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Balck ink tattoo
International

US ophthalmologists draw link between black ink tattoos and uveitis

05/03/2019
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US ophthalmologists have treated a man believed to be the 16th reported case of tattoo-associated uveitis, a rare link eye doctors say warrants further research.

The case involving the 26-year-old patient has added weight to the theory that heavy metal compounds in black tattoo pigment may act as an environmental trigger, prompting an immune response and causing inflammation of the uvea. It did not necessarily mean that black-ink tattoos cause uveitis, but in some people there appears to be an association.

According to research published in JAMA Clincial Challenge, a male patient noticed tattoo elevation on his left arm that was associated with the onset of decreased vision. He had recurrent episodes of ocular redness and blurred vision, coinciding with the inflammation of the skin surrounding his tattoo.

Despite being prescribed adalimumab and methotrexate, the patient continued to have episodes of uveitis, which resulted in him being administered short-acting intraocular steroids. His vision worsened progressively over the subsequent nine months until he had difficulty counting fingers at 0.3m in each eye.

The visual decline was attributed to cataract and persistent inflammation, and he underwent bilateral fluocinolone acetonide implantation for improved long-term control, with concomitant cataract surgery 12 months after presentation.

“Tattoo-associated uveitis may possibly occur because of an environmental trigger in a genetically predisposed host. The pathophysiology and clinical course of tattoo-associated uveitis remain poorly understood. To help identify the diagnosis, clinicians should ask patients presenting with uveitis about history of tattoos,” researcher paper stated.

According to the American Academy of Ophthalmology (AAO), up until 2014, there had only been eight reported cases involving uveitis and tattoos. However, Dr Trucian Ostheimer and his colleagues at Wilmer Eye Institute recently observed seven additional cases two-years period.

In all seven of Ostheimer’s cases, parts of the skin that were covered by black-ink tattoos became raised and hard at the same time that uveitis symptoms began. Successful treatments of uveitis symptoms also cleared skin symptoms.

AAO representative Dan Gudgel added: “This research does not mean that black-ink tattoos cause uveitis, but it definitely points to something that needs further research."

AFT Pharmaceuticals
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