Clinical Ophthalmology (May 2023)

Posterior Segment Ocular Findings in HLA-B27 Positive Patients with Uveitis: A Retrospective Analysis

  • Or C,
  • Lajevardi S,
  • Ghoraba H,
  • Park JH,
  • Onghanseng N,
  • Halim MS,
  • Hasanreisoglu M,
  • Hassan M,
  • Uludag G,
  • Akhavanrezayat A,
  • Nguyen QD

Journal volume & issue
Vol. Volume 17
pp. 1271 – 1276

Abstract

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Chris Or,1 Sherin Lajevardi,1 Hashem Ghoraba,1 Jung Hyun Park,1 Neil Onghanseng,1,2 Muhammad Sohail Halim,1 Murat Hasanreisoglu,3 Muhammad Hassan,1 Gunay Uludag,1 Amir Akhavanrezayat,1 Quan Dong Nguyen1 1Department of Ophthalmology, Stanford University, Palo Alto, CA, USA; 2Department of Ophthalmology, Makati Medical Center, Manila, Philippines; 3Department of Ophthalmology, Koç University, School of Medicine, Istanbul, TurkeyCorrespondence: Quan Dong Nguyen, Spencer Center for Vision Research, Byers Eye Institute at Stanford University, 2370 Watson Court, Suite 200, Palo Alto, CA, 94303, USA, Tel +1 650 725 7245, Email [email protected]: To describe the prevalence and characteristics of posterior segment manifestations in patients with HLA-B27-associated uveitis using wide field imaging.Methods: Medical records of patients diagnosed with HLA-B27-associated uveitis from a tertiary uveitis clinic were reviewed. Posterior segment involvements including but not limited to peripheral vasculitis, optic disc inflammation, and macula edema documented based on medical records and various imaging modalities including wide field fluorescein angiography and optical coherence tomography, were noted. Demographic characteristics, accompanied with systemic diseases as well as duration and chronicity of uveitis, were also evaluated. Patients with significant systemic and ocular comorbidities were excluded. Statistical analyses including chi-squared tests and paired t-tests were employed.Results: Of the 44 patients with HLA-B27 associated uveitis, 22 patients (50%) were noted to demonstrate posterior segment involvement. Disc leakage and peripheral vasculitis were the most common findings of posterior involvement. Those with anterior chamber inflammation were found to have a significantly increased risk of posterior involvement. Those with posterior involvement were also noted to have a statistically significant decreased visual acuity. No significant association was found between documented duration of disease and posterior segment involvement.Conclusion: The prevalence of posterior segment involvement in HLA-B27 associated uveitis is higher compared to previous reports when evaluated with wide angle imaging modalities. Careful examination of the posterior segment is required in patients with HLA-B27 associated uveitis.Keywords: HLA-B27, uveitis, retinal vasculitis, vitreous haze, vitreous cells, macular edema, anterior chamber cells, anterior chamber flare

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