The Effect of Anterior Uveitis and Previously Undiagnosed Spondyloarthritis: Results from the DUET Cohort

Abstract

Objective.Anterior uveitis (AU) is an intraocular inflammatory condition closely linked to spondyloarthritis (SpA). Clinical disease variables may often underestimate the true effect of the disease on patient’s quality of life. This study examines AU and associated undiagnosed SpA using established quality-of-life tools to inform clinicians of the effect of these diseases.Methods.The Dublin Uveitis Evaluation Tool (DUET) algorithm was developed and validated in a cohort of consecutive patients with AU who were all screened by a rheumatologist for the presence of SpA. This same cohort completed vision-related [Vision Core Measure 1 (VCM1)] and general health [Medical Outcomes Study Short Form-36 (SF-36)] questionnaires when AU was active and resolved.Results.VCM1 scores improved with AU resolution. VCM1 did not correlate with vision at baseline, but did on resolution of inflammation. Physical SF-36 scores were reduced during AU episodes and improved on resolution remaining below those of population norms. Subanalysis revealed that SpA scores were more affected than the idiopathic AU group.Conclusion.AU affects physical aspects of quality of life more than is appreciated by clinical variables, especially in those with pre-existing, undiagnosed SpA. 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.