Triggering Factors Associated With a New Episode of Recurrent Acute Anterior Uveitis

Abstract To identify triggering factors for the next inflammatory episode of recurrent acute anterior uveitis (RAAU), a 1:1 case-control study was conducted. Patients with recent acute anterior uveitis and matched controls were interviewed using Srithanya Stress Test (ST-5) and questionnaires about potential triggering factors. Asymptomatic controls were matched for age (±5 years), sex, and HLA-B27. There were 39 pairs of cases and controls. Within 1-month before the interview, patients who recently experienced a uveitis attack demonstrated higher mean ST-5 scores (3.7±2.9 vs 0.7±1.1) and shorter sleep time (6.3±1.4 vs 7.4±0.7) compared with their controls. In the multivariate conditional logistic regression analysis, ST-5 score ≥3 (OR 9.17; 95%CI 1.15-72.84, p=0.036) and sleep time <7 hours per day (OR 11.57; 95% CI 1.42-94.55, p=0.022) were more likely to trigger a uveitis attack in RAAU accounted for age, sex, and HLA-B27 positivity of the patients. Other suspected triggering factors were not found to have any significant association. In short, emotional stress and inadequate sleep are the major triggering factors that lead to the future episode of acute anterior uveitis in RAAU. Both physical and emotional stress management may be helpful to minimize recurrences and further complications.

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Triggering factors associated with a new episode of recurrent acute anterior uveitis

Scientific Reports ◽

10.1038/s41598-021-91701-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Nutnicha Neti ◽

Anchisa Pimsri ◽

Sutasinee Boonsopon ◽

Nattaporn Tesavibul ◽

Pitipol Choopong

Keyword(s):

Anterior Uveitis ◽

Conditional Logistic Regression ◽

Stress Test ◽

Sleep Time ◽

Hla B27 ◽

Acute Anterior Uveitis ◽

Conditional Logistic Regression Analysis ◽

Triggering Factors ◽

Inflammatory Drugs ◽

Uveitis Attack

AbstractTo identify triggering factors for the next inflammatory episode of recurrent acute anterior uveitis (RAAU), a 1:1 case–control study was conducted. We interviewed RAAU patients with recent acute anterior uveitis attack and quiescent controls for their information during a previous month using Srithanya Stress Test (ST-5) and questionnaires about potential triggering factors. Asymptomatic controls were matched for age (± 5 years), sex, and HLA-B27. There were 39 pairs of cases and controls. Patients who recently experienced a uveitis attack demonstrated higher mean ST-5 scores (3.7 ± 2.9 vs 0.7 ± 1.1) and shorter sleep time (6.3 ± 1.4 vs 7.4 ± 0.7 h per day) compared with their controls. In the multivariate conditional logistic regression analysis, ST-5 score ≥ 3 (OR 9.07, 95% CI 1.14–72.16, p = 0.037) and sleep time < 7 h per day (OR 12.12, 95% CI 1.37–107.17, p = 0.025) were more likely to trigger a uveitis attack in RAAU accounted for patients’ age, sex, HLA- B27 positivity, and presence of concurrent anti-inflammatory drugs for co-existing diseases. Other suspected triggering factors were not found to have any significant association. In short, stress and inadequate sleep may lead to the future episode of acute anterior uveitis in RAAU. Both physical and emotional stress management should be advised to RAAU patients to minimize recurrences and further complications.

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HLA-B27 frequency in Greek patients with acute anterior uveitis.

British Journal of Ophthalmology ◽

10.1136/bjo.61.11.699 ◽

1977 ◽

Vol 61 (11) ◽

pp. 699-701 ◽

Cited By ~ 15

Author(s):

J Zervas ◽

G Tsokos ◽

G Papadakis ◽

E Kabouklis ◽

D Papadopoulos

Keyword(s):

Anterior Uveitis ◽

Hla B27 ◽

Acute Anterior Uveitis

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Serum Levels of β2-Microglobulin in HLA-B27+Patients with Acute Anterior Uveitis and Ankylosing Spondylitis

Scandinavian Journal of Rheumatology ◽

10.3109/03009749009097068 ◽

1990 ◽

Vol 19 (sup87) ◽

pp. 104-107 ◽

Cited By ~ 2

Author(s):

M. F. C. Beersma ◽

P. J. F. M. Derhaag ◽

T. E. W. Feltkamp

Keyword(s):

Ankylosing Spondylitis ◽

Anterior Uveitis ◽

Serum Levels ◽

Hla B27 ◽

Acute Anterior Uveitis ◽

Β2 Microglobulin

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Is a positive family history of spondyloarthritis relevant for diagnosing axial spondyloarthritis once HLA-B27 status is known?

Rheumatology ◽

10.1093/rheumatology/kez095 ◽

2019 ◽

Vol 58 (9) ◽

pp. 1649-1654 ◽

Cited By ~ 7

Author(s):

Miranda van Lunteren ◽

Désirée van der Heijde ◽

Alexandre Sepriano ◽

Inger J Berg ◽

Maxime Dougados ◽

...

Keyword(s):

Back Pain ◽

Family History ◽

Anterior Uveitis ◽

Chronic Back Pain ◽

Axial Spondyloarthritis ◽

Positive Family History ◽

Hla B27 ◽

Acute Anterior Uveitis ◽

Negative Results ◽

History Of

Abstract Objectives A positive family history (PFH) of spondyloarthritis, in particular a PFH of AS or acute anterior uveitis, is associated with HLA-B27 carriership in chronic back pain patients. As it is unknown, the study aimed to investigate if a PFH contributes to diagnosing axial spondyloarthritis (axSpA) once HLA-B27 status is known. Methods In axSpA-suspected patients from the Assessment of SpondyloArthritis international Society (ASAS), DEvenir des Spondyloarthropathies Indifférenciéés Récentes (DESIR) and SPondyloArthritis Caught Early (SPACE) cohorts, logistic regression analyses were performed with HLA-B27 status and PFH according to the ASAS definition (ASAS-PFH) as determinants and clinical axSpA diagnosis as outcome at baseline. Analyses were repeated with a PFH of AS or acute anterior uveitis. Results In total, 1818 patients suspected of axSpA were analysed (ASAS n = 594, DESIR n = 647, and SPACE n = 577). In patients from the ASAS, DESIR and SPACE cohorts, respectively 23%, 39% and 38% had an ASAS-PFH, 52%, 58% and 43% were HLA-B27 positive, and 62%, 47% and 54% were diagnosed with axSpA. HLA-B27 was independently associated with an axSpA diagnosis in each cohort but an ASAS-PFH was not [ASAS cohort: HLA-B27 odds ratio (OR): 6.9 (95% CI: 4.7, 10.2), ASAS-PFH OR: 0.9 (95% CI: 0.6, 1.4); DESIR: HLA-B27 OR: 2.1 (95% CI: 1.5, 2.9), ASAS-PFH OR: 1.0 (95% CI 0.7, 1.3); SPACE: HLA-B27 OR: 10.4 (95% CI: 6.9, 15.7), ASAS-PFH OR: 1.0 (95% CI: 0.7, 1.5)]. Similar negative results were found for PFH of AS and acute anterior uveitis. Conclusion In three independent cohorts with different ethnical backgrounds, ASAS, DESIR and SPACE, a PFH was not associated independently of HLA-B27 with a diagnosis of axSpA. This indicates that in the vast majority of patients presenting with back pain, a PFH does not contribute to the likelihood of an axSpA diagnosis if HLA-B27 status is known.

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