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Purpose: To report clinical profiles of multiple sclerosis (MS)-associated uveitis in seven cases from a single tertiary eye care center in South India.
Methods: Retrospective case series 2013-2023.
Results: Seven cases of MS-associated uveitis were retrieved from our databases. There were five females and two males. The diagnosis of MS was made by the neurologist in all cases. Bilaterality was seen in all cases. Intermediate uveitis was the most common presentation (five cases). It was associated with peripheral retinal vasculitis (two cases) and disc pallor (two cases). Fuchs heterochromic iridocyclitis (one case) and incomplete Vogt-Koyanagi-Harada (VKH)-like presentation with a peripapillary choroidal neovascular membrane (one case) were the other presentations. In the case with incomplete VKH-like presentation, whole genome sequencing revealed a heterozygous non-synonymous variation (c.1228C>T) in exon 10 of TNFRSF1A, suggestive of susceptibility to multiple sclerosis 5 due to mutation in the TNFRS1A gene on chromosome 12p13.31. All cases received systemic steroids. Azathioprine (three cases) and rituximab (three cases) were the commonly used immunomodulatory drugs. The visual outcome was good in all cases at the last follow-up.
Conclusion: MS-associated uveitis is underreported in India. This series highlights the clinical profile of MS-associated uveitis in India.
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http://dx.doi.org/10.4103/IJO.IJO_1724_23 | DOI Listing |
Ocul Immunol Inflamm
May 2025
Ophthalmology, Guy's and St Thomas' NHS Foundation Trust, London, UK.
Multiple sclerosis (MS)-associated uveitis is characterised most frequently by bilateral intermediate uveitis with peripheral vascular leakage or panuveitis. The interesting association between these autoimmune diseases, which develop in two immune-privileged sites, places some undifferentiated uveitis patients at heightened risk of demyelination and clinical MS precipitation from the use of licensed anti-tumour necrosis factor α (TNFα) biologic therapy. However, their association may also open novel treatment avenues, considering the rapidly expanding arsenal of highly effective MS disease-modifying therapies.
View Article and Find Full Text PDFMult Scler J Exp Transl Clin
December 2024
Department of Neurosciences, Concord Repatriation General Hospital, Sydney, Australia.
Intermediate uveitis (IU) may be associated with multiple sclerosis (MS), with both conditions possibly sharing pathogenic mechanisms Two patients presented with bilateral IU. Despite targeted uveitis treatment with corticosteroids and methotrexate, both had ongoing disease activity with symptoms, and fluorescein angiographic abnormalities. Both were subsequently identified to have radiologically isolated MS in the absence of clinical demyelination.
View Article and Find Full Text PDFJ Ophthalmic Inflamm Infect
May 2024
Ophthalmology Department, Ocular Immunology and Uveitis Foundation, Waltham, MA, USA.
Background: To report a case of Pediatric-onset MS associated uveitis managed with local and systemic medications.
Case Presentation: An 11-year-old boy who was diagnosed with Pediatric-onset MS (POMS) with the first presentation of left optic neuritis in another center, was referred to our clinic with the complaint of non-improved vision in the left eye despite receiving IV 5gr methylprednisolone. After the ophthalmologic examinations, the patient was diagnosed as bilateral POMS-associated intermediate uveitis, and local treatment with corticosteroid was administered to both eyes.
Ocul Immunol Inflamm
November 2024
Department of Ophthalmology, Hopital Timone, Marseille, France.
Introduction: Uveitis may occur during approximately 1-3% of MS patients, corresponding to 10 times higher than in the general population. The development of uveitis is not currently considered as an inflammatory relapse of MS. There are no clinical guidelines for treating.
View Article and Find Full Text PDFCesk Slov Oftalmol
March 2024
Purpose: To draw attention to the higher proportion of Fuchs heterochromic iridocyclitis (FHI) cases in patients with multiple sclerosis (MS).
Materials And Methods: Retrospective study of data collected at the Center for the Diagnosis and Treatment of Uveitis.
Results: An analysis of the medical records of 3016 patients with uveitis (in the years 2003-2020) was performed with a focus on MS.