Seronegative spondyloarthropathies and the eye.

PURPOSE OF REVIEW: Ocular inflammation is a common and important manifestation of disease in patients with seronegative spondyloarthropathy.

RECENT FINDINGS: Anterior uveitis is among the most common manifestations of eye disease in patients with seronegative spondyloarthropathies. Additionally, a strong correlation exists among such affected patients and the presence of the HLA-B27 gene. Steroid treatment is often effective for uveitis associated with spondyloarthropathies. Patients with ocular inflammation that is chronic in nature or uncontrolled by steroid treatment have shown good response to immunosuppressive agents known to be effective for articular inflammation, such as methotrexate. Recent studies have shown the possible benefits of tumor necrosis factor-alpha inhibitors, such as infliximab and etanercept.

SUMMARY: Uveitis, a leading cause of blindness, is among the most common eye manifestations in patients affected by seronegative spondyloarthropathies. Evidence suggests both genetic and environmental factors in its pathogenesis. Immunomodulator treatments, including the recently popular biologics, may be effective in the control of chronic uveitis in patients with spondyloarthropathy. Ocular surgery is often needed in these patients, and appropriate cautions are required in order to achieve successful vision rehabilitation.