The Experts below are selected from a list of 42 Experts worldwide ranked by ideXlab platform

Janet E. Pope - One of the best experts on this subject based on the ideXlab platform.

  • Ocular Manifestations in Rheumatoid Arthritis, Connective Tissue Disease, and Vasculitis: A Systematic Review and Metaanalysis.
    The Journal of rheumatology, 2020
    Co-Authors: Matthew A. Turk, Jacqueline Hayworth, Tatiana Nevskaya, Janet E. Pope
    Abstract:

    Objective Rheumatoid Arthritis and other rheumatic diseases may present with ocular manifestations. The purpose of our work was to determine the prevalence and type of eye involvement in rheumatoid arthritis and other connective tissue diseases through a meta-analysis and literature review. Methods A systematic review of the literature was performed using Medline, Web of Science, and the Cochrane library from their inceptions until January 7, 2019. Conjunctivitis, keratoconjunctivitis sicca, xeropthalmia, uveitis, eye Hemorrhage, optic neuritis, papilledema, orbital disease, retinal artery/vein occlusion, macular edema, retinitis, chorioretinitis, scleritis, iridocyclitits, Choroid Hemorrhage, blindness and amaurosis fugax were searched for prevalence in patients with rheumatoid arthritis, systemic lupus erythematosus, antiphospholipid syndrome, dermatomyositis, polymyositis, systemic sclerosis, Sjogren’s syndrome, undifferentiated connective tissue disease, giant cell arteritis, granulomatosis polyangiitis (GPA; formerly Wegener9s granulomatosis), systemic vasculitis, and sarcoidosis. Results 3394 studies were identified and 65 included. The prevalence of eye involvement was 18% in rheumatoid arthritis, 31% in systemic lupus erythematosus, 35% in antiphospholipid syndrome, 27% in giant cell arteritis, 26% in GPA and 27% in sarcoidosis. The most common manifestations was dry eyes (keratoconjunctivitis sicca) in most diseases analyzed with a frequency approaching 90% in Sjogren’s syndrome. Anterior and posterior uveitis were the most common OC in sarcoidosis occurring in 16 [3-28]% and 6 [3-9]% of patients respectively. Conclusion Eye involvement is present in approximately one fifth of rheumatoid arthritis patients, and one quarter to one third of patients with connective tissue diseases (other than Sjogren’s syndrome at 90%) and vasculitis.

  • FRI0069 FREQUENCY OF EYE INVOLVEMENT IN INFLAMMATORY ARTHRITIS AND CONNECTIVE TISSUE DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS
    Poster Presentations, 2019
    Co-Authors: Matthew A. Turk, Jacqueline Hayworth, Tatiana Nevskaya, Janet E. Pope
    Abstract:

    Background: Rheumatoid arthritis commonly presents with extraarticular manifestations. Along with other connective tissue diseases, these manifestations may include eye involvement. Objectives: The purpose of our work was to determine the prevalence and type of eye involvement in rheumatoid arthritis and other connective tissue diseases through a meta-analysis and literature review. Methods: A systematic review of the literature was performed using Medline, Web of Science, and the Cochrane library from their inceptions until January 7, 2019. Conjunctivitis, keratoconjunctivitis sicca, xeropthalmia, uveitis, eye Hemorrhage, optic neuritis, papilledema, orbital disease, retinal artery/vein occlusion, macular edema, retinitis, chorioretinitis, scleritis, iridocyclitits, Choroid Hemorrhage, blindness and amaurosis fugax were searched for prevalence in patients with rheumatoid arthritis, systemic lupus erythematosus, antiphospholipid syndrome, dermatomyositis, polymyositis, systemic sclerosis, Sjogren’s syndrome, undifferentiated connective tissue disease, giant cell arteritis, granulomatosis polyangiitis (GPA; formerly Wegener’s granulomatosis, systemic vasculitis, and sarcoidosis. Results: 3394 studies were identified and 65 included. The prevalence of eye involvement was 18% in rheumatoid arthritis, 31% in systemic lupus erythematosus, 35% in antiphospholipid syndrome, 27% in giant cell arteritis, 26% in GPA and 27% in sarcoidosis. The most common manifestations was dry eyes (keratoconjunctivitis sicca) in most diseases analyzed with a frequency approaching 90% in Sjogren’s syndrome. Anterior and posterior uveitis were the most common OC in sarcoidosis occurring in 16 [3-28]% and 6 [3-9]% of patients respectively. Conclusion: Eye involvement is present in approximately one fifth of rheumatoid arthritis patients, and one quarter to one third of patients with other rheumatic diseases. References: [1] Grassi W, De Angelis R, Lamanna G, Cervini C. The clinical features of rheumatoid arthritis. Eur J Radiol 1998;27 Suppl 1:S18-24. [2] Brito-Zeron P, Acar-Denizli N, Zeher M, Rasmussen A, Seror R, Theander E, et al. Influence of geolocation and ethnicity on the phenotypic expression of primary Sjogren’s syndrome at diagnosis in 8310 patients: a cross-sectional study from the Big Data Sjogren Project Consortium. Ann Rheum Dis 2017;76:1042-50. [3] Zhang C, Zha Q-L, He Y-T, Jiang M, Lu C, Lu A-P. The extraarticular symptoms influence ACR response in the treatment of rheumatoid arthritis with biomedicine: a single-blind, randomized, controlled, multicenter trial in 194 patients. J Tradit Chin Med 2011;31:50-5. [4] Kermani TA, Cuthbertson D, Carette S, Hoffman GS, Khalidi NA, Koening CL, et al. The Birmingham Vasculitis Activity Score as a Measure of Disease Activity in Patients with Giant Cell Arteritis. The Journal of Rheumatology 2016;43:1078-84. [5] Seror R, Theander E, Brun JG, Ramos-Casals M, Valim V, Dorner T, et al. Validation of EULAR primary Sjogren’s syndrome disease activity (ESSDAI) and patient indexes (ESSPRI). Ann Rheum Dis 2015;74:859-66. [6] Valeyre D, Prasse A, Nunes H, Uzunhan Y, Brillet P-Y, Muller-Quernheim J. Sarcoidosis. Lancet 2014;383:1155-67. Disclosure of Interests: Matthew Turk: None declared, Jacqueline Hayworth: None declared, Tatiana Nevskaya: None declared, Janet Pope Consultant for: Eli Lilly and Company

  • SAT0352 THE FREQUENCY OF OCULAR MANIFESTATIONS IN PATIENTS WITH ADULT VS. CHILDHOOD SPONDYLOARTHRITIS
    Saturday 15 June 2019, 2019
    Co-Authors: Matthew A. Turk, Jacqueline Hayworth, Tatiana Nevskaya, Janet E. Pope
    Abstract:

