria Eye and Ear Hospital in Dublin. Patients’ best-corrected visual acuity was assessed by the Snellen or LogMAR visual acuity (VA) charts and acquired from their eyeglass correction. Anterior chamber reaction according to the Standardization of Uveitis Nomenclature working group guidelines was assessed through slit lamp biomicroscopy of the anterior segment. HLA-B27 status was determined in all patients, and additional diagnostic testing was conducted if clinically warranted. Baseline examination was defined as the patient’s first exam in the research clinic, while the resolution assessment was the patient’s final assessment prior to discharge.
All patients were independently examined for rheumatological factors, with radiographs taken as needed. SpA was diagnosed according to the assessment of Spondyloarthritis International Society classification criteria and the classification for psoriatic arthritis criteria.
Patients completed two health-related quality of life (HRQoL) questionnaires: the SF-36 and the Vision Core Measure 1 (VCM1).
Researchers found the mean baseline VCM1 score was 1.06 and the mean VCM1 score at resolution was 0.81. The VCM1 scores showed significant improvement from active AU to AU resolution with effect size of VCM1 being 0.26 in active AU to 0.32 upon resolution.
Overall, patients with AU maintained good VA. The mean LogMAR VA of the affected eye at baseline was 0.18 and 0.06 at resolution, which showed significant improvement.
Investigators found that at baseline 14.6% of patients had a VCM1 score of more than 2, which indicated “more than a little” concern about vision; while at resolution, 11% had a VCM1 score of more than 2. No association between VCM1 score and that affected eye VA was seen at baseline, while a weak correlation was observed between affected eye VA and VCM1 score at resolution.
In 41% of patients, rheumatology assessment revealed a new diagnosis of SpA. A subgroup analysis compared SF-36 scores in those with a new SpA diagnosis vs. those with idiopathic uveitis. Among patients with SpA (n=71), questionnaires completed during active AU demonstrated decreased scores for physical function, role physical, social function and pain.
In SF-36 scores completed on resolution of AU, all of these scores remained decreased except for the pain score, which improved between the active phase of AU and resolution.
The early diagnosis and treatment of SpA has consistently been shown to improve short- and long-term outcomes,” the researchers wrote. “It is imperative that efforts are made to expedite its diagnosis. The results of our study are unique in identifying reduced quality of life scores in patients with underlying SpA prior to diagnosis.”

Disclosures: The researchers report no relevant disclosures.