Ophthalmological significance of HLA associated uveitis.
The association between HLA-A29 and birdshot chorioretinopathy is the strongest association between HLA and disease ever described. The determination of HLA-A29 is therefore of diagnostic significance. The association between HLA-B27 and acute anterior uveitis (AAU) is much weaker. However, it is evident that B27+ AAU is clinically different from B27-AAU. Half of the B27+AAU patients have or will have ankylosing spondylitis or Reiter's syndrome. The determination of HLA-B27 is therefore of clinical significance and should be determined in each case of AAU. The B27+ patients should be referred to a rheumatologist. The determination of HLA-Bw51 is of limited but significant diagnostic value for the diagnosis of Behçet's disease in countries around the Mediterranean Sea or Japan. In Northern Europe HLA-Bw51 determination will not give much practical information. The structure and function of HLA class I molecules is now known. It is probable that HLA-A29 and HLA-B27 molecules are directly involved in the pathogenesis of respectively birdshot chorioretinopathy and AAU.
Feltkamp
T E
TE
Netherlands Ophthalmic Research Institute, Amsterdam.
D000208:Acute Disease; D001528:Behcet Syndrome / Q000276:immunology; D002825:Chorioretinitis / Q000276:immunology; D005819:Genetic Markers; D015235:HLA-B Antigens / Q000276:immunology; D015796:HLA-B27 Antigen / Q000276:immunology*; D059949:HLA-B51 Antigen; D006801:Humans; D010455:Peptides / Q000276:immunology; D012306:Risk; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology; D014606:Uveitis, Anterior / Q000235:genetics / Q000276:immunology*
D005819:Genetic Markers; D015235:HLA-B Antigens; D015796:HLA-B27 Antigen; D059949:HLA-B51 Antigen; D010455:Peptides