Personality and uveitis

Ankush Kawali, Ringhoo Theresa Jose, Aishwarya, Mathew Kurian, Kushal Kacha, Padmamalini Mahendradas, Rohit Shetty

Psycho-immunology is an emerging branch of science which studies the interaction between the brain and the immune system. The purpose of this study is to identify the types of personality factors in patients with non-infectious uveitis and to find its association with a particular uveitic entity if any. This is a prospective, observational, case-control study of 186 patients with non-infectious uveitis (group A) and controls from general ophthalmology outpatient department (group B). "Global 5/SLOAN" personality questionnaire was used which is based on the five-factor theory of personality which describes personality factors based on the presence or absence of five primary dimensions, viz extroversion, orderliness, emotional stability, accommodation, and intellectual curiosity. Personality factors of patients from groups A and B were compared. History of present illness, clinical diagnosis, details of systemic ailment, and demographic information were collected. Group A comprised HLA-B27-related uveitis (n = 30), uveitis due to sarcoidosis (n = 10), Vogt-Koyanagi-Harada syndrome (n = 5), sclero-kerato-uveitis due to rheumatoid arthritis (n = 5), and idiopathic uveitis in rest. Forty-five patients with uveitis had associated systemic ailment. Uveitis patients (n = 56) showed positive personality trait: S (social), C (calm), O (organized), A (accommodative), and I (inquisitive). In contrast, the control group (group B) which mainly comprised patients with non-pathological refractive error and visually insignificant cataract showed more number of negative personality traits (n = 62): R (reserved), L (limbic), U (unstructured), E (egocentric), and N (non-curious). This difference between the uveitis and control group was found to be statistically significant (p ≤ 0.001). The difference was also statistically significant for O (p = 0.008), U (p = 0.004), and C (p = 0.022) with chi-square test. Calm personality was found to be significantly associated with HLA-B27-related uveitis (p = 0.002). N, S, and A traits were seen almost equal in numbers in both the groups. U trait was absent in group A, whereas I trait had negligible presence in group B. Our finding of an association between organized personality type and uveitis and calm personality and HLA-B27-related uveitis warrants further studies to understand the complex mechanism of psycho-immunology in uveitis.