A rare cause of visual impairment in patients with multiple sclerosis: Uveitis.

Abstract

A patient with multiple sclerosis may experience motor, sensory, speech, and visual symptoms depending on the location of central nervous system demyelinating plaque involvement. The most common clinical presentation with visual symptoms is unilateral optic neuritis. However, uveitis rarely causes visual impairment in patients with multiple sclerosis. Multiple sclerosis-associated uveitis may occur after the diagnosis or years before the diagnosis of multiple sclerosis. We report a case of multiple sclerosis that was diagnosed 10 years after uveitis attacks. A 21-year-old female complained of numbness in her left half of the body for 3 days. Her medical history, it was noted that she had been treated for uveitis attacks and glaucoma and retinal detachment 10 years ago. Diagnostic studies for uveitis attacks did not reveal any etiology. Azathioprine and colchicine were recommended to prevent uveitis attacks and the patient was still taking these two medications regularly. Magnetic resonance imaging performed due to focal neurological symptoms showed images compatible with multiple sclerosis plaques. Oligoclonal band type 3 in the cerebrospinal fluid. She was evaluated by an ophthalmologist and a rheumatologist. No rheumatological cause was found. Ophthalmological evaluation was consistent with previous anterior and intermediate uveitis. Previous uveitis attacks were considered multiple sclerosis-associated uveitis. We recommended follow-up with interferon 1β treatment, which is effective in both multiple sclerosis and multiple sclerosis-associated uveitis.