SAT0352 THE FREQUENCY OF OCULAR MANIFESTATIONS IN PATIENTS WITH ADULT VS. CHILDHOOD SPONDYLOARTHRITIS

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.