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January 1997

Uveitis Associated With Inflammatory Bowel Disease Compared With Uveitis Associated With Spondyloarthropathy

Arch Ophthalmol. 1997;115(1):61-64. doi:10.1001/archopht.1997.01100150063010

Background:  Inflammatory bowel disease (IBD) and spondyloarthropathy (SA) such as Reiter syndrome may be characterized by diarrhea, arthritis, stomatitis, and uveitis. Objective: To determine if the characteristics of the eye disease could help distinguish these 2 diagnoses.

Design:  Seventeen patients with uveitis and IBD referred to a university clinic were compared retrospectively with 89 patients with uveitis and SA referred to the same clinic.

Results:  Twelve (80%) of the 15 patients with evaluable IBD had Crohn disease. In marked contrast to patients with SA, patients with IBD were usually female (82%). Whereas uveitis with SA was predominantly anterior, unilateral, sudden in onset, and limited in duration, patients with IBD frequently had uveitis that was bilateral, posterior, insidious in onset, and/or chronic in duration. Results for 89% of the patients with SA who underwent HLA-B27 typing were positive, compared with only 46% of such patients with IBD. Episcleritis, scleritis, and glaucoma were more common among patients with IBD. Arthritis did not easily distinguish the 2 groups, as 13 (76%) of the patients with IBD had a history of joint disease. In 10 (59%) of the patients with IBD, the diagnosis of uveitis preceded that of IBD.

Conclusion:  The hallmarks of uveitis can often distinguish SA and IBD.