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Complicated cataract in a patient with psoriatic arthritis and severe bilateral chronic panuveitis treated with anti-TNFα agents – case report

Poster Details

First Author: T.Mitulescu ROMANIA

Co Author(s):    L. Voinea   D. Predeteanu   A. Dumitrescu   C. Leasu   S. Pricopie   A. Vrapciu

Abstract Details

Purpose:

To present a case of 28 year-old female patient diagnosed with complicated cataract following multiple bilateral flares of bilateral uveitis developed within the context of psoriatic arthritis nonresponsive to traditional remisive therapy (sulphasalazine, hidroxichlorocquine, methotrexate) and treated with anti-TNF drugs (etenercept, adalimumab) To present the ophthalmological approach together with rheumatological treatment in order to obtain a good result in the management of ocular and articular manifestations of the disease.

Setting:

Department of Ophthalmology, University Emergency Hospital, Department of Rheumatology and Internal Medicine, ”Sf. Maria” Clinical Hospital, University of Medicine and Pharmacy ”Carol Davila”, Bucharest, Romania

Methods:

Being a team work approach of ophthalmologist and rheumatologist the 2 main methodes used in the management of this case belonged to Ophthalmology and Rheumatology. From the ophthlamologist΄s point of view the following methods were used: inspection of the eyes, measures of visual acuity, intraocular pressure, funduscopic examination, slit lamp test,ocular echography. From the rheumatologist΄s point of view many paraclinical tests (CRP, antibodies), histopatological examination (skin) and scores for evaluation of the disease΄s activity and psoriasis΄s extenstion (DAS28, PASI) were used for this patient.

Results:

Being a team work approach of ophthalmologist and rheumatologist the 2 main methodes used in the management of this case belonged to Ophthalmology and Rheumatology. From the ophthlamologist΄s point of view the following methods were used: inspection of the eyes, measures of visual acuity, intraocular pressure, funduscopic examination, slit lamp test,ocular echography. From the rheumatologist΄s point of view many paraclinical tests (CRP, antibodies), histopatological examination (skin) and scores for evaluation of the disease΄s activity and psoriasis΄s extenstion (DAS28, PASI) were used for this patient.

Conclusions:

Psoriatic arthritis may become associated with bilateral chronic panuveitis Anti-TNF therapy with good articular results had NO major effect on ocular involvement. The complicated cataract surgery in a patient with a very severe rheumatologic condition is disease-specific and patient-dependent. The strict follow up by both ophthalmologist and rheuamtologist is the best approach for a good management of this patient ACKNOWLEDGEMENT: This paper is partly supported by the Sectorial Operational Programme Human Resources Development (SOPHRD), financed by the European Social Fund and the Romanian Government under the contract number POSDRU 141531”

Financial Disclosure:

NONE

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