OCULAR MANIFESTATIONS IN ANKYLOSING SPONDYLITIS: A CASE REPORT

Introduction. Ankylosing spondylitis (AS) is a chronic, progressive, immune-mediated inflammatory disease that primarily affects the spine and sacroiliac joints, and is frequently associated with the HLA-B27 genetic marker. This condition is characterized by inflammation of axial and peripheral joints, resulting in stiffness, pain, and progressive limitation of movement. In addition to articular manifestations, AS may also present extra-articular involvement, with acute anterior uveitis (AAU) being the most common, affecting up to 40% of patients. AAU is clinically manifested by severe ocular pain, photophobia, conjunctival hyperemia, and blurred vision, often occurring recurrently and, in most cases, unilaterally. Diagnosis is established through detailed clinical evaluation, combined with laboratory and imaging tests, such as magnetic resonance imaging (MRI) of the sacroiliac joints and specific ophthalmologic examinations, which are essential for disease monitoring. Objective. To report a case of acute anterior uveitis as an extra-articular manifestation in a 29-year-old male patient with ankylosing spondylitis, describing its clinical course, diagnostic process, and therapeutic approach. Methodology. This is a case report based on medical record review, patient interviews, and analysis of laboratory and imaging exams. Data were collected after obtaining informed consent from the patient, ensuring confidentiality and compliance with ethical principles of clinical research through the signing of the informed consent form (ICF). Results and Discussion. The patient presented with severe ocular pain, photophobia, and blurred vision, and was diagnosed with acute anterior uveitis associated with ankylosing spondylitis. Initial treatment included topical corticosteroids to control ocular inflammation and nonsteroidal anti-inflammatory drugs (NSAIDs) for pain relief and joint stiffness. Due to symptom recurrence, biological therapy with an anti-TNF agent was introduced, resulting in significant clinical improvement and absence of new ocular flares. The management of AS requires a multidisciplinary approach, integrating rheumatologists and ophthalmologists for effective control of articular and ocular manifestations (10). Biological therapy has proven effective in reducing systemic inflammation and preventing uveitis relapses, contributing to improved function and quality of life (10). Early diagnosis and appropriate treatment are essential to prevent structural complications such as joint ankylosis and permanent visual sequelae, in addition to minimizing the impact of the disease on functionality and overall well-being. Conclusion. Acute anterior uveitis represents a relevant extra-articular manifestation of ankylosing spondylitis and may cause significant visual impairment if not identified and treated promptly. The reported case highlights the importance of integration between rheumatology and ophthalmology for appropriate and individualized disease management. The introduction of biological therapies has modified the prognosis of these patients, reducing inflammation, relapse frequency, and the risk of sequelae. Therefore, early diagnosis and adequate therapeutic intervention are essential to preserve vision and joint mobility, ensuring better quality of life and reducing the systemic impact of the disease.