Intermediate uveitis associated with multiple sclerosis – diagnosis, clinical features, pathogenic mechanisms, and recommendations for management

Alan R Abraham*, Lindsay B Nicholson, Andrew David Dick, Claire M Rice, Denize Atan

*Corresponding author for this work

Research output: Contribution to journalReview article (Academic Journal)peer-review

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Abstract

Uveitis is a major cause of visual impairment and blindness among working-age adults, accounting for 10% of legal blindness in the United States. Among people with MS, the prevalence of uveitis is 10 times higher than among the general population, and because MS and uveitis share similar genetic risk factors and immunologic effector pathways, it is not clear whether uveitis is one of the manifestations of MS or a coincident disorder. This uncertainty raises several diagnostic and management issues for clinicians who look after these patients, particularly with regard to recognizing visual symptoms resulting from demyelination, intraocular inflammation, or the visual complications of disease modifying drugs for MS, e.g., fingolimod. Likewise, management decisions regarding patients with uveitis are influenced by the risk of precipitating or exacerbating episodes of demyelination, e.g., following anti–tumor necrosis factor biologic therapy, and other neurologic complications of immunosuppressive treatments for uveitis. In this review, we explore the similarities in the pathophysiology, clinical features, and treatment of patients with uveitis and MS. Based on the latest evidence, we make a set of recommendations to help guide neurologists and ophthalmologists to best manage patients affected by both conditions.
Original languageEnglish
Article numbere909
Number of pages12
JournalNeurology, Neuroimmunology and Neuroinflammation
Volume8
Issue number1
Early online date30 Oct 2020
DOIs
Publication statusE-pub ahead of print - 30 Oct 2020

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