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BMJ Publishing Group, Annals of the Rheumatic Diseases, Suppl 1(81), p. 1542.2-1542, 2022

DOI: 10.1136/annrheumdis-2022-eular.3351

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AB0832 Noninfectious uveitis from the rheumatologist’s perspective: patterns from a single Tertiary Referral Rheumatologic Clinic in Italy

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This paper was not found in any repository, but could be made available legally by the author.

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Abstract

BackgroundThe noninfectious uveitis (NIU) is the intraocular inflammation that can be the first or one of extra-articular manifestations of systemic inflammatory rheumatic diseases mainly including spondyloarthritis (SpA), Behcet’s disease (BD) and juvenile idiopathic arthritis (JIA)1. Rheumatologists are often asked to help in diagnostic assessment and relatively targeted treatment of particular subsets of NIU2.ObjectivesTo explore patterns and treatments of NIU from a population-based single-center study carried out in a Tertiary Referral Rheumatologic Clinic.MethodsSelection criteria of this cross-sectional descriptive study consisted of having a diagnosis of NIU in an age of onset ≥16 years old regardless of its etiology among patients who were admitted (February 2018-December 2021) to Rheumatologic Clinic of Tor Vergata University Hospital (Rome, Italy). Clinical data were collected from medical records: gender, age of onset and admission, recurrence and anatomic patterns, HLA-B27 susceptibility, associated rheumatologic diagnosis and treatments were investigated.ResultsWe included 100 patients with 58% women. Median age at NIU onset was 39.6±15 years whereas patients were 44±14 years old at the first referral, without gender-difference. NIU represented the main reason of referral in 22% of cases. Anterior uveitis occurred in 73% of patients and posterior in 25%; intermediate (IU) and panuveitis (PanU) were isolated cases. The prevalent course was acute (57%) followed by recurrent (31%) and chronic (12%); both eyes were involved in 39 patients. Almost half of NIU was associated with SpA including IBD-SpA (20%), ankylosing spondylitis (AS, 18%), and Psoriatic Arthritis (12%). A diagnosis of BD was reported in 14% of NIU while Rheumatoid Arthritis and other systemic autoimmune diseases occurred in 11% and 12%, respectively. Idiopathic NIU and JIA-NIU constituted the lowest prevalence (8% and 5%, respectively). A higher prevalence of BD-NIU and AS-NIU resulted in males than females (p<0.01 and p<0.05, respectively). One-third of the NIU cohort (34.3%) showed B27+: a higher percentage of unilateral (p=0.09) and acute course (p=0.02) occurred in B27+ than B27-. AS was prevalent in B27+ NIU than B27- (p<0.00001) while IBD-SpA and BD were mainly present in B27- NIU than B27+ (p=0.09 and p=0.04 respectively). The only two cases of IU and PanU were both idiopathic B27- NIU. At the onset of NIU, most patients were not on systemic treatment (68%): remaining cases were on cDMARDs (22%) and bDMARDs (10%). During rheumatologic follow-up, 80% of patients changed therapies: cDMARDs were added in 43.7% patients while bDMARDs were started in 40%. Systemic steroids were added in the remaining 16.3% of patients. At the latest follow-up (follow-up-time 33±28 months), 86% of patients had achieved remission of NIU while 14% had recurrence of active uveitis.ConclusionFindings from this population-based study describe a representative estimate of extent and patterns of NIU in an Italian adult cohort from a single Rheumatologic Clinic and document that Rheumatologic referral might dramatically impact treatment strategies in NIU.References[1]Hysa, E., et al. (2021). Immunopathophysiology and clinical impact of uveitis in inflammatory rheumatic diseases: An update. European journal of clinical investigation, 51(8), e13572. doi.org/10.1111/eci.13572.[2]Rosenbaum, J. T., et al. (2019). New observations and emerging ideas in diagnosis and management of non-infectious uveitis: A review. Seminars in arthritis and rheumatism, 49(3), 438–445. doi: 10.1016/j.semarthrit.2019.06.004.Disclosure of InterestsNone declared