CLINICAL-FEATURES AND ASSOCIATED SYSTEMIC-DISEASES OF HLA-B27 UVEITIS

PURPOSE: To delineate the clinical features, course, complications, an d associated systemic diseases in patients:with HLA-B27 -associated uv eitis. METHODS: We reviewed the records of 148 patients with HLA-B27-a ssociated uveitis from two large uveitis practices. RESULTS: There wer e 127 (86%) white and 21 (14%) nonwhite patients, and a male-to female ratio of 1.5:1. The median age at onset of uveitis was 32 years; eigh t patients (5%) had their first attack after age 55 years. Acute anter ior uveitis was noted in 129 patients (87%), and nonacute inflammation was noted in 19 (13%). Ocular involvement was categorized as unilater al or unilateral alternating in 138 patients (93%), but ten patients ( 7%) had bilateral, concurrent disease. The median duration of an attac k was six weeks, and the median number of recurrences for patients wit h more than 12 months of follow up was three. Cataracts were associate d with posterior synechiae (P = .03), increased intraocular pressure ( P = .003), and cystoid macular edema (P = .04). An HLA-B27-associated systemic disorder was present in 83 patients (58%), 30 of whom were wo men, and it was diagnosed in 43 of the 83 patients as a result of the ophthalmologic consultation. Thirty-four (30%) of 112 patients had a f amily history of a spondyloarthropathy. CONCLUSIONS: Although HLA-B27- associated uveitis is usually described as a disease of young white me n, women and nonwhites may also be affected. A subgroup of patients ha ve severe disease and consequently more complications. Most patients h ave an associated systemic disease, including women, who appear to hav e more atypical spondyloarthropathies. The systemic diseases were freq uently undiagnosed before the onset of the ocular disease and before t he uveitis consultation.