ABSTRACT
PURPOSE: To describe the clinical profile of HLA B-27-associated uveitis in Indian population. METHOD: We conducted a retrospective review of medical records of 431 eyes of 255 consecutive patients with HLA B-27-associated uveitis, presented to our institute between 2012 and 2017. RESULT: The study observed a male preponderance (75.7%) and the mean age of patients was 35.6 ± 13.3 years. A total of 412 (95.3%) eyes had anterior uveitis, 17(3.9%) eyes had anterior and intermediate uveitis and 3 eyes (0.7%) had intermediate uveitis. Retinal vasculitis was detected in four eyes (0.9%). A total of 176 patients (69%) in the study had evidence of systemic disease and 85% patients developed recurrences. In addition to the treatment with topical and oral steroid, immunosuppressive was required in 39.6% patients and 4% patients received biological therapy. The majority of the eyes (78.4%) had a good visual outcome, while 61 (14.2%) eyes had moderate visual impairment and 32 (7.4%) eyes had severe visual impairment at the time of final follow-up. CONCLUSION: HLA-B27-associated uveitis can be associated with higher number of posterior segment involvement than it is estimated and aggressive therapy in moderate-to-severe uveitis can prevent severe visual impairment in these patients.
Subject(s)
Uveitis, Anterior , Uveitis , Adult , HLA-B27 Antigen , Humans , India/epidemiology , Male , Middle Aged , Retrospective Studies , Uveitis/diagnosis , Uveitis/epidemiology , Uveitis, Anterior/diagnosis , Uveitis, Anterior/epidemiology , Young AdultABSTRACT
Purpose: The aim of this study was to evaluate the efficacy of adalimumab (ADL) and golimumab (GLM) in patients with HLA-B-27-associated uveitis.Method: We conducted a retrospective analysis of patients with HLA-B-27-associated uveitis who had received subcutaneous GLM and ADL between 2014 and 2018.Results: The study included 14 patients, 12 of whom received subcutaneous ADL and two patients were treated with subcutaneous GLM. Median age of the patients was 31.5 years (range 17-53 years). The most common associated systemic disease in these patients was ankylosing spondylitis (92.8%). Majority of the patients had anterior uveitis (71.4%) followed by anterior uveitis and intermediate uveitis (28.6%).Conclusion: ADL/GLM is a useful therapeutic option in refractory cases of HLA-B-27-associated uveitis, especially in patients with associated systemic manifestations.
Subject(s)
Adalimumab/therapeutic use , Antibodies, Monoclonal/therapeutic use , Disease Management , HLA-B27 Antigen/immunology , Uveitis/drug therapy , Adolescent , Adult , Anti-Inflammatory Agents/therapeutic use , Female , Fluorescein Angiography/methods , Fundus Oculi , Humans , Male , Middle Aged , Retrospective Studies , Tumor Necrosis Factor Inhibitors/therapeutic use , Uveitis/epidemiology , Uveitis/immunology , Young AdultABSTRACT
A 42-year-old male presented to us after an episode of acute anterior human leukocyte antigen (HLA)-B27-associated uveitis, and intraocular pressure (IOP) in the right eye was 4 mmHg. Ultrasound biomicroscopy revealed ciliary body edema with supraciliary effusion. He was on a frequent topical corticosteroid, and oral steroid in addition to receiving a periocular injection depot corticosteroid 20 days back. He was started on treatment with subcutaneous golimumab (GLM). After a month, his IOP in the right eye was 14 mm of Hg with UBM showing resolution of ciliary body edema. GLM can be useful in the management of steroid-resistant cases of HLA B-27-associated ocular hypotony.