    Background Adult spondyloarthritis (SpA) is characterized by abnormal bone overgrowth and inflammatory erosive osteopenia in the spine. SpA may be associated with psoriasis and psoriatic arthritis (PsA), inflammatory bowel disease, reactive arthritis, enthesitis, and ocular features such as acute anterior iritis, and chronic uveitis. Juvenile SpA onsets in children under 16 years old and may present with more peripheral enthesopathies and arthritis than adult SpA. Objectives This meta-analysis investigated the frequency and type of ocular involvement in childhood and adult SpA. The difference in frequency between childhood and adult SpA was also investigated. Methods Medline, Web of Science and Cochrane databases were searched to September, 2018 to identify publications related to spondyloarthropathy (SpA), and ankylosing spondylitis (AS) with ocular conditions (OC) (conjunctivitis, keratoconjunctivitis sicca, xeropthalmia, uveitis, eye Hemorrhage, optic neuritis, papilledema, orbital disease, retinal artery/vein occlusion, macular edema, retinitis, chorioretinitis, scleritis, iridocyclitits, Choroid Hemorrhage, blindness and amaurosis fugax). The rates of OC were extracted and random effects models estimated their frequency. Heterogeneity was evaluated using I2. Inclusion criteria were studies in SpA of either children or adults that included a frequency of OC. Differences in frequencies of OC between childhood and adult disease were compared using chi squared tests. Results The search process identified 3164 articles, of which 41 were eligible for inclusion. A pooled random effects model showed the prevalence of uveitis was 24% [20%-27%] in adult AS (23 studies, N= 11943 patients), 10% [7%-14%] in adult PsA (9 studies, N=1817), and 17% [10%-24%] in undifferentiated adult SpA (9 studies, 6568 patients). In juveniles with AS, the prevalence of uveitis was 27% [16%-39%] (8 studies, 927 patients). In child onset PsA, uveitis occurred in 16% [10%-21%] (5 studies, N=498), and in juvenile undifferentiated SpA, uveitis had a frequency of 7% [1%-12%] (2 studies, N=1531). The differences in frequency of uveitis in adults vs. child onset SpA spectrum diseases were not significantly different between AS and JAS (p=0.891), PsA and JPsA (p=0.732) and between SpA and JSpA. Conclusion This meta-analysis compares the frequency of ocular involvement in seronegative spectrum diseases in adults and children where it appears that the frequency of uveitis is not statistically different in adult vs. child onset SpA and the subsets. References [1] Reveille JD, Weisman MH. The epidemiology of back pain, axial spondyloarthritis and HLA-B27 in the United States. Am J Med Sci2013;345:431-6. [2] Smith JA. Update on ankylosing spondylitis: current concepts in pathogenesis. Curr Allergy Asthma Rep2015;15:489. [3] Stolwijk C, Essers I, van Tubergen A, Boonen A, Bazelier MT, De Bruin ML, et al. The epidemiology of extra-articular manifestations in ankylosing spondylitis: a population-based matched cohort study. Annals of the Rheumatic Diseases2015;74:1373-8. [4] Lin Y-C, Liang T-H, Chen W-S, Lin H-Y. Differences between juvenile-onset ankylosing spondylitis and adult-onset ankylosing spondylitis. J Chin Med Assoc2009;72:573-80. [5] Cantini F, Nannini C, Cassara E, Kaloudi O, Niccoli L. Uveitis in Spondyloarthritis: An Overview. J Rheumatol Suppl2015;93:27-9. Disclosure of Interests Matthew Turk: None declared, Jacqueline Hayworth: None declared, Tatiana Nevskaya: None declared, Janet Pope Consultant for: Eli Lilly and Company

  • THU0692 OCULAR MANIFESTATIONS IN BEHCET’S DISEASE MAY BE MORE COMMON IN CHILDREN THAN ADULTS: RESULTS OF A SYSTEMATIC REVIEW
    Poster Presentations, 2019
    Co-Authors: Matthew A. Turk, Jacqueline Hayworth, Tatiana Nevskaya, Janet E. Pope
    Abstract:

    Background: Behcet’s disease (BD) can develop in both children and adults, but they may have different clinical features. Ocular involvement is common in BD and causes substantial impairment. The frequency of ocular involvement in BD has a wide range (5 to 89%). Objectives: This study determined the frequency and type of ocular manifestations in childhood and adult BD and compared prevalence of ocular manifestations by geographic location in those with BD. Methods: The protocol of ocular conditions in rheumatic conditions was registered at clintrials.gov (NCT03753893). Search terms were: conjunctivitis, keratoconjunctivitis sicca, xeropthalmia, uveitis, eye Hemorrhage, optic neuritis, papilledema, orbital disease, retinal artery/vein occlusion, macular edema, retinitis, chorioretinitis, scleritis, iridocyclitits, Choroid Hemorrhage, blindness and amaurosis fugax in patients with BD. The search was performed with the assistance of an information specialist. Medline, Cochrane and Web of Science were used searching papers that spanned from their inception (1966, 1991 and 1990 respectively) to October 5, 2018. Studies were included if they had a minimum of twenty patients and reported the frequency of ocular manifestations within BD. Random effects models were used to combine the prevalence of ocular manifestations using Revman 5.3. Heterogeneity was evaluated using I2 and funnel plots. Results: The search resulted in 3129 articles, of which 33 were included for meta-analysis. Eye manifestations were more frequent in childhood onset BD with the mean [95% Confidence Interval] frequency of 50 [38-63]% compared to 34 [25-43]% in adults. In both children and adults, posterior uveitis (children 27% vs. adults 25%) was the most common ocular manifestation, followed by anterior uveitis (children 18% vs. adults 23%). When comparing the distribution of ocular manifestations in Behcet’s in adults, there was geographic variation higher along the ancient Silk Road with ocular manifestations occurring in 40% of patients from Turkey and the Middle East. Ocular manifestations were similar in Europe (36%) and North America (36%), but less frequent in North Africa (26%) and East Asia (20%). Conclusion: The frequency of ocular involvement is higher in children when compared to adults with BD. The most common manifestation in the eyes is posterior and then anterior uveitis. Ocular involvement also presents regional differences. References: [1] Arevalo JF, Lasave AF, Al Jindan MY, Al Sabaani NA, Al-Mahmood AM, Al-Zahrani YA, et al. Uveitis in Behcet Disease in a Tertiary Center Over 25 Years: The KKESH Uveitis Survey Study Group. American Journal of Ophthalmology 2015;159:177-184.e2. [2] Frigui M, Kechaou M, Jemal M, Ben Zina Z, Feki J, Bahloul Z. Optic neuropathy in Behcet’s disease: a series of 18 patients. Rev Med Interne 2009;30:486-91. [3] Keino H, Okada AA. Behcet’s disease: global epidemiology of an Old Silk Road disease. Br J Ophthalmol 2007;91:1573-4. [4] Leonardo NM, McNeil J. Behcet’s Disease: Is There Geographical Variation? A Review Far from the Silk Road. International Journal of Rheumatology 2015;2015:1-7. [5] Uva L, Miguel D, Pinheiro C, Filipe P, Freitas JP. Mucocutaneous manifestations of Behcet’s disease. Acta Reumatol Port 2013;38:77-90. Disclosure of Interests: Matthew Turk: None declared, Jacqueline Hayworth: None declared, Tatiana Nevskaya: None declared, Janet Pope Consultant for: Eli Lilly and Company

  • AB0771 The Prevalence of Inflammatory Eye Diseases in Rheumatologic Conditions: Results From a Meta-Analysis
    Annals of the Rheumatic Diseases, 2015
    Co-Authors: Jacqueline Hayworth, Janet E. Pope
    Abstract:

    Background Many inflammatory rheumatic conditions are associated with ocular involvement. The actual prevalence of these complications is not fully known. Objectives This meta-analysis was performed to systematically investigate the prevalence of ocular involvement in inflammatory rheumatic diseases in order to determine the frequency and type of ocular involvement. Methods Medline, Web of Science and Cochrane databases were searched up to July 8, 2014, to identify full text publications related to inflammatory rheumatic diseases and associated ocular conditions. Disease terms included; juvenile arthritis (JIA), rheumatoid arthritis (RA), Sjogren9s syndrome, Still9s disease, systemic lupus erythematosus (SLE), connective tissue disease, spondyloarthropathy, and ankylosing spondylitis (AS). For eye involvement terms were; conjunctivitis, keratoconjunctivitis sicca, xeropthalmia, uveitis, eye Hemorrhage, optic neuritis, papilledema, orbital disease, retinal artery/vein occlusion, macular edema, retinitis, chorioretinitis, scleritis, iridocyclitits, Choroid Hemorrhage, blindness and amaurosis fugax. Data regarding the rates of various ocular complications were extracted. Random effects models pooled rates to estimate the frequency of each complication in the included inflammatory rheumatic diseases. Results Most of the 7124 studies were excluded, leaving 263 for full review. There were 13 AS cohort studies, 30 Behcet9s disease (BD), 31 JIA, 12 PsA, 11 RA and 165 others. Pooled prevalence for commonly reported ocular manifestation were uveitis rates of: 22% (95% CI: 16-24%) in AS, Behcet9s 55% (41-68%), JIA [oligoarthritis 36% (20-51%), polyarticular 13% (8-19%) systemic onset 3% (0-7%)], pediatric Behcet9s 33% (0-74%), and PsA 15% (5-24%) for anterior uveitis and 0.2% for posterior uveitis. In RA, keratoconjunctivitis sicca occurred in 16% (8-25%), sicca symptoms in 31% (21-42%), marginal ulcerative keratitis in 1-3%, episcleritis in 1-2% and retinal vasculitis in 0.2%. In SLE 29% of patients had dry eyes. There may have been publication bias (over reporting due to selection bias of cohorts enriched for ocular complications such as patients from university clinics where complications could be higher, and several estimates had herterogeneity. Data were lacking on confounding variables (such as screening programs and treatment). Conclusions Extra-articular manifestations of inflammatory rheumatic diseases frequently complicate the ocular health of afflicted individuals. Although the rates vary, an awareness of potential complications can aid in early identification and treatment of these rheumatic complications. Disclosure of Interest None declared

