New episodes of recurrent acute anterior uveitis associated with stress and insomnia

In patients with recurrent acute anterior uveitis, insufficient sleep and stress can trigger an attack of uveitis, according to a study published in Scientific Reports.

A team of researchers in Thailand conducted a coordinated case-control study to determine the potential triggering factors associated with a recent episode of uveitis in people with relapsed acute anterior uveitis compared to those at rest. Comparisons included personal or telephone interview questionnaires on patient stress, sleep time, life events, alcohol consumption, smoking, exercise, financial stress, and joint pain.

The study included 78 patients with recurrent acute anterior uveitis; 39 patients were assigned to the case group (mean age 50.7 years) and 39 patients (mean age 50.9 years) to the control group. The majority of patients in both groups were women (64.1% each) and most of the patients were positive for human leukocyte antigen B27 (HLA-B27; 82.1% each). Unilateral anterior uveitis was also common in the majority of patients with 97.4% of the case cohort and 94.9% of the control cohort.

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The prevalence of previous episodes of recurrent uveitis was comparable between the two groups (median twice in each group). Fundamental immunological diseases were present in 43% of the case group and in 41.03% of the control group, with the proportion of patients who also took anti-inflammatory drugs for rheumatological diseases somewhat more frequently in the control group than in the case group (20.5% vs. , 4% and).

In a univariate analysis, the patients in the case group had statistically significantly higher stress levels as reported by the Srithanya Stress Test (ST-5) score (P <0.003) and more cases of less than 7 hours of sleep per day (P <0.003) im Compared to patients in the control group. The results for exercise, alcohol consumption, joint pain, anxiety, and financial stress did not differ significantly between the groups.

The results of a multivariate conditional analysis, adjusted for possible triggering factors, age, gender, and HLA-B27 typing, also resulted in significant stress (ST-5 score of 3 or more) and less than optimal sleep. These results were more likely to lead to an episode of acute anterior uveitis with an adjusted odds ratio of 9.07 for stress (P = 0.037) and an adjusted odds ratio of 12.12 for sleep (P = 0.025).

“These associations emphasize the importance of mental and behavioral management in order to support the control of the anterior uveitis,” said the investigators. “Knowing your stress level and sleep time can prevent recurring eye infections and the [recurrent acute anterior uveitis] Patients from the potentially vision-threatening complications. Hence, stress relievers and enough sleep time should be added too [recurrent acute anterior uveitis] Patient advice. “


Neti N, Pimsri A, Boonsopon S, Tesavibul N, Choopong P. Triggering factors associated with a new episode of recurrent acute anterior uveitis. Sci Rep. 2021; 11 (1): 12156. doi: 10.1038 / s41598-021-91701-6

This article originally appeared on Ophthalmology Advisor

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