OBJECTIVE: This study aimed to test the hypothesis that patients presenting with
anterior uveitis who are
HLA-B27 positive, either with or without 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-seven patients who were
HLA-B27 positive with no systemic disease, 94 patients who were
HLA-B27 positive with systemic disease, and 72 patients 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 macular edema, and
optic disc edema), medical and
surgical treatment, number 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 complications than did the patients who were
HLA-B27 negative. Periocular
corticosteroids, systemic
corticosteroids, and systemic
immunosuppressive chemotherapy were required in a far greater number of HLA-B27-positive patients than in HLA-B27-negative patients (60% vs. 11%, 53% vs. 7%, and 18% vs. 1%, respectively; P < 0.001). The percentage of
legally 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 uveitis.