Jacqueline Hayworth - One of the best experts on this subject based on the ideXlab platform.

  • Ocular Manifestations in Rheumatoid Arthritis, Connective Tissue Disease, and Vasculitis: A Systematic Review and Metaanalysis.
    The Journal of rheumatology, 2020
    Co-Authors: Matthew A. Turk, Jacqueline Hayworth, Tatiana Nevskaya, Janet E. Pope
    Abstract:

    Objective Rheumatoid Arthritis and other rheumatic diseases may present with ocular manifestations. The purpose of our work was to determine the prevalence and type of eye involvement in rheumatoid arthritis and other connective tissue diseases through a meta-analysis and literature review. Methods A systematic review of the literature was performed using Medline, Web of Science, and the Cochrane library from their inceptions until January 7, 2019. Conjunctivitis, keratoconjunctivitis sicca, xeropthalmia, uveitis, eye Hemorrhage, optic neuritis, papilledema, orbital disease, retinal artery/vein occlusion, macular edema, retinitis, chorioretinitis, scleritis, iridocyclitits, Choroid Hemorrhage, blindness and amaurosis fugax were searched for prevalence in patients with rheumatoid arthritis, systemic lupus erythematosus, antiphospholipid syndrome, dermatomyositis, polymyositis, systemic sclerosis, Sjogren’s syndrome, undifferentiated connective tissue disease, giant cell arteritis, granulomatosis polyangiitis (GPA; formerly Wegener9s granulomatosis), systemic vasculitis, and sarcoidosis. Results 3394 studies were identified and 65 included. The prevalence of eye involvement was 18% in rheumatoid arthritis, 31% in systemic lupus erythematosus, 35% in antiphospholipid syndrome, 27% in giant cell arteritis, 26% in GPA and 27% in sarcoidosis. The most common manifestations was dry eyes (keratoconjunctivitis sicca) in most diseases analyzed with a frequency approaching 90% in Sjogren’s syndrome. Anterior and posterior uveitis were the most common OC in sarcoidosis occurring in 16 [3-28]% and 6 [3-9]% of patients respectively. Conclusion Eye involvement is present in approximately one fifth of rheumatoid arthritis patients, and one quarter to one third of patients with connective tissue diseases (other than Sjogren’s syndrome at 90%) and vasculitis.

  • FRI0069 FREQUENCY OF EYE INVOLVEMENT IN INFLAMMATORY ARTHRITIS AND CONNECTIVE TISSUE DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS
    Poster Presentations, 2019
    Co-Authors: Matthew A. Turk, Jacqueline Hayworth, Tatiana Nevskaya, Janet E. Pope
    Abstract:

    Background: Rheumatoid arthritis commonly presents with extraarticular manifestations. Along with other connective tissue diseases, these manifestations may include eye involvement. Objectives: The purpose of our work was to determine the prevalence and type of eye involvement in rheumatoid arthritis and other connective tissue diseases through a meta-analysis and literature review. Methods: A systematic review of the literature was performed using Medline, Web of Science, and the Cochrane library from their inceptions until January 7, 2019. Conjunctivitis, keratoconjunctivitis sicca, xeropthalmia, uveitis, eye Hemorrhage, optic neuritis, papilledema, orbital disease, retinal artery/vein occlusion, macular edema, retinitis, chorioretinitis, scleritis, iridocyclitits, Choroid Hemorrhage, blindness and amaurosis fugax were searched for prevalence in patients with rheumatoid arthritis, systemic lupus erythematosus, antiphospholipid syndrome, dermatomyositis, polymyositis, systemic sclerosis, Sjogren’s syndrome, undifferentiated connective tissue disease, giant cell arteritis, granulomatosis polyangiitis (GPA; formerly Wegener’s granulomatosis, systemic vasculitis, and sarcoidosis. Results: 3394 studies were identified and 65 included. The prevalence of eye involvement was 18% in rheumatoid arthritis, 31% in systemic lupus erythematosus, 35% in antiphospholipid syndrome, 27% in giant cell arteritis, 26% in GPA and 27% in sarcoidosis. The most common manifestations was dry eyes (keratoconjunctivitis sicca) in most diseases analyzed with a frequency approaching 90% in Sjogren’s syndrome. Anterior and posterior uveitis were the most common OC in sarcoidosis occurring in 16 [3-28]% and 6 [3-9]% of patients respectively. Conclusion: Eye involvement is present in approximately one fifth of rheumatoid arthritis patients, and one quarter to one third of patients with other rheumatic diseases. References: [1] Grassi W, De Angelis R, Lamanna G, Cervini C. The clinical features of rheumatoid arthritis. Eur J Radiol 1998;27 Suppl 1:S18-24. [2] Brito-Zeron P, Acar-Denizli N, Zeher M, Rasmussen A, Seror R, Theander E, et al. Influence of geolocation and ethnicity on the phenotypic expression of primary Sjogren’s syndrome at diagnosis in 8310 patients: a cross-sectional study from the Big Data Sjogren Project Consortium. Ann Rheum Dis 2017;76:1042-50. [3] Zhang C, Zha Q-L, He Y-T, Jiang M, Lu C, Lu A-P. The extraarticular symptoms influence ACR response in the treatment of rheumatoid arthritis with biomedicine: a single-blind, randomized, controlled, multicenter trial in 194 patients. J Tradit Chin Med 2011;31:50-5. [4] Kermani TA, Cuthbertson D, Carette S, Hoffman GS, Khalidi NA, Koening CL, et al. The Birmingham Vasculitis Activity Score as a Measure of Disease Activity in Patients with Giant Cell Arteritis. The Journal of Rheumatology 2016;43:1078-84. [5] Seror R, Theander E, Brun JG, Ramos-Casals M, Valim V, Dorner T, et al. Validation of EULAR primary Sjogren’s syndrome disease activity (ESSDAI) and patient indexes (ESSPRI). Ann Rheum Dis 2015;74:859-66. [6] Valeyre D, Prasse A, Nunes H, Uzunhan Y, Brillet P-Y, Muller-Quernheim J. Sarcoidosis. Lancet 2014;383:1155-67. Disclosure of Interests: Matthew Turk: None declared, Jacqueline Hayworth: None declared, Tatiana Nevskaya: None declared, Janet Pope Consultant for: Eli Lilly and Company

  • SAT0352 THE FREQUENCY OF OCULAR MANIFESTATIONS IN PATIENTS WITH ADULT VS. CHILDHOOD SPONDYLOARTHRITIS
    Saturday 15 June 2019, 2019
    Co-Authors: Matthew A. Turk, Jacqueline Hayworth, Tatiana Nevskaya, Janet E. Pope
    Abstract:

