SAT0541 Anterior Uveitis in Female Patients: Clinical and Evolutionary Features and Etiological Typification
Authors: L. Expόsito Pérez, P.R. Cabrera, V.L. Lόpez, M.J.L. Castillo, V.H. Hernández, M.G. González, M. Ά. G. Mora, B.R. Lozano
Journal: Annals of the Rheumatic Diseases (2015)

<h3>Background</h3> Acute anterior uveitis (AAU) is the most common type of uveitis and could be the leading sign for <i>de novo</i> diagnosis of spondyloarthropathies (SpA), the most frequent systemic diseases related to anterior uveitis (AU). The occurrence of AU often doesn9t parallel articular disease activity. There is a male predominance around 2-3:1 using MRI scans of the sacroiliac joints<sup>1</sup>, women are underdiagnosed. <h3>Objectives</h3> 1.Definition of clinical profile and etiological typification in female patients with AU referred to an Uveitis Unit in a tertiary hospital. 2.Describe the differences due to age at onset of ocular disease. 3.Study of clinical behaviour in women with AU with <i>de novo</i> diagnosis of SpA. <h3>Methods</h3> Observational cross-sectional descriptive study in women with complicated and relapsing AU referred to HUC from Jan 2005 to Dec 2014 for non-infectious systemic disease screening or established disease control. Etiological typification according to the ocular presentation and affectation pattern was made. Used criteria: EA NY, ASAS 2009, FIWOS 2010. Statistical analysis: Chi-square test. <h3>Results</h3> From 698 patients referred, 170 were female with a median age 50,7 years (±17,03) and a median follow-up of 9,05 years (±8). Ocular presentation in 7/170 women had a childhood-onset (&lt;16 years), in 24/170 women had an elderly-onset (≥65 years). Ocular pattern and diagnosis based on age at onset of ocular disease are shown in image 1. 14% patients (24/170) developed another inflammatory ocular affectation. 60,5% patients developed ocular complications. Related to diagnosis highlights macular edema associated with sarcoidosis (33,3%)(p&lt;0.025). Etiological typification: 12% of patients (21/170) had previous rheumatological diagnosis. Adult-onset (12%), elderly-onset (12%),against childhood-onset (43%):7 ankylosing spondylitis (AS)(4%) with median age at diagnosis 40,4 years,2 undifferentiated SpA (1,2%), others (1 multiple sclerosis, 1 ulcerative colitis)(1,2%). 16% of women had SpA as de novo diagnosis: 10 AS, 2 psoriatic SpA, 2 SAPHO syndrome, 2 enteropathic SpA (Crohn, Whipple), 5 non-radiographic SpA (3%). Half of the patients had AU as first sign of disease, after inflammatory lumbalgia in 16% of patients and concomitant begin in the remaining patients. Median age at diagnosis 48,5 years with mean time to develop AU of 9,6 years. <h3>Conclusions</h3> 1. 24,3% of patients were women who had AU. 14% had elderly-onset of ocular disease and 4% had childhood-onset. 2. Most frequent ocular patterns were RUAAU and UAAU, with predominance in adult and elderly onset groups, respectively. In childhood-onset group CAU was predominant. 60,5% of women developed ocular complications, highlighting synechiae and cataracts. 3.Etiological typification highlights idiopathic AU (28%) and AU secondary to SpA (18,4%) in women, is still relevant B27 associated UAAU in elderly-onset and JA in childhood-onset. 4. SpA was de novo diagnosed in 16% of women, with non-radiographic axial SpA in a 3%. AU was the leading sign in half of the patients. <h3>References</h3> Van der Horst BruinsmA IE et al. Female patients with ankylosing spondylitis:analysis of the impact of gender across treatment studies. Ann Rheum Dis 2013;72:1221-4. <h3>Disclosure of Interest</h3> None declared