CHANGES OF EYE AT ANKYLOSING SPONDYLARTHRITIS

Abstract

Relevance. At present, all variants of changes in the eye in case of ankylosing spondylitis have not been determined, their relationship to the musculoskeletal system has not been studied, the degree of influence of certain eye diseases on the clinical and X-ray manifestations of ankylosing spondylitis and their prognostic significance remains unknown.
 Objective. The purpose: to study different variants of changes in the eye in case of ankylosing spondylitis, their relationship to the defeat of the musculoskeletal system, the degree of influence of certain eye diseases on the clinical and X-ray manifestations of ankylosing spondylitis and their prognostic significance.
 Materials and methods. 79 patients with AS (75 men and 4 women) aged 15 to 66 years were under observation. The quartiles of the disease duration were 3.9 ÷ 18.8 years, median 11.4 years. The Richie index was 7.0 ± 4.22 points, the Lansbury index - 37.3 ± 28.45 points, the index of arthritis progression - 0.6 ± 1.56 p.u. Patients underwent x-ray and ultrasound examination of peripheral joints, sacroiliac joints and spine, as well as dual-energy X-ray osteodensitometry of the proximal femur. The following X-ray indices were assessed: peripheral metacarpal, Barnett-Nordin, Rokhlin, disc and concavity. In addition, electrocardiography, echocardiography and spirography were performed. Statistical processing of the results was carried out with the help of computer variational, correlation, nonparametric, one- and multifactorial variance analysis. Mean values ​​and average quadratic deviations, correlation coefficients, dispersion criteria, Student’s test, Wilcoxon-Rao, McNemara-Fisher and reliability of statistical indicators were evaluated.
 Results. Changes in the organ of vision in a cases of ankylosing spondylitis are diagnosed in 29% of the number of examined patients in the ratio of uveitis-scleritis-cataract-keratitis-glaucoma-conjunctivitis as 7: 5: 2: 2: 2: 1, and, eye diseases determine the degree of activity of the disease and the rate of progression of the pathology of the musculoskeletal system, as well as the severity of arthritis based on data of Richie and Lansbury indices, significantly affects the integral signs of the course of the joint syndrome, the incidence of sternocleid, metacarpophalangeal and ulnar articulations, the degree of narrowing of articular fissures, subchondral sclerosis and osteo cystosis, the development of osteo usuration and epiphyseal osteoporosis, pathology of the skin (uveitis, keratitis, glaucoma, cataracts), kidneys (keratitis, glaucoma, conjunctivitis) and the heart (scleritis).
 Conclusions. Practical significance can be found in the lesion of the sternoclavicular joints as a risk factor for the development of lesions in the organ of vision, the presence of osteo usurations - as a risk factor for severe inflammation of the choroid of the eye, involvement in the process of wrist and elbow joints - as a predictor of the peripheral variant of uveitis.