Prospective follow up of patients with terior, posterior/panuveitis with unknown etiology

Uveitis is the inflammatory disease of the uvea tissue and a serious health problem with such complications that can border to blindness. On the other hand, Behcet?s Disease (BD) is a multisystem disease of unknown aetiology and almost 70% of these patients have ocular involvement, particularly in the form of uveitis. Morbidity and mortality of BD can be reduced with early detection and treatment. BD is one of those diseases which must be considered in the first place when searching the aetiology of uveitis. In this study, we aimed at examining prospectively those patients who were sent by the clinic of eye diseases with evidence of uveitis for diagnosis and follow up of rheumatologic diseases.This study included a total of 50 patients between the ages of 18-65 with anterior, posterior or panuveitis of unknown or idiopathic aetiology as previously diagnosed who were referred by Gazi University Faculty of Medicine Clinic of Eye Diseases in between May 2011 ? May 2012. Demographic data of the patients as well as characteristics of the uveitis were recorded. Patients underwent physical examinations and pathergy tests where clinical evidence of rheumatologic diseases was sought for. All the patients were examined for existence of the tissue groups of HLA-B27 and HLA-B5 and ferguson radiograph was performed with a view to evaluating the existence of sacroiliitis. Ultrasound examination was performed in five different enthesis zones in both of the lower limbs with a view to evaluating the existence of enthesitis. Furthermore, ASAS classification criteria were used for diagnosis of axial and peripheral spondylarthritis, as well as Modified New York criteria for diagnosis of ankylosing spondylitis and O?Duffy Criteria and International Working Group Criteria for diagnosis of BD. Following the examinations that were undertaken, those patients of unknown aetiology of uveitis were called back for the repetition of the same examination procedures.Patients were divided into three groups based on the location of uveitis; namely, anterior (32%), posterior (48%) and panuveitis (20%). It was obvious that women were more in number in patients with anterior uveitis while men dominated the group with posterior uveitis. HLAB27 (p=0,000) had a higher incidence in patients with anterior uveitis while HLAB5 (p=0,026) was more frequent in patients with posterior uveitis, which was statistically significant. No significant difference was found between the groups in existence of enthesitis (p>0,05). Idiopathic uveitis was the most common type in all the groups. The second most common type of uveitis was HLAB27 uveitis in patients with anterior uveitis and BD in patients with posterior and panuveitis. Results of the examinations were no different after six months when compared to the initial findings.This study confirmed the relation between acute anterior uveitis, ankylosing spondylitis and HLA-B27. Furthermore, it was observed that most common group was posterior uveitis among all the uveitis groups and most common cause of uveitis was BD. Enthesitis was quite common in patients with acute anterior uveitis with positive HLAB27. Therefore, it was once more confirmed that BD held an important position among the causes of uveitis in the geography where Turkey is located. To conclude, regular follow up of patients and systemic research at defined intervals must be undertaken in searching the aetiology of uveitis.