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Posterior Segment Manifestations in Patients with HLA-B27-associated Uveitis

Presenter:

Gunay Uludag, MD

Authors:

Gunay Uludag1, Jung Hyun Park1, Neil Onghanseng1, Muhammad Sohail Halim1, Muhammad Hassan1, Hien Luong Doan, MD1, Sophaktra Chea1, Jiawen Xiang1, Amir Akhavanrezayat1, Diana V. Do1, Yasir J. Sepah1, Quan Dong Nguyen1

  1. Byers Eye Institute, Stanford University, Palo Alto, CA, USA

Affiliation:

  1. Purpose:To describe the characteristics of posterior segment findings in HLA-B27- associated uveitis.
  2. Methods:Medical records of 47 patients with HLA-B27-associated uveitis managed at a university uveitis clinic were reviewed. Patients with vitreous haze/vitritis, vasculitis, optic disc leakage and macular edema are considered to have posterior segment findings, which were determined based on medical records, color fundus photographs, fluorescein angiography and optic coherence tomography. Clinical course of anterior uveitis was recorded as acute, recurrent and chronic according to the standardization of uveitis (SUN) nomenclature classification.Five patients who had significant systemic and ocular comorbidities were excluded from study.
  3. Results:42 patients with HLA-B27-associated uveitis were included in the study. The mean age of the patients was 42.4 years. 31% subjects were female. Posterior segment findings were seen in 13 patients (30.9%). The most common posterior findings included optic disc leakage (10 patients, 62.5%) followed by peripheral retinal vasculitis (7 patients, 44%). Other posterior findings included macular edema (4 patients, 25%), posterior pole retinal vasculitis (2 patients, 12.5%), vitreous haze (2 patients, 12.5%) and vitreous cells (one patient, 6.2%). Figure demonstrates posterior segment manifestations in a representative patient. Five out of 7 patients (71.4%) with chronic uveitis (≥3 months) developed posterior segment involvement, while all chronic uveitis patients with ≥6 months duration of disease (100%) presented with posterior ocular manifestations.
  4. Conclusion: Posterior ocular findings can be seen up to 31% of patients with HLA-B27-associated uveitis. Patients with chronic uveitis ( ≥ 3 months) are more likely to have posterior segment involvements.

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