Etiological and Clinical Characteristics of HLA-B27-associated Uveitis in a Tertiary Referral Center

OBJECTIVES: To investigate the demographic, etiologic, and clinical features of HLA-B27-associated uveitis. MATERIALS AND METHODS: The clinical records of 91 patients diagnosed with HLA-B27-associated uveitis at the Ulucanlar Eye Training and Research Hospital between the years of 2005 and 2016 were reviewed. Each patient’s presenting complaints, best-corrected visual acuities in first and last visits, biomicroscopic and fundoscopic examination findings, frequency and seasonal distribution of attacks, and demographic data such as age and sex were noted. Therapeutic approaches, duration of follow-up, and complications were analyzed. RESULTS: A total of 91 patients (179 eyes) aged 19-82 years (mean age 46.52±13.06 years) were included. Forty-three patients (47.3%) were female and 48 (52.7%) were male. Bilateral involvement was observed in 44 (48.4%) and unilateral involvement was observed in 47 (51.6%) patients. The most frequent complaint was redness (67%), followed by decreased and/or blurred vision (50.5%). The mean follow-up time was 38.2 months (range, 1-245 months). Anterior uveitis was most common anatomical subtype, seen in 86 (94.5%) of the patients. Mean number of attacks was 1.93±1.45 per patient-year and a significantly higher number of uveitis attacks (47%) occurred in winter. Twenty-four patients (26.3%) were diagnosed with ankylosing spondylitis. Fibrinous uveitis was detected in 36 patients (39.5%). Posterior synechia developed in 41 (22.9%) and hypopyon developed in 7 (3.9%) eyes. The most common complications were cataract (n=12, 6.7%) and ocular hypertension (n=15, 8.3%). CONCLUSION: Ninety-one (6.3%) of the 1422 patients followed in our uvea clinic were diagnosed with HLA-B27-associated uveitis. HLA-B27-associated uveitis is characterized by acute, recurring sudden-onset iridocyclitis with a moderate to severe amount of fibrin and cells in the anterior chamber, and is easily treatable. Visual prognosis is good despite the complications.