Tay-Kearney M L, Schwam B L, Lowder C, Dunn J P, Meisler D M, Vitale S, Jabs D A
Department of Ophthalmology, Wilmer Ophthalmological Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland 21205, USA.
Am J Ophthalmol. 1996 Jan;121(1):47-56. doi: 10.1016/s0002-9394(14)70533-1.
To delineate the clinical features, course, complications, and associated systemic diseases in patients with HLA-B27-associated uveitis.
We reviewed the records of 148 patients with HLA-B27-associated uveitis from two large uveitis practices.
There were 127 (86%) white and 21 (14%) nonwhite patients, and a male-to-female ratio of 1.5:1. The median age at onset of uveitis was 32 years; eight patients (5%) had their first attack after age 55 years. Acute anterior uveitis was noted in 129 patients (87%), and nonacute inflammation was noted in 19 (13%). Ocular involvement was categorized as unilateral or unilateral alternating in 138 patients (93%), but ten patients (7%) had bilateral, concurrent disease. The median duration of an attack was six weeks, and the median number of recurrences for patients with more than 12 months of follow-up was three. Cataracts were associated with posterior synechiae (P = .03), increased intraocular pressure (P = .003), and cystoid macular edema (P = .04). An HLA-B27-associated systemic disorder was present in 83 patients (58%), 30 of whom were women, and it was diagnosed in 43 of the 83 patients as a result of the ophthalmologic consultation. Thirty-four (30%) of 112 patients had a family history of a spondyloarthropathy.
Although HLA-B27-associated uveitis is usually described as a disease of young white men, women and nonwhites may also be affected. A subgroup of patients have severe disease and consequently more complications. Most patients have an associated systemic disease, including women, who appear to have more atypical spondyloarthropathies. The systemic diseases were frequently undiagnosed before the onset of the ocular disease and before the uveitis consultation.
描述HLA - B27相关性葡萄膜炎患者的临床特征、病程、并发症及相关全身性疾病。
我们回顾了来自两家大型葡萄膜炎诊疗机构的148例HLA - B27相关性葡萄膜炎患者的病历。
有127例（86%）白人患者和21例（14%）非白人患者，男女比例为1.5:1。葡萄膜炎发病的中位年龄为32岁；8例患者（5%）在55岁以后首次发病。129例患者（87%）出现急性前葡萄膜炎，19例（13%）出现非急性炎症。138例患者（93%）的眼部受累被分类为单侧或单侧交替性，但10例患者（7%）患有双侧同时性疾病。一次发作的中位持续时间为6周，随访超过12个月的患者复发的中位次数为3次。白内障与后粘连（P = 0.03）、眼压升高（P = 0.003）和黄斑囊样水肿（P = 0.04）相关。83例患者（58%）存在与HLA - B27相关的全身性疾病，其中30例为女性，83例患者中有43例是由于眼科会诊而被诊断出该全身性疾病。112例患者中有34例（30%）有脊柱关节病家族史。
尽管HLA - B27相关性葡萄膜炎通常被描述为年轻白人男性的疾病，但女性和非白人也可能受到影响。一部分患者患有严重疾病，因此并发症更多。大多数患者患有相关的全身性疾病，包括女性，她们似乎患有更多非典型脊柱关节病。全身性疾病在眼病发作前以及葡萄膜炎会诊前常常未被诊断出来。
