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Jennifer L. Lyons, MD; James T. Rosenbaum, MD

Arch Ophthalmol. 1997;115(1):61-64.

Abstract
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.

Author Affiliations
From the Casey Eye Institute, Oregon Health Sciences University, Portland.

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