Ipsilateral uveitis and optic neuritis in multiple sclerosis

Abstract

Background. Uveitis is 20 times more frequent in multiple sclerosis (MS) patients than in the general population. Methods. A retrospective study of local multiple sclerosis (n = 700) and uveitis cohorts (n = 450) described the ophthalmological and neurological characteristics of patients with multiple sclerosis and uveitis. Results. Uveitis and multiple sclerosis were associated in seven patients. The time intervals between diagnoses of MS and uveitis ranged from 6 months to 15 years. Analysis of the patients' characteristics revealed that multiple sclerosis was associated with an older age of onset than usually expected, that is, 39 years. Uveitis was bilateral in three cases and mainly posterior (5/10). Five patients presented with acute optic neuritis (two in one eye and three in both eyes). All eyes presenting with acute optic neuritis were also affected by uveitis (P = 0.02), though not simultaneously. Conclusion. The ipsilateral association between optic neuritis and uveitis in this series of patients with multiple sclerosis may suggest a reciprocal potentiation between optic neuritis and uveitis in multiple sclerosis.

Figure 1

Fundus photographs. Top, late-phase fluorescein angiograms from patient 6 (panuveitis, (a)) showing retinal vasculitis with cystoid macular edema (arrow) and disc leakage (arrowhead), and from patient 7 (posterior uveitis, (b)) showing retinal vasculitis with diffuse cystoid macular edema (arrow). However, because of the severity of the vitritis, the vessels are poorly visualized (a). Bottom, fluorescein angiograms from patient 5 (posterior uveitis, (c) and (d)) showing retinal occlusive vasculitis with arteriolar leakage at a late phase.