Vitreous Hemorrhage in Multiple Sclerosis-Associated Uveitis

Abstract

Purpose: To report on six patients who developed vitreous hemorrhage (VH) in the course of intermediate uveitis (IU) associated with multiple sclerosis (MS). Methods: Observational case series. Results: Six out of 25 patients (24%) with IU and MS seen at two tertiary centers developed VH. Average age at onset of MS was 26 years and average age at the onset of IU was 25 years. IU developed before the onset of MS in four of the six patients (67%). All patients had IU associated with peripheral phlebitis. The average interval between the onset of IU and the occurrence of VH was five years (range: 0–11 years; VH was the initial sign of uveitis in 2 patients). VH cleared spontaneously in all cases; however, subsequent retinal detachment developed in two eyes. All six patients had ischemic retinal areas and four had subretinal neovascularizations. Optimal visual acuity five years after VH varied from no light perception to full visual acuity. The causes of diminished acuity included optic neuritis, cystoid macular edema (CME), and retinal detachment. Conclusion: The possibility of MS-associated uveitis should be considered in patients with IU and VH.

KEYWORDS:

• Multiple sclerosis
• uveitis
• vitreous hemorrhage