Outcomes in anterior uveitis associated with the HLA-B27 haplotype.
OBJECTIVE
This study aimed to test the hypothesis that patients presenting with anterior uveitis who are HLA-B27 positive, either with or without associated systemic disease, have a less-favorable outcome than do patients with idiopathic anterior uveitis who are HLA-B27 negative.


METHODS
Retrospective case-controlled series.


METHODS
Ninety-seven patients who were HLA-B27 positive with no systemic disease, 94 patients who were HLA-B27 positive with systemic disease, and 72 patients who were HLA-B27 negative who presented with anterior uveitis were studied.


METHODS
Ocular complications (e.g., secondary glaucoma, cataract formation, pupillary synechiae, vitritis, cystoid macular edema, and optic disc edema), medical and surgical treatment, number of recurrent attacks, and final visual acuity were recorded for all patients.


RESULTS
The patients who were HLA-B27 positive, either with or without systemic disease, experienced a greater number of complications than did the patients who were HLA-B27 negative. Periocular corticosteroids, systemic corticosteroids, and systemic immunosuppressive chemotherapy were required in a far greater number of HLA-B27-positive patients than in HLA-B27-negative patients (60% vs. 11%, 53% vs. 7%, and 18% vs. 1%, respectively; P < 0.001). The percentage of legally blind eyes was significantly greater in the HLA-B27-positive group, both with and without systemic disease, when compared with the HLA-B27-negative group (11% vs. 2%; P < 0.005).


CONCLUSIONS
The prognosis of anterior uveitis associated with the HLA-B27 haplotype, either with or without associated systemic disease, is less favorable when compared with that of HLA-B27-negative patients with idiopathic anterior uveitis.
Power
W J
WJ
Immunology & Uveitis Service, Massachusetts Eye & Ear Infirmary, Harvard Medical School, Boston, USA.
Rodriguez
A
A
Pedroza-Seres
M
M
Foster
C S
CS
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D001168:Arthritis / Q000150:complications; D016022:Case-Control Studies; D002648:Child; D015331:Cohort Studies; D003093:Colitis, Ulcerative / Q000150:complications; D005260:Female; D015796:HLA-B27 Antigen / Q000235:genetics*; D006239:Haplotypes; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D014606:Uveitis, Anterior / Q000150:complications / Q000175:diagnosis* / Q000235:genetics; D014792:Visual Acuity
D015796:HLA-B27 Antigen