THU0400 COMPLICATIONS OF ANTERIOR UVEITIS ASSOCIATED WITH HLA-B27 ANTIGEN IN PATIENTS WITH AND WITHOUT SPONDYLOARTHRITIS

2019 
Background HLA-B27- associated anterior uveitis (AU) can be an isolated disease or part of а systemic inflammatory process, such as spondyloarthritis. Differences in the outcome of uveitis with and without spondyloarthritisare still under researh. Objectives To compare the incidence of complications in HLA-B27- associated anterior uveitis patients with and without spondyloarthritis (SpA). Methods 189 patients with HLA-B27- associated anterior uveitis were observed in Research Institute of Eye Disease for 10 years. The pts were underwent standard ophthalmological examination, and, if necessary, computer perimetry, ultrasound examination (B-scan.), optical coherence tomography of the retina and optic nerve (OCT), fluorescence fundus angiography (FAGD) and electrophysiological studies (EFI). All pts were examined for clinical and imaging signs of SpA: inflammatory back pain, arthritis, enthesitis, sacroiliitis. Different variants of SpA were diagnosed in 108 pts: ankylosing spondylitis – in 48 (44,4%), reactive arthritis – in 9 (8,3%), psoriatic arthritis - in 9 (8,3%), inflammatory bowel disease – in 2(1,9%), juvenile SpA – in 4 (3,7%), undifferented SpA - in 36 (33,3%). In 81 pts SpA was not confirmed: 11 had a viral infection (13,5%), 7- bacterial infection (8,6%), 1 (1,2%)-multiple sclerosis, 3 (3,7%) -psoriasis, 59 (72,8%)- idiopathic AU. Results Complications were identified in 74 of 108 (68,5%) pts – 147 eyes in SpA-group and in 39of 81(48,1%) – 110 eyes in group without SpA. Cataract was identified in 89 (60,5%) of 147 eyes in SpA-group and in 35(1,8%) of 110 eyes in group without SpA, p=0,0001;glaucoma – in 28 of 147 eyes (19,0%) in SpA-group and 8 of 110 eyes (7,3%) in group without SpA, p=0,005; synechia - in 24(16,3%) and in 8 (7,3%) respectively, p=0,021;vitreous destruction - in 59(40,1%) and in 26 (23,6%), p=0,005. Maculopathy, оptic atrophy, сorneal degeneration, panuveitis were observed more often in SpA-group, but the differences were not significant. Combinations of several complications were detected in 59 (40,1%) in SpA-group and in 31 (28,2%) in group without SpA, p=0,03. Conclusion Complications of HLA-B27- associated AU were identified more often in pts with SpA than without SpA (the majority of which was idiopathic AU). It confirms the effect of systemic inflammatory disease on the severity of uveitis. Reference [1] Yang P, Wan W, Du L, et al. Clinical features of HLA-B27-positive acute anterior uveitis with or without ankylosing spondylitis in a Chinese cohort. Br J Ophthalmol. 2018Feb;102(2):215-219. doi: 10.1136/bjophthalmol-2016-309499. Epub 2017 Jun 12 Disclosure of Interests None declared
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