Publication: HLA-B27 ön üveiti: Demografik ve klinik özellikleri
Abstract
Amaç: Akut ön üveit en sık görülen üveit tipidir ve seronegatif artropatiler ve HLA-B27 haplotipi ile ilişkisi bilinmektedir. HLA-B27 ile ilişkili ön üveit akut, unilateral veya bilateral alternan, nongranülomatöz ve rekürran iridosiklit atakları ile karakterizedir. Bu çalışma, HLA-B27 pozitif ön üveit tanısı ile izlenen olguların demografik ve klinik özelliklerinin araştırılması amacı ile planlanmıştır. Materyal ve Metod: Marmara Üniversitesi Göz Hastalıkları Anabilim Dalı Uvea Birimince HLA-B27 ön üveit tanısı ile izlenmiş olan 23 olgunun kayıtları incelendi. Eşlik eden sistemik hastalıklar incelendiğinde 15 olguya ankilozan spondilit (%65.2) tanısı konulduğu görüldü. Kalan 8 olguda sistemik ve/veya radyolojik bulgu saptanmadı. Bulgular: Toplam 23 olgunun 32 gözü çalışma kapsamına alındı. Ortalama başvuru yaşı 40.3±8.1 (28-55) idi. Olgular 12 erkek (%52.1) ve 11 kadından (%47.9) oluşmaktaydı. Dokuz olguda tutulum bilateral (%39.1), 14 olguda ise unilateral (%60.9) idi. Ortalama takip süresi 18.5±20.9 ay (1ay-7 yıl) idi. Yirmidokuz gözde izole ön üveit mevcuttu. Ortalama atak sayısı 1.37±0.68 (1-3) idi. Takip süresi içinde l gözde hipopyon (%3.1) gelişimi oldu. Üç gözde (%9.3) ön üveite eşlik eden arka segment bulguları görüldü. Arka segment bulgularına ek olarak 5 gözde kalıcı sinesi (%15.6) gelişimi ve 2 gözde ise katarakt (%6.2) gelişimi saptandı. Sonuç görme keskinliği değerlendirildiğinde 30 gözün (%93.8) görme keskinliği 0.5 ve üstü bulunmuştur. Görme keskinliği hiçbir gözde 0.2 altına düşmemiştir. Sonuç: Sonuç olarak, HLA-B27 ile ilişkili ön üveit olgularında görme keskinliği, ortalama rekürrans ve komplikasyon sıklığı esas alındığında prognoz iyi gibi gözükmektedir. Ancak bu olgularda sonuç görme keskinliği iyi ve klinik ön segment ağırlıklı olsa da eşlik edebilecek arka segment komplikasyonlarına rastlanılabileceği göz önünde bulundurulmalıdır.
Aim: Acute anterior uveitis is the most frequent type of uveitis in ophthalmological practice and its association with seronegative spondiloarthropathies and the HLA-B27 haplotype is well established. Anterior uveitis associated with HLA-B27 is characterized by unilateral or bilateral alternating, nongranulomatous and recurrent iridocyclitis attacks. This study was designed to investigate the demographic and clinical features of this disorder. Material and Methods: The clinical records of 23 patients (32 eyes) examined at the Marmara University, Medical Faculty Department of Ophthalmology with the diagnosis of anterior uveitis associated with HLA-B27 were reviewed. Eight patients had no underlying systemic disease and/or radiologic findings attributable to their disease. Fifteen patients were diagnosed as having ankylosing spondylitis (65.2%). Results: Thirty-two eyes of 23 patients were included in the study. Mean age at presentation was 40.3+8.1 (range:28-55). Twelve patients (52.1%) were male and 11 (47.9%) were female. Bilateral involvement was observed in 9 (39.1%) and unilateral involvement was observed in 14 (60.9%) patients. Mean follow-up was 18.5+.20.9 months (range: lmonth-7 years). In twenty nine eyes isolated anterior uveitis was observed. Mean number of attacks were 1.37±0.68 (range:l-3). Hypopyon developed in one eye (3.1%). Posterior segment manifestation accompanied anterior uveitis in 3 eyes (9.3%). In addition to posterior segment manifestations persistent posterior synechia developed in 5 (15.6%) and cataract in 2 (6.2%) eyes. Final visual acuity was 0.5 or better in 93.8% of eyes. In none of the eyes final visual acuity was worse than 0.2. Conclusion: The prognosis of anterior uveitis associated with HLA-B27 haplotype seems to be favorable if visual acuity, mean recurrence and complications are taken as criteria for prognosis. Even though associated with a good final visual acuity and the clinical picture is predominantly of anterior type, the association with posterior segment complications should be kept in mind.
Aim: Acute anterior uveitis is the most frequent type of uveitis in ophthalmological practice and its association with seronegative spondiloarthropathies and the HLA-B27 haplotype is well established. Anterior uveitis associated with HLA-B27 is characterized by unilateral or bilateral alternating, nongranulomatous and recurrent iridocyclitis attacks. This study was designed to investigate the demographic and clinical features of this disorder. Material and Methods: The clinical records of 23 patients (32 eyes) examined at the Marmara University, Medical Faculty Department of Ophthalmology with the diagnosis of anterior uveitis associated with HLA-B27 were reviewed. Eight patients had no underlying systemic disease and/or radiologic findings attributable to their disease. Fifteen patients were diagnosed as having ankylosing spondylitis (65.2%). Results: Thirty-two eyes of 23 patients were included in the study. Mean age at presentation was 40.3+8.1 (range:28-55). Twelve patients (52.1%) were male and 11 (47.9%) were female. Bilateral involvement was observed in 9 (39.1%) and unilateral involvement was observed in 14 (60.9%) patients. Mean follow-up was 18.5+.20.9 months (range: lmonth-7 years). In twenty nine eyes isolated anterior uveitis was observed. Mean number of attacks were 1.37±0.68 (range:l-3). Hypopyon developed in one eye (3.1%). Posterior segment manifestation accompanied anterior uveitis in 3 eyes (9.3%). In addition to posterior segment manifestations persistent posterior synechia developed in 5 (15.6%) and cataract in 2 (6.2%) eyes. Final visual acuity was 0.5 or better in 93.8% of eyes. In none of the eyes final visual acuity was worse than 0.2. Conclusion: The prognosis of anterior uveitis associated with HLA-B27 haplotype seems to be favorable if visual acuity, mean recurrence and complications are taken as criteria for prognosis. Even though associated with a good final visual acuity and the clinical picture is predominantly of anterior type, the association with posterior segment complications should be kept in mind.