Possible ankylosing spondylitis in acute anterior uveitis

Area of Science:

• Ophthalmology
• Rheumatology
• Immunogenetics

Background:

• Acute anterior uveitis (AAU) is an ocular inflammatory condition.
• Ankylosing spondylitis (AS) is a form of inflammatory arthritis primarily affecting the spine.
• The Human Leukocyte Antigen B27 (HLA-B27) is a specific protein on the surface of white blood cells.

Purpose of the Study:

• To investigate the association between HLA-B27 and acute anterior uveitis (AAU).
• To determine the prevalence of ankylosing spondylitis (AS) and possible AS in AAU patients based on HLA-B27 status.
• To assess the diagnostic value of HLA-B27 typing in the early detection of AS in AAU patients.

Main Methods:

• HLA-B27 antigen typing was performed on 103 patients diagnosed with AAU.
• Patients were evaluated for the presence of AS using the New York criteria.
• Patients were also assessed for criteria indicative of possible AS.

Main Results:

• 48% of AAU patients were positive for HLA-B27.
• Among HLA-B27 positive AAU patients, 55% met the New York criteria for AS.
• A significant proportion of HLA-B27 positive AAU patients without formal AS diagnosis exhibited features of possible AS.
• Only a small percentage of HLA-B27 negative AAU patients had AS or possible AS.
• No patients with posterior uveitis (PU) were HLA-B27 positive or met criteria for AS.

Conclusions:

• There is a strong association between AAU, AS (or possible AS), and the presence of the HLA-B27 antigen.
• HLA-B27 testing is a valuable tool for the early diagnosis and management of AS in patients presenting with AAU.
• Posterior uveitis does not appear to be associated with HLA-B27 or AS in this cohort.