Clinical Studies in Patients with HLA-B 27 Positive Uveitis

ABSTRACT

It is well known that HLA-B 27-associated uveitis is mostly anterior uveitis and has systemic manifestations.20 Patients [27 eyes]followed up at department of Ophthalmology of Kangnam St.Mary`s hospital, Catholic University Medical College from November 1989 to June 1998, were studied to delineate the clinical manifestations, treatments and prognosis in patients with HLA-B 27-associated uveitis.An HLA B27 associated systemic disorder was present in 10 patients, all of whom were ankylosing spondylitis. Systemic manifestations occurred in 19 patients included oral ulcer in 7 patients, genital ulcer in 3 patients, arthralgia in 16 patients, and skin lesion in 3 patients.Among the total 27 eyes, anterior uveitis was noted in 23 eyes and posterior segment involvement occurred in 4 eyes.The findings of posterior segment involvement included retinal vasulitis in 2 eyes and chorioretinitis in 1 eyes.Severe vitritis occurred in 1 eyes.Most of anterior uveitis was treated with topical steroid eyedrops and periocular steroid injections.In 3 eyes of posterior segment involvement, systemic steroid therapy was required for control of inflammation.After treatment, visual acuity in 23 eyes among 27 eyes was 20/40 or better.And, visual acuity in 4 eyes of posterior segment involvement was 20/25 or better following medical treatment.In conclusion, although HLA-B 27-associated uveitis was mostly related to anterior uveitis, posterior segment manifestations may be occurred in some patients;these patients may require the use of aggressive systemic immunosuppressive therapy to control inflammation and preserve vision.