    Background Adult spondyloarthritis (SpA) is characterized by abnormal bone overgrowth and inflammatory erosive osteopenia in the spine. SpA may be associated with psoriasis and psoriatic arthritis (PsA), inflammatory bowel disease, reactive arthritis, enthesitis, and ocular features such as acute anterior iritis, and chronic uveitis. Juvenile SpA onsets in children under 16 years old and may present with more peripheral enthesopathies and arthritis than adult SpA. Objectives This meta-analysis investigated the frequency and type of ocular involvement in childhood and adult SpA. The difference in frequency between childhood and adult SpA was also investigated. Methods Medline, Web of Science and Cochrane databases were searched to September, 2018 to identify publications related to spondyloarthropathy (SpA), and ankylosing spondylitis (AS) with ocular conditions (OC) (conjunctivitis, keratoconjunctivitis sicca, xeropthalmia, uveitis, eye Hemorrhage, optic neuritis, papilledema, orbital disease, retinal artery/vein occlusion, macular edema, retinitis, chorioretinitis, scleritis, iridocyclitits, Choroid Hemorrhage, blindness and amaurosis fugax). The rates of OC were extracted and random effects models estimated their frequency. Heterogeneity was evaluated using I2. Inclusion criteria were studies in SpA of either children or adults that included a frequency of OC. Differences in frequencies of OC between childhood and adult disease were compared using chi squared tests. Results The search process identified 3164 articles, of which 41 were eligible for inclusion. A pooled random effects model showed the prevalence of uveitis was 24% [20%-27%] in adult AS (23 studies, N= 11943 patients), 10% [7%-14%] in adult PsA (9 studies, N=1817), and 17% [10%-24%] in undifferentiated adult SpA (9 studies, 6568 patients). In juveniles with AS, the prevalence of uveitis was 27% [16%-39%] (8 studies, 927 patients). In child onset PsA, uveitis occurred in 16% [10%-21%] (5 studies, N=498), and in juvenile undifferentiated SpA, uveitis had a frequency of 7% [1%-12%] (2 studies, N=1531). The differences in frequency of uveitis in adults vs. child onset SpA spectrum diseases were not significantly different between AS and JAS (p=0.891), PsA and JPsA (p=0.732) and between SpA and JSpA. Conclusion This meta-analysis compares the frequency of ocular involvement in seronegative spectrum diseases in adults and children where it appears that the frequency of uveitis is not statistically different in adult vs. child onset SpA and the subsets. References [1] Reveille JD, Weisman MH. The epidemiology of back pain, axial spondyloarthritis and HLA-B27 in the United States. Am J Med Sci2013;345:431-6. [2] Smith JA. Update on ankylosing spondylitis: current concepts in pathogenesis. Curr Allergy Asthma Rep2015;15:489. [3] Stolwijk C, Essers I, van Tubergen A, Boonen A, Bazelier MT, De Bruin ML, et al. The epidemiology of extra-articular manifestations in ankylosing spondylitis: a population-based matched cohort study. Annals of the Rheumatic Diseases2015;74:1373-8. [4] Lin Y-C, Liang T-H, Chen W-S, Lin H-Y. Differences between juvenile-onset ankylosing spondylitis and adult-onset ankylosing spondylitis. J Chin Med Assoc2009;72:573-80. [5] Cantini F, Nannini C, Cassara E, Kaloudi O, Niccoli L. Uveitis in Spondyloarthritis: An Overview. J Rheumatol Suppl2015;93:27-9. Disclosure of Interests Matthew Turk: None declared, Jacqueline Hayworth: None declared, Tatiana Nevskaya: None declared, Janet Pope Consultant for: Eli Lilly and Company

  • THU0692 OCULAR MANIFESTATIONS IN BEHCET’S DISEASE MAY BE MORE COMMON IN CHILDREN THAN ADULTS: RESULTS OF A SYSTEMATIC REVIEW
    Poster Presentations, 2019
    Co-Authors: Matthew A. Turk, Jacqueline Hayworth, Tatiana Nevskaya, Janet E. Pope
    Abstract:

    Background: Behcet’s disease (BD) can develop in both children and adults, but they may have different clinical features. Ocular involvement is common in BD and causes substantial impairment. The frequency of ocular involvement in BD has a wide range (5 to 89%). Objectives: This study determined the frequency and type of ocular manifestations in childhood and adult BD and compared prevalence of ocular manifestations by geographic location in those with BD. Methods: The protocol of ocular conditions in rheumatic conditions was registered at clintrials.gov (NCT03753893). Search terms were: conjunctivitis, keratoconjunctivitis sicca, xeropthalmia, uveitis, eye Hemorrhage, optic neuritis, papilledema, orbital disease, retinal artery/vein occlusion, macular edema, retinitis, chorioretinitis, scleritis, iridocyclitits, Choroid Hemorrhage, blindness and amaurosis fugax in patients with BD. The search was performed with the assistance of an information specialist. Medline, Cochrane and Web of Science were used searching papers that spanned from their inception (1966, 1991 and 1990 respectively) to October 5, 2018. Studies were included if they had a minimum of twenty patients and reported the frequency of ocular manifestations within BD. Random effects models were used to combine the prevalence of ocular manifestations using Revman 5.3. Heterogeneity was evaluated using I2 and funnel plots. Results: The search resulted in 3129 articles, of which 33 were included for meta-analysis. Eye manifestations were more frequent in childhood onset BD with the mean [95% Confidence Interval] frequency of 50 [38-63]% compared to 34 [25-43]% in adults. In both children and adults, posterior uveitis (children 27% vs. adults 25%) was the most common ocular manifestation, followed by anterior uveitis (children 18% vs. adults 23%). When comparing the distribution of ocular manifestations in Behcet’s in adults, there was geographic variation higher along the ancient Silk Road with ocular manifestations occurring in 40% of patients from Turkey and the Middle East. Ocular manifestations were similar in Europe (36%) and North America (36%), but less frequent in North Africa (26%) and East Asia (20%). Conclusion: The frequency of ocular involvement is higher in children when compared to adults with BD. The most common manifestation in the eyes is posterior and then anterior uveitis. Ocular involvement also presents regional differences. References: [1] Arevalo JF, Lasave AF, Al Jindan MY, Al Sabaani NA, Al-Mahmood AM, Al-Zahrani YA, et al. Uveitis in Behcet Disease in a Tertiary Center Over 25 Years: The KKESH Uveitis Survey Study Group. American Journal of Ophthalmology 2015;159:177-184.e2. [2] Frigui M, Kechaou M, Jemal M, Ben Zina Z, Feki J, Bahloul Z. Optic neuropathy in Behcet’s disease: a series of 18 patients. Rev Med Interne 2009;30:486-91. [3] Keino H, Okada AA. Behcet’s disease: global epidemiology of an Old Silk Road disease. Br J Ophthalmol 2007;91:1573-4. [4] Leonardo NM, McNeil J. Behcet’s Disease: Is There Geographical Variation? A Review Far from the Silk Road. International Journal of Rheumatology 2015;2015:1-7. [5] Uva L, Miguel D, Pinheiro C, Filipe P, Freitas JP. Mucocutaneous manifestations of Behcet’s disease. Acta Reumatol Port 2013;38:77-90. Disclosure of Interests: Matthew Turk: None declared, Jacqueline Hayworth: None declared, Tatiana Nevskaya: None declared, Janet Pope Consultant for: Eli Lilly and Company

  • AB0771 The Prevalence of Inflammatory Eye Diseases in Rheumatologic Conditions: Results From a Meta-Analysis
    Annals of the Rheumatic Diseases, 2015
    Co-Authors: Jacqueline Hayworth, Janet E. Pope
    Abstract:

