title: Optic neuritis with positive HLA-B27: Characteristic phenotype in the Chinese population.
abstract: OBJECTIVE
  This study retrospectively reviewed the clinical features of optic neuritis (ON) with positive HLA-B27.
  
  
  METHODS
  Clinical data were reviewed for HLA-B27-positive ON in the Chinese People's Liberation Army General Hospital from January 2009 through June 2015. The prevalence of HLA-B27 and spondyloarthropathies was analyzed. Clinical features of HLA-B27-positive ON based on serum aquaporin 4-antibody (AQP4-Ab) were compared.
  
  
  RESULTS
  A total of 22 ON patients (14 female/8 male, 38 involved eyes) with positive HLA-B27 were collected from 410 ON patients. Recurrent episodes were observed in 14/22 patients, and seven patients presented as bilateral simultaneous ON. A total of 68.4% (22/38) of involved eyes exhibited severe visual impairment (<0.1) at onset. A total of 8/22 patients were seropositive for AQP4-Ab, and clinical features did not differ based on AQP4-Ab status. Bilateral sacroiliitis was revealed in over 50% (7/13) of patients screened using pelvic computed tomography. Three patients were diagnosed with ankylosing spondylitis (AS), and one patient experienced co-occurrence of active AS and bilateral ON.
  
  
  CONCLUSIONS
  HLA-B27-positive ON may presented recurrent episodes and severe visual impairment at onset. The co-occurrence of ON and AS, and the frequent presence of bilateral sacroiliitis may indicate an underlying alternation of autoimmune background in this condition.
authors.affiliation: Department of Neuro-Ophthalmology, The Chinese People's Liberation Army General Hospital, Beijing, China; School of Medicine, Nankai University, Tianjin, China.
authors.forename: Shuo
authors.initials: S
authors.lastname: Zhao
authors.affiliation: Department of Neuro-Ophthalmology, The Chinese People's Liberation Army General Hospital, Beijing, China.
authors.forename: Huanfen
authors.initials: H
authors.lastname: Zhou
authors.affiliation: Department of Health Care, The Chinese People's Liberation Army General Staff Department Guard Bureau, Beijing, China.
authors.forename: Xudong
authors.initials: X
authors.lastname: Peng
authors.affiliation: Department of Rheumatology, The Chinese People's Liberation Army General Hospital, Beijing, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Zhu
authors.affiliation: School of Medicine, Sun Yat-Sen University, Guangzhou, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.affiliation: Department of Neuro-Ophthalmology, The Chinese People's Liberation Army General Hospital, Beijing, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Kang
authors.affiliation: Department of Neuro-Ophthalmology, The Chinese People's Liberation Army General Hospital, Beijing, China.
authors.forename: Tingjun
authors.initials: T
authors.lastname: Chen
authors.affiliation: Department of Neuro-Ophthalmology, The Chinese People's Liberation Army General Hospital, Beijing, China. Electronic address: xuquangang@126.com.
authors.forename: Quangang
authors.initials: Q
authors.lastname: Xu
authors.affiliation: Department of Neuro-Ophthalmology, The Chinese People's Liberation Army General Hospital, Beijing, China. Electronic address: dr_weishihui@163.com.
authors.forename: Shihui
authors.initials: S
authors.lastname: Wei
mesh_terms: D000293:Adolescent; D000328:Adult; D000906:Antibodies / Q000097:blood; D051401:Aquaporin 4 / Q000276:immunology; D044466:Asian People; D002097:C-Reactive Protein / Q000378:metabolism; D002648:Child; D004247:DNA / Q000276:immunology; D003941:Diagnostic Techniques, Ophthalmological; D005260:Female; D015796:HLA-B27 Antigen / Q000378:metabolism; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage; D008875:Middle Aged; D009902:Optic Neuritis / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000378:metabolism* / Q000503:physiopathology; D010641:Phenotype; D012189:Retrospective Studies; D013129:Spinal Puncture; D014792:Visual Acuity / Q000502:physiology
chemical_list: C496030:AQP4 protein, human; D000906:Antibodies; D051401:Aquaporin 4; D015796:HLA-B27 Antigen; D002097:C-Reactive Protein; D004247:DNA; D008775:Methylprednisolone
keywords: Ankylosing spondylitis; Aquaporin 4; Autoimmune diseases; HLA-B27; Multiple sclerosis; Neuromyelitis optica; Optic neuritis