Ultra-widefield fundus fluorescein angiography findings in patients with ankylosing spondylitis experiencing uveitis
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ORIGINAL PAPER
Ultra-widefield fundus fluorescein angiography findings in patients with ankylosing spondylitis experiencing uveitis Dilek Uzlu
. Bu¨s¸ ra Ko¨se . Hidayet Erdo¨l . Nurettin Akyol
Received: 2 March 2020 / Accepted: 23 May 2020 Ó Springer Nature B.V. 2020
Abstract Aim To evaluate ultra-widefield fundus fluorescein angiography (FFA) findings in cases of ankylosing spondylitis (AS)-associated uveitis. Materials and methods Forty-five eyes of 23 AS patients followed up with a diagnosis of uveitis were included. Results Sixteen (69.6%) men and seven (30.4%) women with a mean age of 46.26 ± 10.87 years were included in the study. Retinal vascular leakage was observed in 19 (42.2%) eyes at FFA, diffuse in six (13.3%) and peripheral in 13 (28.9%) eyes. Active anterior uveitis attack was present in seven (36.8%) eyes with vascular leakage at FFA, while no active uveitis findings were present in 12 (63.15%) eyes. No statistical relation was determined between peripheral and diffuse leakage and active uveitis (p = 0.195). No significant association was also determined between both diffuse and peripheral leakage and visual acuity (p = 0.066). Conclusion We observed widespread retinal vascular leakage at UWF angiography in AS patients (in
D. Uzlu (&) H. Erdo¨l N. Akyol Department of Ophthalmology, Medical Faculty, Karadeniz Technical University, Trabzon, Turkey e-mail: [email protected] B. Ko¨se The State Hospital of Bayburt, Bayburt, Turkey
eyes undergoing active uveitis attacks and inactive eyes). Keywords Ankylosing spondylitis Acute anterior uveitis Inflammation Fluorescein angiography
Introduction Ankylosing spondylitis (AS) is a chronic, progressive, inflammatory disease leading to sacroiliac joint inflammation in the early stage and to axial and peripheral joint inflammation in the late period [1]. Acute anterior uveitis is one of the most common extra-articular findings, with a prevalence of 25–40% in AS patients [2–4]. Fifty percent of AS-associated uveitis appears in the form of acute anterior uveitis. Uveitis can develop as acute, recurrent, non-granulomatous iridocyclitis attacks exhibiting unilateral and/ or bilateral involvement. AS frequently appears together with anterior uveitis findings, and vitreous involvement and retinal vascular leakage have been reported in 15–25% of cases [5, 6]. The ultra-widefield (UWF) imaging systems permit detailed evaluation and recording of peripheral retina. Peripheral findings in uveitis that may not be observed at standard angiography can be detected using UWF imaging, thus facilitating diagnosis. UWF imaging can also reveal vascular leakage in the peripheral
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retina, despite the absence of any clinical findings and a normal appearance in the posterior pole. Although peripheral retinal scanning has been described as a valuable method in the diagnosis, monitoring and treatment of retinal vasculitis, our knowledge of peripheral retinal findings in anterior uveitis is limited. Altho
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