    Background Many inflammatory rheumatic conditions are associated with ocular involvement. The actual prevalence of these complications is not fully known. Objectives This meta-analysis was performed to systematically investigate the prevalence of ocular involvement in inflammatory rheumatic diseases in order to determine the frequency and type of ocular involvement. Methods Medline, Web of Science and Cochrane databases were searched up to July 8, 2014, to identify full text publications related to inflammatory rheumatic diseases and associated ocular conditions. Disease terms included; juvenile arthritis (JIA), rheumatoid arthritis (RA), Sjogren9s syndrome, Still9s disease, systemic lupus erythematosus (SLE), connective tissue disease, spondyloarthropathy, and ankylosing spondylitis (AS). For eye involvement terms were; conjunctivitis, keratoconjunctivitis sicca, xeropthalmia, uveitis, eye Hemorrhage, optic neuritis, papilledema, orbital disease, retinal artery/vein occlusion, macular edema, retinitis, chorioretinitis, scleritis, iridocyclitits, Choroid Hemorrhage, blindness and amaurosis fugax. Data regarding the rates of various ocular complications were extracted. Random effects models pooled rates to estimate the frequency of each complication in the included inflammatory rheumatic diseases. Results Most of the 7124 studies were excluded, leaving 263 for full review. There were 13 AS cohort studies, 30 Behcet9s disease (BD), 31 JIA, 12 PsA, 11 RA and 165 others. Pooled prevalence for commonly reported ocular manifestation were uveitis rates of: 22% (95% CI: 16-24%) in AS, Behcet9s 55% (41-68%), JIA [oligoarthritis 36% (20-51%), polyarticular 13% (8-19%) systemic onset 3% (0-7%)], pediatric Behcet9s 33% (0-74%), and PsA 15% (5-24%) for anterior uveitis and 0.2% for posterior uveitis. In RA, keratoconjunctivitis sicca occurred in 16% (8-25%), sicca symptoms in 31% (21-42%), marginal ulcerative keratitis in 1-3%, episcleritis in 1-2% and retinal vasculitis in 0.2%. In SLE 29% of patients had dry eyes. There may have been publication bias (over reporting due to selection bias of cohorts enriched for ocular complications such as patients from university clinics where complications could be higher, and several estimates had herterogeneity. Data were lacking on confounding variables (such as screening programs and treatment). Conclusions Extra-articular manifestations of inflammatory rheumatic diseases frequently complicate the ocular health of afflicted individuals. Although the rates vary, an awareness of potential complications can aid in early identification and treatment of these rheumatic complications. Disclosure of Interest None declared

Matthew A. Turk - One of the best experts on this subject based on the ideXlab platform.

  • Ocular Manifestations in Rheumatoid Arthritis, Connective Tissue Disease, and Vasculitis: A Systematic Review and Metaanalysis.
    The Journal of rheumatology, 2020
    Co-Authors: Matthew A. Turk, Jacqueline Hayworth, Tatiana Nevskaya, Janet E. Pope
    Abstract:

    Objective Rheumatoid Arthritis and other rheumatic diseases may present with ocular manifestations. The purpose of our work was to determine the prevalence and type of eye involvement in rheumatoid arthritis and other connective tissue diseases through a meta-analysis and literature review. Methods A systematic review of the literature was performed using Medline, Web of Science, and the Cochrane library from their inceptions until January 7, 2019. Conjunctivitis, keratoconjunctivitis sicca, xeropthalmia, uveitis, eye Hemorrhage, optic neuritis, papilledema, orbital disease, retinal artery/vein occlusion, macular edema, retinitis, chorioretinitis, scleritis, iridocyclitits, Choroid Hemorrhage, blindness and amaurosis fugax were searched for prevalence in patients with rheumatoid arthritis, systemic lupus erythematosus, antiphospholipid syndrome, dermatomyositis, polymyositis, systemic sclerosis, Sjogren’s syndrome, undifferentiated connective tissue disease, giant cell arteritis, granulomatosis polyangiitis (GPA; formerly Wegener9s granulomatosis), systemic vasculitis, and sarcoidosis. Results 3394 studies were identified and 65 included. The prevalence of eye involvement was 18% in rheumatoid arthritis, 31% in systemic lupus erythematosus, 35% in antiphospholipid syndrome, 27% in giant cell arteritis, 26% in GPA and 27% in sarcoidosis. The most common manifestations was dry eyes (keratoconjunctivitis sicca) in most diseases analyzed with a frequency approaching 90% in Sjogren’s syndrome. Anterior and posterior uveitis were the most common OC in sarcoidosis occurring in 16 [3-28]% and 6 [3-9]% of patients respectively. Conclusion Eye involvement is present in approximately one fifth of rheumatoid arthritis patients, and one quarter to one third of patients with connective tissue diseases (other than Sjogren’s syndrome at 90%) and vasculitis.

  • FRI0069 FREQUENCY OF EYE INVOLVEMENT IN INFLAMMATORY ARTHRITIS AND CONNECTIVE TISSUE DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS
    Poster Presentations, 2019
    Co-Authors: Matthew A. Turk, Jacqueline Hayworth, Tatiana Nevskaya, Janet E. Pope
    Abstract:

    Background: Rheumatoid arthritis commonly presents with extraarticular manifestations. Along with other connective tissue diseases, these manifestations may include eye involvement. Objectives: The purpose of our work was to determine the prevalence and type of eye involvement in rheumatoid arthritis and other connective tissue diseases through a meta-analysis and literature review. Methods: A systematic review of the literature was performed using Medline, Web of Science, and the Cochrane library from their inceptions until January 7, 2019. Conjunctivitis, keratoconjunctivitis sicca, xeropthalmia, uveitis, eye Hemorrhage, optic neuritis, papilledema, orbital disease, retinal artery/vein occlusion, macular edema, retinitis, chorioretinitis, scleritis, iridocyclitits, Choroid Hemorrhage, blindness and amaurosis fugax were searched for prevalence in patients with rheumatoid arthritis, systemic lupus erythematosus, antiphospholipid syndrome, dermatomyositis, polymyositis, systemic sclerosis, Sjogren’s syndrome, undifferentiated connective tissue disease, giant cell arteritis, granulomatosis polyangiitis (GPA; formerly Wegener’s granulomatosis, systemic vasculitis, and sarcoidosis. Results: 3394 studies were identified and 65 included. The prevalence of eye involvement was 18% in rheumatoid arthritis, 31% in systemic lupus erythematosus, 35% in antiphospholipid syndrome, 27% in giant cell arteritis, 26% in GPA and 27% in sarcoidosis. The most common manifestations was dry eyes (keratoconjunctivitis sicca) in most diseases analyzed with a frequency approaching 90% in Sjogren’s syndrome. Anterior and posterior uveitis were the most common OC in sarcoidosis occurring in 16 [3-28]% and 6 [3-9]% of patients respectively. Conclusion: Eye involvement is present in approximately one fifth of rheumatoid arthritis patients, and one quarter to one third of patients with other rheumatic diseases. References: [1] Grassi W, De Angelis R, Lamanna G, Cervini C. The clinical features of rheumatoid arthritis. Eur J Radiol 1998;27 Suppl 1:S18-24. [2] Brito-Zeron P, Acar-Denizli N, Zeher M, Rasmussen A, Seror R, Theander E, et al. Influence of geolocation and ethnicity on the phenotypic expression of primary Sjogren’s syndrome at diagnosis in 8310 patients: a cross-sectional study from the Big Data Sjogren Project Consortium. Ann Rheum Dis 2017;76:1042-50. [3] Zhang C, Zha Q-L, He Y-T, Jiang M, Lu C, Lu A-P. The extraarticular symptoms influence ACR response in the treatment of rheumatoid arthritis with biomedicine: a single-blind, randomized, controlled, multicenter trial in 194 patients. J Tradit Chin Med 2011;31:50-5. [4] Kermani TA, Cuthbertson D, Carette S, Hoffman GS, Khalidi NA, Koening CL, et al. The Birmingham Vasculitis Activity Score as a Measure of Disease Activity in Patients with Giant Cell Arteritis. The Journal of Rheumatology 2016;43:1078-84. [5] Seror R, Theander E, Brun JG, Ramos-Casals M, Valim V, Dorner T, et al. Validation of EULAR primary Sjogren’s syndrome disease activity (ESSDAI) and patient indexes (ESSPRI). Ann Rheum Dis 2015;74:859-66. [6] Valeyre D, Prasse A, Nunes H, Uzunhan Y, Brillet P-Y, Muller-Quernheim J. Sarcoidosis. Lancet 2014;383:1155-67. Disclosure of Interests: Matthew Turk: None declared, Jacqueline Hayworth: None declared, Tatiana Nevskaya: None declared, Janet Pope Consultant for: Eli Lilly and Company

