Autoimmunity in uveitis

Purpose Recent insights into the pathogenesis of immune‐mediated diseases proposed a new classification, which includes autoimmune and auto‐inflammatory diseases. The prevalence of specific autoimmune and auto‐inflammatory diseases in uveitis and/or scleritis is not yet known. In this study, we examine the presence of systemic immune‐mediated diseases in patients with uveitis and/or scleritis and put a special emphasis on autoimmune disorders by reporting on their clinical manifestations and visual prognosis. Methods In this retrospective study, we reviewed data of 1327 patients presenting with uveitis and/or scleritis between January 2010 and July 2016 at the Erasmus Medical Center, Rotterdam, the Netherlands. All patients with noninfectious uveitis and/or scleritis were classified according to novel criteria for immune‐mediated diseases. Various clinical data, including visual acuity (VA), of patients with uveitis of autoimmune origin were registered during 5‐year follow‐up. Results The origin of uveitis was in 5% (62/1327) autoimmune, in 15% (197/1327) auto‐inflammatory and in 14% (180/1327) mixed autoimmune/auto‐inflammatory. Patients with classical autoimmune connective tissue disease (N = 17) suffered mostly from rheumatoid arthritis and granulomatosis with polyangiitis and exhibited predominantly scleritis (53%). After 5 years of follow‐up, none of the eyes of these patients developed legal blindness (VA of