title: What is new HLA-B27 acute anterior uveitis?
abstract: Acute anterior uveitis (AAU) is the most common form of uveitis, accounting for approximately 90% of all cases. Half of all cases of AAU are HLA-B27 positive. The disease is typically acute in onset, unilateral, nongranulomatous inflammation involving the iris and ciliary body, with a tendency to recurrent attacks. Approximately 50% of all patients with HLA-B27 AAU develop an associated seronegative arthritis (SNA), while approximately 25% of the patients initially diagnosed with HLA-B27 SNA develop AAU. Environmental factors play a critical role in the pathogenesis of AAU; in particular, bacterial triggers have been strongly implicated in the development of this disease. Topical corticosteroids and cycloplegic agents remain the cornerstones of treatment for AAU. Salazopirine and methotrexate are effective in decreasing recurrent attacks. Biological agents such as anti-TNF and anti-CD20 therapy may be effective in refractory severe AU but are rarely required.
authors.affiliation: School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia. D.Wakefield@unsw.edu.au
authors.forename: Denis
authors.initials: D
authors.lastname: Wakefield
authors.forename: John H
authors.initials: JH
authors.lastname: Chang
authors.forename: Shahriar
authors.initials: S
authors.lastname: Amjadi
authors.forename: Zoe
authors.initials: Z
authors.lastname: Maconochie
authors.forename: Ahmed
authors.initials: A
authors.lastname: Abu El-Asrar
authors.forename: Peter
authors.initials: P
authors.lastname: McCluskey
mesh_terms: D000208:Acute Disease; D000287:Administration, Topical; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000818:Animals; D001168:Arthritis / Q000150:complications; D001424:Bacterial Infections; D015796:HLA-B27 Antigen / Q000097:blood*; D006801:Humans; D007113:Immunity, Innate; D015994:Incidence; D008727:Methotrexate / Q000627:therapeutic use; D020412:Multifactorial Inheritance; D009184:Mydriatics / Q000008:administration & dosage; D012008:Recurrence; D012460:Sulfasalazine / Q000627:therapeutic use; D014606:Uveitis, Anterior / Q000150:complications / Q000188:drug therapy / Q000209:etiology / Q000276:immunology*
chemical_list: D000305:Adrenal Cortex Hormones; D015796:HLA-B27 Antigen; D009184:Mydriatics; D012460:Sulfasalazine; D008727:Methotrexate