J Korean Med Sci.  2009 Aug;24(4):722-728. 10.3346/jkms.2009.24.4.722.

Clinical Features and Prognosis of HLA-B27 Positive and Negative Anterior Uveitis in a Korean Population

• Park SC
• Ham DI

• KMID: 1779210
• DOI: http://doi.org/10.3346/jkms.2009.24.4.722

Abstract

Clinical features and prognosis of HLA-B27 positive anterior uveitis (AU) were assessed compared with HLA-B27 negative AU in a Korean population, based on the medical records of AU patients seen at a university hospital. Twenty-seven HLA-B27 negative, idiopathic AU patients (group I) and 55 HLA-B27 positive AU patients (group II) were studied. HLA-B27 positive group was further divided into 29 with associated systemic disease (seronegative spondyloarthropathy) (group IIA) and 26 without associated systemic disease (group IIB). Significantly more severe anterior chamber inflammation in terms of anterior chamber cells (P=0.006) and hypopyon formation (P=0.034) was observed with higher frequency of AU attacks (P=0.007) in the HLA-B27 positive group than in the HLA-B27 negative group. Systemic/periocular steroids were required in significantly more patients in the HLA-B27 positive group than in the HLA-B27 negative group (P=0.015). However, no significant differences were observed for final ocular and visual outcomes between these two groups. Associated systemic disease made no significant difference in the clinical features and prognosis in the HLA-B27 positive AU patients. In conclusion, despite more severe inflammation and a higher recurrence rate, HLA-B27 positive AU shows similar good final ocular and visual outcomes compared to HLA-B27 negative, idiopathic AU in a Korean population.

Keyword

Uveitis, Anterior; HLA-B27 Antigen; Spondylarthropathies

MeSH Terms

Adolescent
Adult
Aged
Alleles
Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
Asian Continental Ancestry Group
Case-Control Studies
Female
HLA-B27 Antigen/genetics/*metabolism
Humans
Immunosuppressive Agents/therapeutic use
Korea
Male
Middle Aged
Prognosis
Retrospective Studies
Severity of Illness Index
Steroids/therapeutic use
Uveitis, Anterior/*diagnosis/drug therapy/metabolism
Visual Acuity

Figure

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  Fig. 1 Anterior chamber cells during the active inflammatory stage. (A) HLA-B27 negative vs. positive anterior uveitis (AU). The proportions of grade 3 or more and grade 4 were significantly higher in the HLA-B27 positive eyes than in the HLA-B27 negative eyes. (B) HLA-B27 positive AU with vs. without systemic disease association. Associated systemic disease made no significant difference in the anterior chamber cells in the HLA-B27 positive AU patients.

• 

  Fig. 2 Kaplan-Meier curves showing cumulative survival of eyes with a potential best-corrected visual acuity of (A) ≥20/40 and (B) ≥20/32 in HLA-B27 negative vs. positive anterior uveitis patients. P values were calculated by log rank test.

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