Thouvenot et al. Ipsilateral uveitis and optic neuritis in multiple sclerosis.Mult Scler Int. 2012;2012:372361. doi: 10.1155/2012/372361
Background: Uveitis is 20 times more frequent in MSers than in the general population.
“Uveitis is the medical term we use to describe inflammation of the middle or internal layers of the eye. The symptoms of uveitis vary depending on if the inflammation involves the anterior or front of the eye or the posterior or back of the eye. Common symptoms include, redness of the eye, blurred vision, sensitivity to light or photophobia, floating spots in the visual field, eye pain, floaters, headaches, injected conjunctiva. When we look in the eyes we often see dilated blood vessels, presence of cells in the eye, and precipitates on the surface of the cornea. If the inflammation is severe there may be evidence of a hypopyon or a layer of pus in the eye (see picture below). Inflammation at the back of the eye generally does not have any of these typical symptoms and is more difficult to assess.”
“Uveitis is a common condition and has many causes. In the context of MS it is considered an autoimmune disease. Up to 30% of MSers get uveitis and therefore it is sensible for an ophthalmologist to assess MSers with visual symptoms to exclude uveitis. Another associated disease which is classified as being uveitis is posterior venulitis, when you see inflammation around the veins in the retinae. This inflammation is considered to be the same inflammation we see around veins in other MS lesions. The big difference is the eye or retina does not normally have any myelin. This implies that the inflammation cannot be in response to myelin, but some other antigen. This is another nugget of gold that challenges the dogma that MS is an autoimmune disease targeting myelin.”
|The white sheathing around the blood vessels of the retinae is called retinal vasculitis and is occurs in up to a third of MSers. This is telling us that what ever is driving inflammation in MS may also be present in the layer of the retinae. It is not myelin and the nerve fibres in the retina don’t have myelin. Interesting?|