Power W J, Rodriguez A, Pedroza-Seres M, Foster C S
Immunology & Uveitis Service, Massachusetts Eye & Ear Infirmary, Harvard Medical School, Boston, USA.
Ophthalmology. 1998 Sep;105(9):1646-51. doi: 10.1016/S0161-6420(98)99033-9.
This study aimed to test the hypothesis that patients presenting with anterior uveitis who are HLA-B27 positive, either with or without associated systemic disease, have a less-favorable outcome than do patients with idiopathic anterior uveitis who are HLA-B27 negative.
Retrospective case-controlled series.
Ninety-seven patients who were HLA-B27 positive with no systemic disease, 94 patients who were HLA-B27 positive with systemic disease, and 72 patients who were HLA-B27 negative who presented with anterior uveitis were studied.
Ocular complications (e.g., secondary glaucoma, cataract formation, pupillary synechiae, vitritis, cystoid macular edema, and optic disc edema), medical and surgical treatment, number of recurrent attacks, and final visual acuity were recorded for all patients.
The patients who were HLA-B27 positive, either with or without systemic disease, experienced a greater number of complications than did the patients who were HLA-B27 negative. Periocular corticosteroids, systemic corticosteroids, and systemic immunosuppressive chemotherapy were required in a far greater number of HLA-B27-positive patients than in HLA-B27-negative patients (60% vs. 11%, 53% vs. 7%, and 18% vs. 1%, respectively; P < 0.001). The percentage of legally blind eyes was significantly greater in the HLA-B27-positive group, both with and without systemic disease, when compared with the HLA-B27-negative group (11% vs. 2%; P < 0.005).
The prognosis of anterior uveitis associated with the HLA-B27 haplotype, either with or without associated systemic disease, is less favorable when compared with that of HLA-B27-negative patients with idiopathic anterior uveitis.
本研究旨在验证以下假设：与无相关全身性疾病的HLA - B27阳性前葡萄膜炎患者相比，无论有无相关全身性疾病，HLA - B27阳性的前葡萄膜炎患者的预后均不如HLA - B27阴性的特发性前葡萄膜炎患者。
回顾性病例对照系列研究。
研究了97例无全身性疾病的HLA - B27阳性患者、94例有全身性疾病的HLA - B27阳性患者以及72例出现前葡萄膜炎的HLA - B27阴性患者。
记录所有患者的眼部并发症（如继发性青光眼、白内障形成、瞳孔粘连、玻璃体炎、黄斑囊样水肿和视盘水肿）、药物和手术治疗情况、复发次数以及最终视力。
无论有无全身性疾病，HLA - B27阳性患者的并发症数量均多于HLA - B27阴性患者。与HLA - B27阴性患者相比，HLA - B27阳性患者需要使用眼周糖皮质激素、全身性糖皮质激素和全身性免疫抑制化疗的比例要高得多（分别为60%对11%、53%对7%和18%对1%；P < 0.001）。与HLA - B27阴性组相比，无论有无全身性疾病，HLA - B27阳性组法定盲眼的比例均显著更高（11%对2%；P < 0.005）。
与HLA - B27阴性的特发性前葡萄膜炎患者相比，与HLA - B27单倍型相关的前葡萄膜炎，无论有无相关全身性疾病，其预后均较差。
