title: Potential Predictors of Poor Visual Outcome in Human Leukocyte Antigen-B27-Associated Uveitis.
abstract: To identify potential predictors of permanent vision loss in patients with human leukocyte antigen (HLA)-B27-associated uveitis in a tertiary referral center.
  
  
  
  Retrospective case-control study.
  
  
  
  The charts of 212 patients (338 eyes) with HLA-B27-associated uveitis that visited the University Medical Center Utrecht with a follow-up of at least 6 months were retrospectively studied. Clinical features at presentation and during follow-up were compared to final visual outcome in quiescent state. Eyes with (sub-) normal vision (>20/50) were compared with visually impaired (≤20/50) and blind (≤5/50, or a visual field of <10 degrees) eyes, using survival analysis. A multivariate Cox proportional hazards analysis was performed to analyze potential predictors for permanent vision loss.
  
  
  
  Median follow-up was 10.4 years (range, 0.5-44.7 years). During follow-up 226 eyes (66%) experienced vision loss up to 20/50, but most recovered. Twenty patients (9%) became permanently visually impaired or blind in at least 1 eye because of uveitis, after a median of 9.7 years (range, 0-20.9 years). The main cause was secondary glaucoma or related to glaucoma surgery (12/22 eyes, 55%). Survival analysis showed, after adjustment for age and sex, an ocular pressure of >21 mm Hg, hypotony, and panuveitis to be potential predictors at presentation, and the development of secondary glaucoma or hypotony to be predictors of blindness or visual impairment during follow-up.
  
  
  
  The long-term visual prognosis of HLA-B27-associated uveitis is relatively good, but the true incidence of permanent vision loss is probably still underestimated. Our findings highlight the importance of proper control of intraocular pressure.
authors.affiliation: Department of Ophthalmology, University Medical Center Utrecht, Utrecht, Netherlands; Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, Netherlands. Electronic address: F.H.Verhagen@umcutrecht.nl.
authors.forename: Fleurieke H
authors.initials: FH
authors.lastname: Verhagen
authors.affiliation: Department of Ophthalmology, University Medical Center Utrecht, Utrecht, Netherlands.
authors.forename: Anna H
authors.initials: AH
authors.lastname: Brouwer
authors.affiliation: Department of Ophthalmology, University Medical Center Utrecht, Utrecht, Netherlands; Laboratory of Translational Immunology, University Medical Center Utrecht, Utrecht, Netherlands.
authors.forename: Jonas J W
authors.initials: JJ
authors.lastname: Kuiper
authors.affiliation: Department of Ophthalmology, University Medical Center Utrecht, Utrecht, Netherlands.
authors.forename: Jeannette
authors.initials: J
authors.lastname: Ossewaarde-van Norel
authors.affiliation: Department of Ophthalmology, University Medical Center Utrecht, Utrecht, Netherlands.
authors.forename: Ninette H
authors.initials: NH
authors.lastname: Ten Dam-van Loon
authors.affiliation: Department of Ophthalmology, University Medical Center Utrecht, Utrecht, Netherlands.
authors.forename: Joke H
authors.initials: JH
authors.lastname: de Boer
mesh_terms: D000328:Adult; D001766:Blindness / Q000175:diagnosis* / Q000276:immunology; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000175:diagnosis; D015796:HLA-B27 Antigen / Q000276:immunology*; D006801:Humans; D007429:Intraocular Pressure; D008297:Male; D009798:Ocular Hypertension / Q000175:diagnosis; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D014605:Uveitis / Q000175:diagnosis* / Q000276:immunology; D015354:Vision, Low / Q000175:diagnosis* / Q000276:immunology; D014792:Visual Acuity
chemical_list: D015796:HLA-B27 Antigen