Abstract
Purpose:
To determine if variations exist in the disease characteristics of HLA-B27/Ankylosing Spondylitis associated uveitis between varying ethnicities (primarily Caucasians and African Americans).
Methods:
Retrospective chart review of all patients seen between 2007 and 2010 (inclusive) at a single tertiary care academic uveitis center in Birmingham, Alabama, USA. Characteristics were compared between racial subgroups using t-test and chi-square test for continuous and categorical variables, respectively.
Results:
Seven hundred thirty two (732) patients were identified as having uveitis from the chart review,42% of which were African-American, 55% Caucasians, and 3% categorized as “other.” A diagnosis of HLA-B27/AS was established in 97 patients (13% of the total uveitis cases) and was the diagnosis in 18% of Caucasians, 7% of African Americans, and 9% of other ethnicities (2 patients, which due to the small number were excluded from further analysis (p=0.000007). Of patients with HLA-B27/AS uveitis, the mean age at presentation was 38 years in Caucasians, 40 in African Americans (p=0.57). Females made up 46% of Caucasians, 60% of African Americans (p=0.26). Caucasians had acute disease 95% of the time, African Americans 86% (p=0.17); unilateral disease was present in 96% of Caucasians, 95% of African Americans (p=0.89). At presentation, 81% of Caucasians had Va in the affected eye of 20/40 or better while 62% of African Americans did. Vision of 20/50 to 20/150 was present in 12% of Caucasians and 29% of African Americans. Vision of 20/200 or worse was present in 7% of Caucasians and 10% of African Americans (p=0.1539). Severity of anterior chamber reaction was skewed to the extreme ends of the scale in African Americans while Caucasians had generally lower levels of inflammation at presentation (p=0.11).
Conclusions:
HLA-B27/AS uveitis is significantly more common among Caucasians than African Americans. While African Americans were overrepresented in the lower visual acuity categories and had a higher percentage of patients with the most significant level of inflammation, no statistically significant differences were found between the two groups.
Keywords: 463 clinical (human) or epidemiologic studies: prevalence/incidence •
557 inflammation •
746 uveitis-clinical/animal model