An Observational Descriptive Cross-Sectional Study of 200 Iraqi Adult Patients with Ankylosing Spondylitis: Analysis of Ocular Manifestations

Abstract

Objective: To analyze the ocular findings in adult patients with ankylosing spondylitis.Patients and methods: A cross sectional study was conducted on (200) ankylosing spondylitis (AS) patients diagnosed according to the modified New York criteria for ankylosing spondylitis. Demographic and clinical data were collected and all patients were examined by same ophthalmologist for ocular findings.Results: The mean age of patients was (35.2 ± 8.6) years with male to female ratio (13.3:1), and mean disease duration was (10.9 ± 6.7) years. Family history of AS was positive in (26%) of patients. HLA-B27 was obtained in (69.5%) of the total number of the patients. Among those patients in whom HLA-B27 test was obtained, (43.2%) had positive HLA-B27. Enthesitis was found in (48%) of patients, and (63.5%) had peripheral arthritis. Ocular manifestations were found in (21.5%) of the patients in the form of anterior uveitis (14.5%), conjunctivitis (3%), ocular dryness (2%), and cataract (2%). Ocular manifestations had significant association with enthesitis, peripheral arthritis, HLA-B27 positivity and positive family history of AS (p<0.05), but not with age, sex, disease duration and disease activity

(p > 0.05).Conclusions: Prevalence of ocular manifestations in adult Iraqi patients with AS was (21.5%). The commonest form was anterior uveitis. Other forms included conjunctivitis, ocular dryness, and cataract. Ocular manifestations had significant association only with enthesitis, peripheral arthritis, HLA-B27 positivity and positive family history of AS. This may suggest that early screening for ocular features in AS is important for early diagnosis and treatment.

Keywords: Ankylosing spondylitis, Ocular manifestations, Anterior Uveitis, Conjunctivitis, Ocular dryness, Cataract.