Review for Disease of the Year: Epidemiology of HLA-B27 Associated Ocular Disorders

Abstract

Acute anterior uveitis is generally recognized as the most common form of uveitis. An association with HLA-B27 is seen in approximately half of cases of acute anterior uveitis. The prevalence of HLA-B27 varies widely between ethnic populations, with an approximate 8-10% prevalence in non-Hispanic whites and lower prevalence in Mexican- (4%) and African- (2-4%) Americans. A group of systemic inflammatory diseases, the spondyloarthropathies, similarly demonstrates a strong association with HLA-B27. The strength of association varies, depending on the specific spondyloarthropathy, with the strongest association found in patients with ankylosing spondylitis. The majority of patients with HLA-B27 associated uveitis will have an underlying spondyloarthropathy. Suspicion for HLA-B27 associated uveitis should prompt a careful clinical history to assess for features of a spondyloarthropathy as the characteristics of any associated uveitis may vary.

S100A8 promotes migration and infiltration of inflammatory cells in acute anterior uveitis

“…An association with HLA-B27 is seen in approximately half of AAU cases. HLA-B27 AAU can be associated with ocular inflammation alone or in association with systemic disease37. Migration and infiltration of cells into the eye occurs in many ocular diseases.…”

Uveitis: Diagnostic work-up. A literature review and recommendations from an expert committee

“…Between 8 and 10% of Caucasians carry the HLA-B27 antigen [110,111]. A diagnosis of spondyloarthritis was established in 21-40% of patients who presented with acute anterior uveitis [112,113].…”

Prise en charge diagnostique des uvéites : recommandations d’un groupe d’experts

“…Seule la détermination du groupage HLA B27 a un intérêt pour les uvéites antérieures aiguës non granulomateuses auxquelles cet antigène d'histocompatibilité est associé dans la moitié des cas. Huit à 10 % des caucasiens sont porteurs de l'antigène HLA B27 [96,97]. Un diagnostic de spondyloarthrite est établi chez 21 à 40 % des patients qui présentent une uvéite antérieure aiguë [98,99].…”