HLA-B27-associated acute anterior uveitis in the University Referral Centre in North Thailand: clinical presentation and visual prognosis.
BACKGROUND
Acute anterior uveitis (AAU) is the most frequent type of uveitis encountered in the west. Although human leucocyte antigen (HLA)-B27-associated ankylosing spondylitis was reported in South East Asia, it is not known whether HLA-B27-associated ocular disease is prevalent in Thailand.


METHODS
A prospective study of 100 unrelated blood donors and 121 consecutive patients with AAU was carried out. All people underwent HLA-B27 typing and full ocular examination. Radiological examination of the sacroiliac joints was conducted in patients with low back pain or arthralgias.


RESULTS
The prevalence of HLA-B27 was 10% among the blood donors in contrast with 44% in the AAU group (p<0.001). The clinical characteristics of HLA-B27-associated AAU were similar to those published throughout the world (unilaterality in 74%, hypopyon in 31%, recurrent AAU in 64%). However, the increased intraocular pressure (IOP) was more common in the HLA-B-27-negative group (p = 0.03) than in their HLA-B27-positive counterparts. At least 15% of the HLA B27-positive group had radiological signs of ankylosing spondylitis.


CONCLUSIONS
The prevalence of HLA-B27 in the population without uveitis in Thailand is about 10% and clinical characteristics of HLA-B27-positive AAU are similar to those reported in the west. In contrast with earlier reports, HLA-B27-negative AAU in Thailand was associated with increased IOP and should be further studied.
Pathanapitoon
K
K
Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Road, Chiang Mai 50200, Thailand. kpathana@mail.med.cmu.ac.th
Suksomboon
S
S
Kunavisarut
P
P
Ausayakhun
S
S
Wattananikorn
S
S
Leetrakool
N
N
Rothova
A
A
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data; D002648:Child; D002675:Child, Preschool; D005260:Female; D020022:Genetic Predisposition to Disease; D015796:HLA-B27 Antigen / Q000235:genetics*; D006650:Histocompatibility Testing; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012008:Recurrence; D013167:Spondylitis, Ankylosing / Q000208:ethnology / Q000276:immunology; D013785:Thailand / Q000453:epidemiology; D014606:Uveitis, Anterior / Q000150:complications / Q000208:ethnology* / Q000276:immunology; D014786:Vision Disorders / Q000209:etiology*; D014792:Visual Acuity
D015796:HLA-B27 Antigen