The clinical characteristics of retinal vasculitis in HLA-B27-positive patients

Braakenburg, Arthur M.D.; Rothova, Aniki

doi:10.3109/09273948.2013.835429

Cited by 15 publications

(7 citation statements)

References 19 publications

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“…Our rates of posterior segment findings are not far from those published by other authors. [29][30][31] Macular edema, in particular, could be either a part of a genuine posterior segment inflammation, or a mere complication of moderate to severe anterior uveitis. 32 In our study, macular edema was found in 101 eyes with HLA-B27-associated uveitis (12.8%), 73 of which had macular edema in the context of significant anterior segment inflammation, whereas in the remaining 28 eyes, macular edema coexisted with signs of true posterior segment involvement as dense vitritis, pars plana exudates, and retinal vasculitis.…”

Section: Discussionmentioning

confidence: 99%

Clinical Profile of HLA-B27-Associated Uveitis in an Egyptian Cohort

Latif

Abdelhalim

2020

OPTH

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Purpose To describe the clinical profile of patients with HLA-B27-associated uveitis at 2 Egyptian tertiary eye centers. Methods A retrospective study reviewing the medical records of all patients with HLA-B27-associated uveitis served at 2 uveitis referral clinics in Egypt between January 2010 and June 2018. Results The study included a total of 554 patients. Anterior uveitis was the most common type. Ankylosing spondylitis was an important systemic comorbidity in the present study, affecting 27.4% of our patients. Cataract was the most frequent ocular complication. By the conclusion of the study, 6.1% of the affected eyes had a BSCVA poorer than 20/200. Conclusion The clinical profile of HLA-B27-associated uveitis in our cohort of Egyptian patients is similar to that reported from other regions of the world. In our study, a relatively high rate of cataract was observed.

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Section: Discussionmentioning

confidence: 99%

Clinical Profile of HLA-B27-Associated Uveitis in an Egyptian Cohort

Latif

Abdelhalim

2020

OPTH

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“…Ocular coherence tomography (OCT) and fluorescein angiography may be indicated to detect these complications. 49,50,58,68 Patients with HLA-B27-associated AU are highly likely to develop several (presumably autoimmune) diseases known as "seronegative spondyloarthropathies" since their rheumatoid factor is negative. The likelihood of HLA-B27-positive patients with uveitis to develop a rheumatic disease varies from 33% to 90% according to several studies.…”

Section: Referral To Rheumatologist or Other Specialistmentioning

confidence: 99%

Clinical Spectrum of HLA-B27-associated Ocular Inflammation

Pathanapitoon

Dodds

Cunningham

et al. 2016

Ocular Immunology and Inflammation

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Human leukocyte antigen (HLA)-B27-associated anterior uveitis (AU) is the most commonly diagnosed form of AU and represents the largest entity of non-infectious uveitis around the world. The most typical ocular manifestation associated with HLA-B27 consists of unilateral AU of acute onset. The HLA-B27-associated acute AU represents a distinct clinical entity occurring typically in young adults between the ages of 20 and 40 years. HLA-B27-associated acute AU is typically unilateral and lasts usually several weeks and diminishes within 3 months in the majority of patients. The anterior chamber shows typically severe cellular reaction and flare, as well as a fibrinous exudate. Frequently, posterior synechiae are formed and occasionally hypopyon is present. The pattern of the disease is recurrent with a full remission between the attacks. Intraocular pressure during active periods is typically low due to inflammation of ciliary body and decreased aqueous production. Less typical presentations are also recognized and include the development of chronic inflammation, posterior segment involvement, episcleritis, and scleritis. An isolated retinal vasculitis in HLA-B27-positive patients may develop, mostly in those with inflammatory bowel disease. Chronic AU, which may be either unilateral or bilateral affects up to 20% of patients. Ocular complications of HLA-B27-associated AU are diverse and include commonly posterior synechiae, cataract, glaucoma and/or hypotony. The visual outcome and complications of HLA-B27-associated AAU are frequently being compared with HLA B27-negative patients with AU and show that the prognosis of HLA-B27-associated uveitis is rather favorable, as <2% developed legal blindness and <5% visual impairment. A novel algorithm called the "Dublin Uveitis Evaluation Tool (DUET)" has been proposed to guide ophthalmologists to refer appropriate HLA-B27-positive patients with uveitis to rheumatologists.

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“…Posterior segment manifestations are also reported including vitritis, cystoid macular edema and optic disc leakage. Cases of retinal vasculitis in HLA-B27 positive patients are also reported and this can be seen associated with posterior segment involvement in 20–25% of patients [37]. In this case, HLA-B27 testing was negative, essentially excluding the HLA-B27 associated arthropathies as an etiology.…”

Section: Differential Diagnosismentioning

confidence: 79%

Retinal vasculitis with Chronic Recurrent Multifocal Osteomyelitis: a case report and review of the literature

et al. 2019

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Background Concurrent presentation of retinal vasculitis with mixed sclerotic and lytic bone lesions is rare. Case presentation We present the case of a 37-year old woman with a several year history of episodic sternoclavicular pain who presented for rheumatologic evaluation due to a recent diagnosis of retinal vasculitis. We review the differential diagnosis of retinal vasculitis, along with the differential diagnosis of mixed sclerotic and lytic bone lesions. Ultimately, bone marrow biopsy confirmed diagnosis of chronic recurrent multifocal osteomyelitis (CRMO). Concurrent presentation of CRMO with retinal vasculitis is extremely rare but important to recognize. The patient demonstrated clinical response to prednisone and tumor necrosis factor-alpha inhibition (TNF-i). Conclusion This case reports and unusual presentation of CRMO spectrum disease involving the sternum and sternoclavicular joint with concurrent retinal vasculitis.

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The clinical characteristics of retinal vasculitis in HLA-B27-positive patients

Abstract: Retinal vasculitis may develop in the wake of HLA-B27-associated uveitis and might represent a rare manifestation of HLA-B27-associated disease.

Cited by 15 publications

References 19 publications

<p>Clinical Profile of <em>HLA-B27</em>-Associated Uveitis in an Egyptian Cohort</p>

<p>Clinical Profile of <em>HLA-B27</em>-Associated Uveitis in an Egyptian Cohort</p>

Clinical Spectrum of HLA-B27-associated Ocular Inflammation

Retinal vasculitis with Chronic Recurrent Multifocal Osteomyelitis: a case report and review of the literature

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