  • SAT0352 THE FREQUENCY OF OCULAR MANIFESTATIONS IN PATIENTS WITH ADULT VS. CHILDHOOD SPONDYLOARTHRITIS
    Saturday 15 June 2019, 2019
    Co-Authors: Matthew A. Turk, Jacqueline Hayworth, Tatiana Nevskaya, Janet E. Pope
    Abstract:

    Background Adult spondyloarthritis (SpA) is characterized by abnormal bone overgrowth and inflammatory erosive osteopenia in the spine. SpA may be associated with psoriasis and psoriatic arthritis (PsA), inflammatory bowel disease, reactive arthritis, enthesitis, and ocular features such as acute anterior iritis, and chronic uveitis. Juvenile SpA onsets in children under 16 years old and may present with more peripheral enthesopathies and arthritis than adult SpA. Objectives This meta-analysis investigated the frequency and type of ocular involvement in childhood and adult SpA. The difference in frequency between childhood and adult SpA was also investigated. Methods Medline, Web of Science and Cochrane databases were searched to September, 2018 to identify publications related to spondyloarthropathy (SpA), and ankylosing spondylitis (AS) with ocular conditions (OC) (conjunctivitis, keratoconjunctivitis sicca, xeropthalmia, uveitis, eye Hemorrhage, optic neuritis, papilledema, orbital disease, retinal artery/vein occlusion, macular edema, retinitis, chorioretinitis, scleritis, iridocyclitits, Choroid Hemorrhage, blindness and amaurosis fugax). The rates of OC were extracted and random effects models estimated their frequency. Heterogeneity was evaluated using I2. Inclusion criteria were studies in SpA of either children or adults that included a frequency of OC. Differences in frequencies of OC between childhood and adult disease were compared using chi squared tests. Results The search process identified 3164 articles, of which 41 were eligible for inclusion. A pooled random effects model showed the prevalence of uveitis was 24% [20%-27%] in adult AS (23 studies, N= 11943 patients), 10% [7%-14%] in adult PsA (9 studies, N=1817), and 17% [10%-24%] in undifferentiated adult SpA (9 studies, 6568 patients). In juveniles with AS, the prevalence of uveitis was 27% [16%-39%] (8 studies, 927 patients). In child onset PsA, uveitis occurred in 16% [10%-21%] (5 studies, N=498), and in juvenile undifferentiated SpA, uveitis had a frequency of 7% [1%-12%] (2 studies, N=1531). The differences in frequency of uveitis in adults vs. child onset SpA spectrum diseases were not significantly different between AS and JAS (p=0.891), PsA and JPsA (p=0.732) and between SpA and JSpA. Conclusion This meta-analysis compares the frequency of ocular involvement in seronegative spectrum diseases in adults and children where it appears that the frequency of uveitis is not statistically different in adult vs. child onset SpA and the subsets. References [1] Reveille JD, Weisman MH. The epidemiology of back pain, axial spondyloarthritis and HLA-B27 in the United States. Am J Med Sci2013;345:431-6. [2] Smith JA. Update on ankylosing spondylitis: current concepts in pathogenesis. Curr Allergy Asthma Rep2015;15:489. [3] Stolwijk C, Essers I, van Tubergen A, Boonen A, Bazelier MT, De Bruin ML, et al. The epidemiology of extra-articular manifestations in ankylosing spondylitis: a population-based matched cohort study. Annals of the Rheumatic Diseases2015;74:1373-8. [4] Lin Y-C, Liang T-H, Chen W-S, Lin H-Y. Differences between juvenile-onset ankylosing spondylitis and adult-onset ankylosing spondylitis. J Chin Med Assoc2009;72:573-80. [5] Cantini F, Nannini C, Cassara E, Kaloudi O, Niccoli L. Uveitis in Spondyloarthritis: An Overview. J Rheumatol Suppl2015;93:27-9. Disclosure of Interests Matthew Turk: None declared, Jacqueline Hayworth: None declared, Tatiana Nevskaya: None declared, Janet Pope Consultant for: Eli Lilly and Company

  • THU0692 OCULAR MANIFESTATIONS IN BEHCET’S DISEASE MAY BE MORE COMMON IN CHILDREN THAN ADULTS: RESULTS OF A SYSTEMATIC REVIEW
    Poster Presentations, 2019
    Co-Authors: Matthew A. Turk, Jacqueline Hayworth, Tatiana Nevskaya, Janet E. Pope
    Abstract:

    Background: Behcet’s disease (BD) can develop in both children and adults, but they may have different clinical features. Ocular involvement is common in BD and causes substantial impairment. The frequency of ocular involvement in BD has a wide range (5 to 89%). Objectives: This study determined the frequency and type of ocular manifestations in childhood and adult BD and compared prevalence of ocular manifestations by geographic location in those with BD. Methods: The protocol of ocular conditions in rheumatic conditions was registered at clintrials.gov (NCT03753893). Search terms were: conjunctivitis, keratoconjunctivitis sicca, xeropthalmia, uveitis, eye Hemorrhage, optic neuritis, papilledema, orbital disease, retinal artery/vein occlusion, macular edema, retinitis, chorioretinitis, scleritis, iridocyclitits, Choroid Hemorrhage, blindness and amaurosis fugax in patients with BD. The search was performed with the assistance of an information specialist. Medline, Cochrane and Web of Science were used searching papers that spanned from their inception (1966, 1991 and 1990 respectively) to October 5, 2018. Studies were included if they had a minimum of twenty patients and reported the frequency of ocular manifestations within BD. Random effects models were used to combine the prevalence of ocular manifestations using Revman 5.3. Heterogeneity was evaluated using I2 and funnel plots. Results: The search resulted in 3129 articles, of which 33 were included for meta-analysis. Eye manifestations were more frequent in childhood onset BD with the mean [95% Confidence Interval] frequency of 50 [38-63]% compared to 34 [25-43]% in adults. In both children and adults, posterior uveitis (children 27% vs. adults 25%) was the most common ocular manifestation, followed by anterior uveitis (children 18% vs. adults 23%). When comparing the distribution of ocular manifestations in Behcet’s in adults, there was geographic variation higher along the ancient Silk Road with ocular manifestations occurring in 40% of patients from Turkey and the Middle East. Ocular manifestations were similar in Europe (36%) and North America (36%), but less frequent in North Africa (26%) and East Asia (20%). Conclusion: The frequency of ocular involvement is higher in children when compared to adults with BD. The most common manifestation in the eyes is posterior and then anterior uveitis. Ocular involvement also presents regional differences. References: [1] Arevalo JF, Lasave AF, Al Jindan MY, Al Sabaani NA, Al-Mahmood AM, Al-Zahrani YA, et al. Uveitis in Behcet Disease in a Tertiary Center Over 25 Years: The KKESH Uveitis Survey Study Group. American Journal of Ophthalmology 2015;159:177-184.e2. [2] Frigui M, Kechaou M, Jemal M, Ben Zina Z, Feki J, Bahloul Z. Optic neuropathy in Behcet’s disease: a series of 18 patients. Rev Med Interne 2009;30:486-91. [3] Keino H, Okada AA. Behcet’s disease: global epidemiology of an Old Silk Road disease. Br J Ophthalmol 2007;91:1573-4. [4] Leonardo NM, McNeil J. Behcet’s Disease: Is There Geographical Variation? A Review Far from the Silk Road. International Journal of Rheumatology 2015;2015:1-7. [5] Uva L, Miguel D, Pinheiro C, Filipe P, Freitas JP. Mucocutaneous manifestations of Behcet’s disease. Acta Reumatol Port 2013;38:77-90. Disclosure of Interests: Matthew Turk: None declared, Jacqueline Hayworth: None declared, Tatiana Nevskaya: None declared, Janet Pope Consultant for: Eli Lilly and Company

Tatiana Nevskaya - One of the best experts on this subject based on the ideXlab platform.

