HLA-B27-associated acute anterior uveitis

Abstract

Acute uveitis is defined as inflammation confined to the anterior segment of the eye, which involves the iris and the anterior part of the ciliary body. It is characterised by a cellular infiltration in the anterior chamber and often in the anterior vitreous. Keratic precipitates and endothelial dust are not uncommon in HLA-B27-associated disease. There may be some “spillover” of inflammatory cells into the anterior vitreous. Depending on the population studied, up to 50 % or more of patients presenting with episodes of acute anterior uveitis may carry the human leukocyte antigen (HLA) B27 gene, thus making HLA-B27-associated anterior uveitis the commonest type of acute anterior uveitis seen in clinical practice. The ophthalmologist is often the first to suspect of a unifying diagnosis when patients with a long history of back pain and/or peripheral joint pain present with acute anterior uveitis. Numerous studies have shown that the ophthalmologist is uniquely placed to draw attention to the rheumatic disorders associated with acute anterior uveitis.