ARE THERE ANY NEW TREATMENTS
LATTLY> AND HOW WILL THIS
AFECT THE EYES
NEED TO KNOW
THANK YOU
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Answered by Richard E. Gans, M. D. (xx102@ofcn.org)
Ankylosing spondylitis (AS) is an unusual type of arthritis. It is characterized by pain which is primarily isolated to the shoulders, lower back and hips. It is an arthritis that is caused and complicated by inflammation in these joints. No specific cure is known. The diagnosis of AS is made, in part by looking at x-rays of the spine and pelvis. Characteristic changes are found in the sacro-iliac joints. In addition, a specific genetic marker is found on blood testing, called HLA- B27. HLA-B27 is found in only 6% of the general population, but is present in 90% of individuals with AS. Treatment includes the use of steroids and nonsteroidal anti- inflammatory medications.
One of the most common complications of Ankylosing Spondylitis (AS) is anterior uveitis. This is inflammation inside the eye, which causes pain, light sensitivity, and can lead to serious, permanent, vision-threatening complications inside the eye. Between 25 - 35% of individuals with AS will have anterior uveitis. The eye condition may develop years before the AS is diagnosed. HLA-B27 is helpful in isolating people at risk for AS, but many people with uveitis can have a positive HLA-B27 and not develop AS.
Treatment of uveitis associated with AS is the same as the treatment for uveitis, in general. Cortisone-type medications are used to suppress the inflammation inside the eye. Dilating eyedrops are used to prevent scarring inside the eye and to alleviate pain.
One of the problems with treating uveitis, historically, is that the cortisone medications that are used, have significant side effects. In some individuals, the steroid medications can cause the pressure inside the eye to increase. Long-term use of steroids can cause cataracts to form. (Chronic uveitis, itself, can also cause cataracts to form). One new form of treatment involves the use of nonsteroidal anti-inflammatory medicines. The same NSAIDs that have been used in pill form to treat arthritis are now available as eyedrop medications. Some of these drops could potentially be used to control the inflammation of uveitis, without the complications associated with steroids. The experience with topical NSAIDs is limited in the treatment of uveitis. None of the topical NSAIDs is specifically approved by the FDA for that indication. Nevertheless, there is mounting evidence that they may have specific advantages in the treatment of uveitis in the future.
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Copyright, 1994. Richard E. Gans, M.D.
A RICHARD E. GANS, M.D. 11
A A OFCN Primary Sysop, The Eye Clinic 111
AAAAA xx102@ofcn.org 11
A A A C A D E M Y O N E 1111
http://www.ofcn.org:80/about.ofcn/whois/reg/
NOTICE: OFCN is not engaged in the rendering of professional medical services. The information contained on this system or any other OFCN system should not supplant individual professional consultation. It is offered exclusively as a community education service. Advice on individual problems must be obtained directly from a professional.
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