Abstract | OBJECTIVE: To analyze ocular and extraocular manifestations in patients with HLA-B27-associated uveitis. DESIGN: Large, observational case series. PARTICIPANTS: One hundred seventy-five consecutive patients with HLA-B27-associated uveitis seen in a single center between January 1996 and March 2001. METHODS: MAIN OUTCOME MEASURES: Percentage of patients with extraocular manifestations. The time between the first episode of uveitis and symptoms or diagnosis of extraocular disease was estimated. Characteristics of uveitis were analyzed. RESULTS: The male-to-female ratio was 1.3 to 1, and the median age at the time of the first attack of uveitis was 31 years. An HLA-B27-associated extraocular disorder was seen in 136 cases (77.7%). Of these, ankylosing spondylitis was diagnosed in 81 patients (46.3%) and presumed in 17 (9.7%). Undifferentiated spondyloarthropathy was observed in 21 patients (12%) and other HLA-B27-associated diseases in 17 patients (9.7%). The onset of extraocular symptoms occurred at a younger age (mean+/-standard deviation [SD], 26.4+/-11.1 years) than the first attack of uveitis (mean+/-SD, 34.0+/-14.1 years; P<0.0001). The diagnosis of an extraocular disease was made only after the appearance of ophthalmic manifestations in 88 of 136 patients. Among 117 patients (66.9%) with more than 1 episode of uveitis, same eye attacks were observed in 48 of 117 patients (41.0%), more than the expected percentage than attacks of a random eye (P<0.0001). The median +/- SD frequency of active episodes of uveitis was 0.8+/-0.6 per year and decreased as the duration of the disease lengthened (P<0.0001). Patients with extraocular disease had a greater total number of attacks of uveitis (P = 0.02), but other ophthalmic findings did not differ between patients with and without an extraocular disorder. CONCLUSIONS:
Uveitis is frequently the first indication of a previously undiagnosed HLA-B27-associated extraocular disease. The most common of these diseases are spondyloarthropathies.
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Authors | Dominique Monnet, Maxime Breban, Christophe Hudry, Maxime Dougados, Antoine P Brézin |
Journal | Ophthalmology
(Ophthalmology)
Vol. 111
Issue 4
Pg. 802-9
(Apr 2004)
ISSN: 0161-6420 [Print] United States |
PMID | 15051216
(Publication Type: Journal Article)
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Chemical References |
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Topics |
- Acute Disease
- Adolescent
- Adult
- Age of Onset
- Aged
- Child
- Diagnostic Techniques, Ophthalmological
- Female
- HLA-B27 Antigen
(immunology)
- Humans
- Male
- Middle Aged
- Prevalence
- Recurrence
- Spondylarthropathies
(diagnosis, immunology)
- Uveitis, Anterior
(diagnosis, immunology)
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