A new study led by the University of Auckland’s Associate Professor Rachael Niederer will investigate the connection between stress and the recurrence of HLA-B27 uveitis, thanks to an Auckland Hospital Research Endowment Fund (AHREF) grant.

“Patients often tell me that their uveitis flares after a particularly stressful event or period of time,” said A/Prof Niederer. “This study is the direct result of listening to patients’ experience and wanting to explore it further.”

Psychological and physiological stress are perceived threats known to impact the immune system and systemic inflammation, she said. “Some observational studies have reported that people with active or recurrent uveitis describe higher levels of psychological stress than those whose disease is inactive. Some patients also recall significant stressful life events in the months before a flare.” However, research findings are not consistent and studies relying on patients recalling past events or stress levels can introduce bias, she said. “It is also unclear whether stress triggers uveitis flares, or whether problems associated with living with uveitis raise stress levels. This study is exciting as it addresses those biases through a prospective study, which will allow us far greater insights.” 

Study candidates will be graded on the perceived stress scale, said A/Prof Niederer. “This is a series of 10 questions that determine how unpredictable, uncontrollable and overloaded respondents find their lives. We administer the questionnaire at initial presentation then every three months to see how stress levels are changing and whether the patient has experienced a recurrence of uveitis.”

Recruitment of 250 patients with HLA-B27 uveitis, along with healthy controls, is expected to take around three years, plus an additional year of follow-up, she explained. “Research is a slow process! But I’m really looking forward to sharing the results when we get them.

“We would love more people with HLA-B27 uveitis to get involved. We would also love healthy volunteers. This just involves a single visit to the eye department, filling out a couple of questionnaires, an eye scan and one blood test,” said A/Prof Niederer.

Eyecare professionals who may have patients who are interested can email treve.dromgool@auckland.ac.nz