OUTCOMES IN ANTERIOR UVEITIS ASSOCIATED WITH THE HLA-B27 HAPLOTYPE

Objective: This study aimed to test the hypothesis that patients prese nting with anterior uveitis who are HLA-B27 positive, either with or w ithout associated systemic disease, have a less-favorable outcome than do patients with idiopathic anterior uveitis who are HLA-B27 negative . Design: Retrospective case-controlled series. Participants: Ninety-s even patients who were HLA-B27 positive with no systemic disease, 94 p atients who were HLA-B27 positive with systemic disease, and 72 patien ts who were HLA-B27 negative who presented with anterior uveitis were studied. Main Outcome Measures: Ocular complications (e.g., secondary glaucoma, cataract formation, pupillary synechiae, vitritis, cystoid m acular edema, and optic disc edema), medical and surgical treatment, n umber of recurrent attacks, and final visual acuity were recorded for all patients. Results: The patients who were HLA-B27 positive, either with or without systemic disease, experienced a greater number of comp lications than did the patients who were HLA-B27 negative. Periocular corticosteroids, systemic corticosteroids, and systemic immunosuppress ive chemotherapy were required in a far greater number of HLA-B27-posi tive patients than in HLA-B27-negative patients (60% vs. 11%, 53% vs. 7%, and 18% vs. 1%, respectively; P < 0.001). The percentage of legall y blind eyes was significantly greater in the HLA-B27-positive group, both with and without systemic disease, when compared with the HLA-B27 -negative group (11% vs. 2%; P < 0.005). Conclusions The prognosis of anterior uveitis associated with the HLA-B27 haplotype, either with or without associated systemic disease, is less favorable when compared with that of HLA-B27-negative patients with idiopathic anterior uveiti s.