ANKYLOSING SPONDYLITIS: OPHTHALMOLOGIST PLAYS A MAJOR CRUCIAL ROLE!
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2019, Vol 6, Issue 34
Abstract
BACKGROUND Ankylosing spondylitis (AS) is a chronic inflammatory systemic disorder affecting the axial skeleton with chronic pain and stiffness in the lower back or buttocks region and progressive limitation of spinal movements. Many patients exhibit extra-articular manifestations and anterior uveitis is a common form of extra articular manifestation of AS. Other findings are episcleritis, scleritis, peripheral ulcerative keratitis, retinal vasculitis, dry eye, cataract and secondary glaucoma. Sometimes ocular signs are the only presentation. It is very challenging for an ophthalmologist to carefully examine the patients of AS so that permanent bony deformity is minimised. We wanted to evaluate the magnitude of ocular manifestations in patients suffering from AS and establish the statistical significance of age of patients and determine the frequency of ocular manifestations for epidemiological purposes. METHODS This is a cross sectional observational study done among one hundred and forty-four patients (n=144) with AS conducted between December 2018 and July 2019. Slit lamp biomicroscopy with 90 D Volk lens was done for anterior and posterior segment examination. Gonioscopy, Applanation Tonometry, Automated Perimetry and Indirect Ophthalmoscopy were done. Schirmer's and TBUT tests were done. RESULTS Anterior uveitis (30%) was the most common ocular manifestation followed by vitritis (18%), cataract (15.2%), episcleritis and scleritis (7.6%), dry eye (6.2%), retinal vasculitis (8%) and peripheral ulcerative keratitis (5%). Males are more commonly affected. The duration of disease was found to be statistically significant (p<0.001) when correlated with age groups with patients in the age group of >60 years and with respect to unilateral/bilateral presentation of ocular manifestations (p=0.016). CONCLUSIONS Ophthalmologist has a great role for diagnosing of AS. Patients usually come to ophthalmology OPD for management of ocular symptoms with undiagnosed AS and physician must be cautious while assessing ocular signs and symptoms for suspecting AS. As a result, irreversible bony deformities can be minimized as much as possible.
Authors and Affiliations
Santanu Sinha Babu, Prasenjit Mait, Md. Nazarul Islam
Keywords
Related Articles
- EP ID EP670510
- DOI 10.18410/jebmh/2019/461
- Views 103
- Downloads 0
ANESTHETIC MANAGEMENT OF A PATIENT WITH IMPLANTED PERMANENT PACEMAKER FOR EXCISION OF PHEOCHROMOCYTOMA
Pheochromocytoma is a potentially lethal catecholamine secreting tumor of chromaffin tissues of the adrenal medulla and sympathetic chain. [1] Incidence across the globe is around 1 to 2 per million population. [2] Repor...
TO STUDY THE EFFECT OF ANGIOTENSIN RECEPTOR BLOCKERS ON DIABETIC RETINOPATHY
BACKGROUND Diabetic Retinopathy (DR) is the most common microvascular complication of Diabetes Mellitus (DM) and is the leading cause of blindness in working age adults of patients with type 1 and 2 DM. Large observation...
A PROSPECTIVE, OBSERVATIONAL STUDY TO UNDERSTAND THE DRUG USAGE COMPOSITION OF ANTI-DIABETIC MEDICATIONS IN A RURAL CENTRE IN KERALA
BACKGROUND With exponentially higher number of patients being diagnosed with diabetes in India, it has gained an epidemic status here.1,2 Globally, the prevalence of diabetes in 2030 is expected to be almost double that...
CORRELATION OF INTRAOCULAR PRESSURE MEASUREMENTS WITH NON CONTACT TONOMETER AND GOLDMANN APPLANATION TONOMETRY
BACKGROUND A complete ophthalmologic examination includes intraocular pressure (IOP) measurement, which is a routine procedure and is important for diagnosis and monitoring of glaucoma. IOP measurement is most commonly d...
A STUDY ON RELATIONSHIP BETWEEN EDUCATIONAL AND SOCIOECONOMIC STATUS AND EARLY DIAGNOSIS OF CARCINOMA BREAST IN FEMALES
BACKGROUND Breast cancer distribution differs by geography, regional lifestyle, racial or ethnic background. In general, both breast cancer incidence and mortality are relatively lower among the female populations of Asi...