In the internal diseases Rheumatology Clinic follow-up of uveitis patients evaluation

Background: Uveitis is a term used to describe inflammation of the uvea. The causes of uveitis are varied and can include ophthalmic diseases, infectious diseases, systemic diseases, medications, or it can be idiopathic. Objective: The aim of this study is to determine the rate of rheumatologic disease diagnosis among patients diagnosed with non-infectious uveitis and referred to the rheumatology clinic; furthermore, to evaluate the demographic, clinical, and laboratory characteristics of patients diagnosed with rheumatologic diseases. Methods: A total of 140 patients presenting with a diagnosis of non-infectious uveitis to the Rheumatology Clinic of the Department of Internal Medicine at Afyon Health Sciences University Hospital between January 2020 and January 2023 were retrospectively reviewed for rheumatologic etiology. Results: Of the patients, 78 (55.7%) were male, and 62 (44.3%) were female. The mean age was 44.88 ± 14.76 years (min: 21, max: 81), with a mean age at the first uveitis attack of 43.63 ± 15.88 years (min: 19, max: 78). When family histories were queried, 10 (7.1%) patients had a family history of rheumatic disease. At the time of initial referral to the rheumatology department, 105 (75%) patients did not have a known history of rheumatic disease; 10 (7.1%) had ankylosing spondylitis (AS), and 23 (16.4%) had Behçet's disease, 1 (0.71%) had rheumatoid arthritis, and 1 (0.71%) had FMF. Thirty-one (22.14 %) patients had a chronic disease. 53.6% of the patients had an active attack at the time of admission to the rheumatology outpatient clinic. This condition was not present in 46.4%. Unilateral involvement was observed in 74.3% of patients, while bilateral involvement was seen in 25.7%. Anterior uveitis was present in 59.2% of patients, posterior uveitis in 18.5%, and panuveitis in 22.1%. Non-granulomatous uveitis was present in 93.5% of patients, while granulomatous uveitis was present in 6.4%. At the time of admission, 54.3% of patients had a single attack, 27,9 % had between 2 and 5 attacks, and 17.9 % had more than 5 attacks. The rheumatologic investigations at admission were evaluated, with HLA-B27 positivity detected in 46 patients, and among these patients, 41 were diagnosed with Spondyloarthropathy. Spondyloarthropathy was diagnosed in 37.1% of patients, Behçet's disease in 20.7%, and sarcoidosis in 1.42%. Spondyloarthropathies were the most common rheumatic diseases observed among these patients. Fifty-six patients did not receive a diagnosis of any rheumatic disease. Topical treatment was administered to 59.29% of patients diagnosed with uveitis, intravitreal steroid treatment to 12.86%, and systemic treatment to 45.71% of patients. Conclusion In our study, the most common cause found in the etiological evaluation of non-infectious uveitis patients was idiopathic. A significant portion of the causes of non-infectious uveitis are rheumatologic diseases. In patients presenting with non-infectious uveitis, spondyloarthropathies and Behçet's disease should primarily be considered. Key words: Anterior uveitis, Behçet's disease, Etiology, Idiopathy, Non- infectious uveitis, Panuveitis, Rheumatology, Spondyloarthropathy