Clinical features and missed and inaccurate diagnosis of uveitis associated with ankylosing spondylitis

Abstract

Objectiye To investigate the clinical manifestations and possible reasons of the missed and inaccurate diagnosis of uveitis associated with ankylosing spondylitis. Methods The clinical data of 83 patients with uveitis associated with ankylosing spondylitis who were diagnosed and treated from June 1998 to December2007 were retrospectively analyzed. The disease history of each patient was carefully recorded. Slit-lamp microscopy was performed on the patients. The character and distribution of keratic precipitates( KP), the cell number and the flare degree in anterior chamber were noted in detail, especially The anterior chamber cellulose、oculuspurulentus and cacroiliac joint's X-ray examination. The data recorded in other hospitals were analyzed and thereasons of missed and inaccurate diagnosis were statistically analyzed. Results In the 83 patients of Uveitis asyears,the mean age 34.8 year-old. Sacroiliitis equal to or over grade two 44(53.01% ) ,equal to or over gradethree 39(46.99% ). Binocular involvement was noted in 76 patients. All of the patients showed ciliary congestion、 KP、Anterior-chamber flare and anterior-chamber cells, anterior chamber cellulose or oculus purulentus 73(87.95% ), HLA-B27 positive 76 (91.57%), relapse 71 (85.54%). Conclusion Uveitis associated with AS has larger case rate in male people、more relapse and blind cases、 typical joint's X-ray change and more positive HLA-B27. Missed and inaccurate diagnosisis mainly due to the unawareness of its clinical features. Key words: Ankylosing spondylitis; Uveitis; Diagnosis; Misdiagnosis; Missed diagnosis