Abstract
To identify triggering factors for the next inflammatory episode of recurrent acute anterior uveitis (RAAU), a 1:1 case-control study was conducted. Patients with recent acute anterior uveitis and matched controls were interviewed using Srithanya Stress Test (ST-5) and questionnaires about potential triggering factors. Asymptomatic controls were matched for age (±5 years), sex, and HLA-B27. There were 39 pairs of cases and controls. Within 1-month before the interview, patients who recently experienced a uveitis attack demonstrated higher mean ST-5 scores (3.7±2.9 vs 0.7±1.1) and shorter sleep time (6.3±1.4 vs 7.4±0.7) compared with their controls. In the multivariate conditional logistic regression analysis, ST-5 score ≥3 (OR 9.17; 95%CI 1.15-72.84, p=0.036) and sleep time <7 hours per day (OR 11.57; 95% CI 1.42-94.55, p=0.022) were more likely to trigger a uveitis attack in RAAU accounted for age, sex, and HLA-B27 positivity of the patients. Other suspected triggering factors were not found to have any significant association. In short, emotional stress and inadequate sleep are the major triggering factors that lead to the future episode of acute anterior uveitis in RAAU. Both physical and emotional stress management may be helpful to minimize recurrences and further complications.