  • Ocular Manifestations in Rheumatoid Arthritis, Connective Tissue Disease, and Vasculitis: A Systematic Review and Metaanalysis.
    The Journal of rheumatology, 2020
    Co-Authors: Matthew A. Turk, Jacqueline Hayworth, Tatiana Nevskaya, Janet E. Pope
    Abstract:

    Objective Rheumatoid Arthritis and other rheumatic diseases may present with ocular manifestations. The purpose of our work was to determine the prevalence and type of eye involvement in rheumatoid arthritis and other connective tissue diseases through a meta-analysis and literature review. Methods A systematic review of the literature was performed using Medline, Web of Science, and the Cochrane library from their inceptions until January 7, 2019. Conjunctivitis, keratoconjunctivitis sicca, xeropthalmia, uveitis, eye Hemorrhage, optic neuritis, papilledema, orbital disease, retinal artery/vein occlusion, macular edema, retinitis, chorioretinitis, scleritis, iridocyclitits, Choroid Hemorrhage, blindness and amaurosis fugax were searched for prevalence in patients with rheumatoid arthritis, systemic lupus erythematosus, antiphospholipid syndrome, dermatomyositis, polymyositis, systemic sclerosis, Sjogren’s syndrome, undifferentiated connective tissue disease, giant cell arteritis, granulomatosis polyangiitis (GPA; formerly Wegener9s granulomatosis), systemic vasculitis, and sarcoidosis. Results 3394 studies were identified and 65 included. The prevalence of eye involvement was 18% in rheumatoid arthritis, 31% in systemic lupus erythematosus, 35% in antiphospholipid syndrome, 27% in giant cell arteritis, 26% in GPA and 27% in sarcoidosis. The most common manifestations was dry eyes (keratoconjunctivitis sicca) in most diseases analyzed with a frequency approaching 90% in Sjogren’s syndrome. Anterior and posterior uveitis were the most common OC in sarcoidosis occurring in 16 [3-28]% and 6 [3-9]% of patients respectively. Conclusion Eye involvement is present in approximately one fifth of rheumatoid arthritis patients, and one quarter to one third of patients with connective tissue diseases (other than Sjogren’s syndrome at 90%) and vasculitis.

  • FRI0069 FREQUENCY OF EYE INVOLVEMENT IN INFLAMMATORY ARTHRITIS AND CONNECTIVE TISSUE DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS
    Poster Presentations, 2019
    Co-Authors: Matthew A. Turk, Jacqueline Hayworth, Tatiana Nevskaya, Janet E. Pope
    Abstract:

    Background: Rheumatoid arthritis commonly presents with extraarticular manifestations. Along with other connective tissue diseases, these manifestations may include eye involvement. Objectives: The purpose of our work was to determine the prevalence and type of eye involvement in rheumatoid arthritis and other connective tissue diseases through a meta-analysis and literature review. Methods: A systematic review of the literature was performed using Medline, Web of Science, and the Cochrane library from their inceptions until January 7, 2019. Conjunctivitis, keratoconjunctivitis sicca, xeropthalmia, uveitis, eye Hemorrhage, optic neuritis, papilledema, orbital disease, retinal artery/vein occlusion, macular edema, retinitis, chorioretinitis, scleritis, iridocyclitits, Choroid Hemorrhage, blindness and amaurosis fugax were searched for prevalence in patients with rheumatoid arthritis, systemic lupus erythematosus, antiphospholipid syndrome, dermatomyositis, polymyositis, systemic sclerosis, Sjogren’s syndrome, undifferentiated connective tissue disease, giant cell arteritis, granulomatosis polyangiitis (GPA; formerly Wegener’s granulomatosis, systemic vasculitis, and sarcoidosis. Results: 3394 studies were identified and 65 included. The prevalence of eye involvement was 18% in rheumatoid arthritis, 31% in systemic lupus erythematosus, 35% in antiphospholipid syndrome, 27% in giant cell arteritis, 26% in GPA and 27% in sarcoidosis. The most common manifestations was dry eyes (keratoconjunctivitis sicca) in most diseases analyzed with a frequency approaching 90% in Sjogren’s syndrome. Anterior and posterior uveitis were the most common OC in sarcoidosis occurring in 16 [3-28]% and 6 [3-9]% of patients respectively. Conclusion: Eye involvement is present in approximately one fifth of rheumatoid arthritis patients, and one quarter to one third of patients with other rheumatic diseases. References: [1] Grassi W, De Angelis R, Lamanna G, Cervini C. The clinical features of rheumatoid arthritis. Eur J Radiol 1998;27 Suppl 1:S18-24. [2] Brito-Zeron P, Acar-Denizli N, Zeher M, Rasmussen A, Seror R, Theander E, et al. Influence of geolocation and ethnicity on the phenotypic expression of primary Sjogren’s syndrome at diagnosis in 8310 patients: a cross-sectional study from the Big Data Sjogren Project Consortium. Ann Rheum Dis 2017;76:1042-50. [3] Zhang C, Zha Q-L, He Y-T, Jiang M, Lu C, Lu A-P. The extraarticular symptoms influence ACR response in the treatment of rheumatoid arthritis with biomedicine: a single-blind, randomized, controlled, multicenter trial in 194 patients. J Tradit Chin Med 2011;31:50-5. [4] Kermani TA, Cuthbertson D, Carette S, Hoffman GS, Khalidi NA, Koening CL, et al. The Birmingham Vasculitis Activity Score as a Measure of Disease Activity in Patients with Giant Cell Arteritis. The Journal of Rheumatology 2016;43:1078-84. [5] Seror R, Theander E, Brun JG, Ramos-Casals M, Valim V, Dorner T, et al. Validation of EULAR primary Sjogren’s syndrome disease activity (ESSDAI) and patient indexes (ESSPRI). Ann Rheum Dis 2015;74:859-66. [6] Valeyre D, Prasse A, Nunes H, Uzunhan Y, Brillet P-Y, Muller-Quernheim J. Sarcoidosis. Lancet 2014;383:1155-67. Disclosure of Interests: Matthew Turk: None declared, Jacqueline Hayworth: None declared, Tatiana Nevskaya: None declared, Janet Pope Consultant for: Eli Lilly and Company

  • SAT0352 THE FREQUENCY OF OCULAR MANIFESTATIONS IN PATIENTS WITH ADULT VS. CHILDHOOD SPONDYLOARTHRITIS
    Saturday 15 June 2019, 2019
    Co-Authors: Matthew A. Turk, Jacqueline Hayworth, Tatiana Nevskaya, Janet E. Pope
    Abstract:

