Eye Disease May Signal Onset of MS

Multiple sclerosis tied to eye condition uveitis in new study

(RxWiki News) Multiple sclerosis (MS) can be difficult to diagnose because early symptoms can come and go. The eye disease uveitis, however, may be a warning sign that could help doctors detect MS early, a new study found.

For decades, scientists have known of a link between uveitis and MS. A large new study found that the risk of having MS was greater among those with uveitis.

Diagnosing uveitis may help doctors detect MS early and treat it before it progresses, the study authors said.

The research was led by Wyatt B. Messenger, MD, from the Casey Eye Institute at the Oregon Health and Science University in Portland. Scientists from the Casey Eye Institute worked with researchers from the University of Heidelberg in Germany.

They observed that MS was 18 times more likely among US patients with uveitis than among those without the eye condition. MS was 21 more times likely among European patients with uveitis compared to those without it.

Uveitis is inflammation of the uvea, the middle layer of the eye. It can lead to blindness if left untreated. Researchers in this study found, however, that patients with MS and this eye disease were able to achieve clearness of vision with treatment.

With MS, the body's immune system attacks the coverings surrounding the nerves. The nerves themselves may deteriorate. Patients may have fatigue, numbness and trouble walking.

After being diagnosed with uveitis, more than half of the patients were also diagnosed with MS. MS was identified in 29 percent of patients before their uveitis was diagnosed. Doctors diagnosed the two diseases at the same time in 15 percent of the patients.

The authors studied a total of 113 patients with both conditions — 24 from the Casey Institute and 89 from the University of Heidelberg.

The study authors found patients with both diseases in a database of about 3,000 patients with uveitis from the Casey Institute and 5,319 with uveitis from the University of Heidelberg.

The study authors observed that MS patients with uveitis were likely to maintain fair clearness of vision over time. In fact, most patients improved after treatment.

“Knowing more about the onset [of MS] may enable patients to seek treatment earlier, therefore slowing the progression of the disease and limiting the damage done to the nervous system, ” Dr. Messenger said in a press release.

The National Multiple Sclerosis Society noted that MS can be hard to diagnose. Symptoms may be nonspecific and similar to other disorders of the nervous system. Early symptoms can come and go, so they may be ignored.

In this study, intermediate uveitis was most common among patients with both conditions. With this type of uveitis, inflammation affects the middle part of the eye. About 8 in 10 subjects had intermediate uveitis at the time of MS diagnosis.

Almost 1 in 6 had anterior uveitis, which occurs in the front of the eye.

The authors noted that about 3 out of 4 MS patients with uveitis were women. Patients ranged in age from 13 to 64 with a mean age of about 40.

The study was presented in October at AAO 2014, the 118th annual meeting of the American Academy of Ophthalmology. It was published in the British Journal of Ophthalmology.

The authors noted competing interests with Merck and Genentech. They disclosed no funding sources.

Review Date: 
October 26, 2014