Human leukocyte antigen-B27-associated uveitis: long-term follow-up and gender differences.
OBJECTIVE
To evaluate clinical features and gender differences in human leukocyte antigen (HLA)-B27-associated acute anterior uveitis (AAU) in long-term follow-up.


METHODS
Retrospective cohort study.


METHODS
The clinical records of 177 HLA-B27-positive patients (96 males [54%] and 81 females [46%]) who sought treatment for acute anterior uveitis (AAU) at the University Medical Center Utrecht between January 1995 and December 2005 were evaluated. All patients had a minimum follow-up of at least one year. The clinical data were analyzed at standardized intervals (one, five, and 10 years after the onset of uveitis).


RESULTS
Average age at onset of AAU was 36 years, with no differences between males and females. HLA-B27-associated systemic disease developed earlier in males than in females (31 vs 37 years; P=.021). Consequently, at onset of AAU, HLA-B27-associated systemic disease were more frequent in males than in females (25/75 [33%] males vs nine/54 [17%] females; P=.030); however over time, males and females were at equal risk of developing a HLA-B27-associated systemic disease. Bilateral uveitis developed more frequently in females (6/45 [13%] of males vs 11/35, [31%] of females; P=.05). In none of the patients did bilateral visual acuity of less than 0.5 develop after the follow-up of 10 years.


CONCLUSIONS
The long-term visual prognosis of HLA-B27-associated AAU was favorable, despite the frequent attacks of severe AAU. At the onset of AAU, the prevalence of HLA-B27-associated systemic disease was more frequent in males, but after the onset of uveitis, the risk of developing a HLA-B27-associated systemic disease is similar for both males and females.
Braakenburg
Arthur M D
AM
FC Donders Institute of Ophthalmology, University Medical Center Utrecht, Utrecht, The Netherlands. a.braakenburg@umcutrecht.nl
de Valk
Harold W
HW
de Boer
Joke
J
Rothova
Aniki
A
D000208:Acute Disease; D000328:Adult; D017668:Age of Onset; D005260:Female; D005500:Follow-Up Studies; D015796:HLA-B27 Antigen / Q000276:immunology*; D006801:Humans; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D014606:Uveitis, Anterior / Q000276:immunology*; D014792:Visual Acuity / Q000502:physiology
D015796:HLA-B27 Antigen