    Background Adult spondyloarthritis (SpA) is characterized by abnormal bone overgrowth and inflammatory erosive osteopenia in the spine. SpA may be associated with psoriasis and psoriatic arthritis (PsA), inflammatory bowel disease, reactive arthritis, enthesitis, and ocular features such as acute anterior iritis, and chronic uveitis. Juvenile SpA onsets in children under 16 years old and may present with more peripheral enthesopathies and arthritis than adult SpA. Objectives This meta-analysis investigated the frequency and type of ocular involvement in childhood and adult SpA. The difference in frequency between childhood and adult SpA was also investigated. Methods Medline, Web of Science and Cochrane databases were searched to September, 2018 to identify publications related to spondyloarthropathy (SpA), and ankylosing spondylitis (AS) with ocular conditions (OC) (conjunctivitis, keratoconjunctivitis sicca, xeropthalmia, uveitis, eye Hemorrhage, optic neuritis, papilledema, orbital disease, retinal artery/vein occlusion, macular edema, retinitis, chorioretinitis, scleritis, iridocyclitits, Choroid Hemorrhage, blindness and amaurosis fugax). The rates of OC were extracted and random effects models estimated their frequency. Heterogeneity was evaluated using I2. Inclusion criteria were studies in SpA of either children or adults that included a frequency of OC. Differences in frequencies of OC between childhood and adult disease were compared using chi squared tests. Results The search process identified 3164 articles, of which 41 were eligible for inclusion. A pooled random effects model showed the prevalence of uveitis was 24% [20%-27%] in adult AS (23 studies, N= 11943 patients), 10% [7%-14%] in adult PsA (9 studies, N=1817), and 17% [10%-24%] in undifferentiated adult SpA (9 studies, 6568 patients). In juveniles with AS, the prevalence of uveitis was 27% [16%-39%] (8 studies, 927 patients). In child onset PsA, uveitis occurred in 16% [10%-21%] (5 studies, N=498), and in juvenile undifferentiated SpA, uveitis had a frequency of 7% [1%-12%] (2 studies, N=1531). The differences in frequency of uveitis in adults vs. child onset SpA spectrum diseases were not significantly different between AS and JAS (p=0.891), PsA and JPsA (p=0.732) and between SpA and JSpA. Conclusion This meta-analysis compares the frequency of ocular involvement in seronegative spectrum diseases in adults and children where it appears that the frequency of uveitis is not statistically different in adult vs. child onset SpA and the subsets. References [1] Reveille JD, Weisman MH. The epidemiology of back pain, axial spondyloarthritis and HLA-B27 in the United States. Am J Med Sci2013;345:431-6. [2] Smith JA. Update on ankylosing spondylitis: current concepts in pathogenesis. Curr Allergy Asthma Rep2015;15:489. [3] Stolwijk C, Essers I, van Tubergen A, Boonen A, Bazelier MT, De Bruin ML, et al. The epidemiology of extra-articular manifestations in ankylosing spondylitis: a population-based matched cohort study. Annals of the Rheumatic Diseases2015;74:1373-8. [4] Lin Y-C, Liang T-H, Chen W-S, Lin H-Y. Differences between juvenile-onset ankylosing spondylitis and adult-onset ankylosing spondylitis. J Chin Med Assoc2009;72:573-80. [5] Cantini F, Nannini C, Cassara E, Kaloudi O, Niccoli L. Uveitis in Spondyloarthritis: An Overview. J Rheumatol Suppl2015;93:27-9. Disclosure of Interests Matthew Turk: None declared, Jacqueline Hayworth: None declared, Tatiana Nevskaya: None declared, Janet Pope Consultant for: Eli Lilly and Company

  • THU0692 OCULAR MANIFESTATIONS IN BEHCET’S DISEASE MAY BE MORE COMMON IN CHILDREN THAN ADULTS: RESULTS OF A SYSTEMATIC REVIEW
    Poster Presentations, 2019
    Co-Authors: Matthew A. Turk, Jacqueline Hayworth, Tatiana Nevskaya, Janet E. Pope
    Abstract:

    Background: Behcet’s disease (BD) can develop in both children and adults, but they may have different clinical features. Ocular involvement is common in BD and causes substantial impairment. The frequency of ocular involvement in BD has a wide range (5 to 89%). Objectives: This study determined the frequency and type of ocular manifestations in childhood and adult BD and compared prevalence of ocular manifestations by geographic location in those with BD. Methods: The protocol of ocular conditions in rheumatic conditions was registered at clintrials.gov (NCT03753893). Search terms were: conjunctivitis, keratoconjunctivitis sicca, xeropthalmia, uveitis, eye Hemorrhage, optic neuritis, papilledema, orbital disease, retinal artery/vein occlusion, macular edema, retinitis, chorioretinitis, scleritis, iridocyclitits, Choroid Hemorrhage, blindness and amaurosis fugax in patients with BD. The search was performed with the assistance of an information specialist. Medline, Cochrane and Web of Science were used searching papers that spanned from their inception (1966, 1991 and 1990 respectively) to October 5, 2018. Studies were included if they had a minimum of twenty patients and reported the frequency of ocular manifestations within BD. Random effects models were used to combine the prevalence of ocular manifestations using Revman 5.3. Heterogeneity was evaluated using I2 and funnel plots. Results: The search resulted in 3129 articles, of which 33 were included for meta-analysis. Eye manifestations were more frequent in childhood onset BD with the mean [95% Confidence Interval] frequency of 50 [38-63]% compared to 34 [25-43]% in adults. In both children and adults, posterior uveitis (children 27% vs. adults 25%) was the most common ocular manifestation, followed by anterior uveitis (children 18% vs. adults 23%). When comparing the distribution of ocular manifestations in Behcet’s in adults, there was geographic variation higher along the ancient Silk Road with ocular manifestations occurring in 40% of patients from Turkey and the Middle East. Ocular manifestations were similar in Europe (36%) and North America (36%), but less frequent in North Africa (26%) and East Asia (20%). Conclusion: The frequency of ocular involvement is higher in children when compared to adults with BD. The most common manifestation in the eyes is posterior and then anterior uveitis. Ocular involvement also presents regional differences. References: [1] Arevalo JF, Lasave AF, Al Jindan MY, Al Sabaani NA, Al-Mahmood AM, Al-Zahrani YA, et al. Uveitis in Behcet Disease in a Tertiary Center Over 25 Years: The KKESH Uveitis Survey Study Group. American Journal of Ophthalmology 2015;159:177-184.e2. [2] Frigui M, Kechaou M, Jemal M, Ben Zina Z, Feki J, Bahloul Z. Optic neuropathy in Behcet’s disease: a series of 18 patients. Rev Med Interne 2009;30:486-91. [3] Keino H, Okada AA. Behcet’s disease: global epidemiology of an Old Silk Road disease. Br J Ophthalmol 2007;91:1573-4. [4] Leonardo NM, McNeil J. Behcet’s Disease: Is There Geographical Variation? A Review Far from the Silk Road. International Journal of Rheumatology 2015;2015:1-7. [5] Uva L, Miguel D, Pinheiro C, Filipe P, Freitas JP. Mucocutaneous manifestations of Behcet’s disease. Acta Reumatol Port 2013;38:77-90. Disclosure of Interests: Matthew Turk: None declared, Jacqueline Hayworth: None declared, Tatiana Nevskaya: None declared, Janet Pope Consultant for: Eli Lilly and Company

Gernot I.w. Duncker - One of the best experts on this subject based on the ideXlab platform.

  • Severe intra- and postoperative supra-Choroid Hemorrhage. Risk factors, therapy, results
    Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft, 1999
    Co-Authors: Georg Häring, Stephan Behrendt, Burkhard Wiechens, Gernot I.w. Duncker
    Abstract:

    BACKGROUND The aim of this study was to analyze risk factors, therapeutic strategies, and functional and anatomic results of eyes with severe supraChoroidal Hemorrhage. PATIENTS Eight of 11 bleeding episodes occurred intraoperatively and 3/11 postoperatively. Bleeding was associated with the following surgical procedures: perforating keratoplasty (5x), extracapsular cataract extraction (3x), pars plana vitrectomy (2x), intracapsular cataract extraction (1x). RESULTS Nine operations were performed with general anesthesia, two after retrobulbar injection. Ocular risk factors (e.g., prior operations, ocular diseases) and general risk factors (e.g., cardiovascular diseases, diabetes) were analyzed. At the end of the follow-up time visual acuity had improved in three eyes, and it was unchanged in one eye and worse in seven eyes. Four eyes were amaurotic; two of them had to be enucleated. CONCLUSIONS In spite of using state-of-the-art surgical techniques the prognosis of supraChoroidal bleeding remains serious. Patients who have a combination of several ocular and general risk factors almost exclusively are the ones who afflicted by this complication.