Anterior uveitis is the most common form of uveitis in most regions of the world. A recent study reported that 50 % of patients with anterior uveitis have a related systemic illness. The most common cause of anterior uveitis to date remains idiopathic (45–50 %), followed by HLA-B27-positive acute anterior uveitis. Ours is a retrospective study of the clinical records of 42 patients with anterior uveitis seen at a tertiary care eye hospital in south India. To diagnose the associated systemic disease, the investigations carried out were erythrocyte sedimentation rate, red and white blood cell counts, anti-nuclear antibody (ANA) analysis and HLA-B27 antigen determination. Based on clinical features, patients were also investigated for serum angiotensin-converting enzyme, high-resolution computed tomography scan, Mantoux test and QuantiFERON-TB Gold test. American College of Rheumatology criteria were followed to diagnose spondyloarthropathies and juvenile idiopathic arthritis (JIA). Of the 42 patients, 14 (33.33 %) were HLA-B27-positive and the remaining 28 (66.66 %) HLA-B27-negative. Overall, 32 of the 42 had no causative association, three patients were diagnosed with JIA, two with ankylosing spondylitis, two were associated with systemic tuberculosis, two with sarcoidosis and one with Vogt–Koyanagi–Harada syndrome. Our case series shows the incidence of various systemic diseases associated with anterior uveitis. Though the overall incidence of HLA-B27-positive acute anterior uveitis in our series (33 %) is similar to that in the Western literature, only 14 % of such patients were positive for a spondyloarthropathy. A few interesting cases like HLA-B27-positive, ANA-negative JIA presenting with chronic persisting anterior uveitis were also seen.
Anterior uveitis HLA B-27
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