title: Systemic associations of anterior uveitis in a tertiary care ophthalmic centre in south India.
abstract: Anterior uveitis is the most common form of uveitis in most regions of the world. A recent study reported that 50 % of patients with anterior uveitis have a related systemic illness. The most common cause of anterior uveitis to date remains idiopathic (45-50 %), followed by HLA-B27-positive acute anterior uveitis. Ours is a retrospective study of the clinical records of 42 patients with anterior uveitis seen at a tertiary care eye hospital in south India. To diagnose the associated systemic disease, the investigations carried out were erythrocyte sedimentation rate, red and white blood cell counts, anti-nuclear antibody (ANA) analysis and HLA-B27 antigen determination. Based on clinical features, patients were also investigated for serum angiotensin-converting enzyme, high-resolution computed tomography scan, Mantoux test and QuantiFERON-TB Gold test. American College of Rheumatology criteria were followed to diagnose spondyloarthropathies and juvenile idiopathic arthritis (JIA). Of the 42 patients, 14 (33.33 %) were HLA-B27-positive and the remaining 28 (66.66 %) HLA-B27-negative. Overall, 32 of the 42 had no causative association, three patients were diagnosed with JIA, two with ankylosing spondylitis, two were associated with systemic tuberculosis, two with sarcoidosis and one with Vogt-Koyanagi-Harada syndrome. Our case series shows the incidence of various systemic diseases associated with anterior uveitis. Though the overall incidence of HLA-B27-positive acute anterior uveitis in our series (33 %) is similar to that in the Western literature, only 14 % of such patients were positive for a spondyloarthropathy. A few interesting cases like HLA-B27-positive, ANA-negative JIA presenting with chronic persisting anterior uveitis were also seen.
authors.affiliation: Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, 18 College Road, Chennai, Tamil Nadu, India. gaurav36vaishali@gmail.com
authors.forename: Gaurav
authors.initials: G
authors.lastname: Mathur
authors.forename: Jyotirmay
authors.initials: J
authors.lastname: Biswas
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D015796:HLA-B27 Antigen / Q000276:immunology*; D006801:Humans; D007154:Immune System Diseases / Q000150:complications* / Q000453:epidemiology / Q000276:immunology; D015994:Incidence; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D063128:Tertiary Health Care / Q000706:statistics & numerical data*; D014606:Uveitis, Anterior / Q000453:epidemiology* / Q000276:immunology; D055815:Young Adult
chemical_list: D015796:HLA-B27 Antigen