OCULAR INVOLVEMENT IN ANKYLOSING SPONDILITIS

Ankylosing spondylitis is a chronic inflammatory disease pertaining to the group commonly labeled spondylarthritides, a heterogeneous cluster of disorders characterized by enthesial and synovial involvement of both axial and peripheral skeleton. Inflammation in AS usually starts at the sacroiliac joints at early stages and may involve the axial skeleton at later stages of the disease. Extra-articular manifestations are not uncommon and patients with AS may also suffer from: acute anterior uveitis, conduction abnormalities and neurological complications due to fractures. This study aims to present prevalence of ocular involvement in a group of patients with AS. This is a retrospective study of the charts of 90 patients, diagnosed with AS based upon the modified New York diagnostic criteria. Trained rheumatologists diagnosed these patients by examining them physically; reviewing theirs x-rays in order to assess the presence of sacroiliac arthritis, bamboo spine and syndesmophytes. All relevant biochemical and immunological tests have been ordered and evaluated. Trained ophtalmologists examined unilateral eye pain and redness, photophobia and increased lachrymation and all other ocular symptoms. There were 79 (87%) men and 11 (12%) women in the group with a gender ratio 7.19. The mean age of patients was (34.35 ± 10.53) and disease duration (8.92 ±7.20). In total there were 12 cases with acute anterior uveitis (13.3%) in this group of patients. Ocular involvement is a common extra- articular involvement in patients with AS. Acute anterior uveitis typically presents with unilateral eye pain and redness, photophobia and increased lachrymation and the disorder tends to reoccur sometimes in the contra-lateral eye. Patients with AS should undergo routine ophthalmologic examinations because if the eye is left untreated or if treatment is delayed, posterior synechiae and glaucoma may develop.