April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
Ocular Complications And Treatment Of HLA-B27-associated Uveitis: Comparison Of Pediatric And Adult Patients
Author Affiliations & Notes
  • Harpreet Walia
    Ophthalmology,
    Emory University, Atlanta, Georgia
  • Sheila Angeles-Han
    Emory University, Atlanta, Georgia
  • Larry Vogler
    Emory University, Atlanta, Georgia
  • Sampath Prahalad
    Emory University, Atlanta, Georgia
  • Christine Kennedy
    Emory University, Atlanta, Georgia
  • Sunil Srivastava
    Cleveland Clinic, Cleveland, Ohio
  • G B. Hubbard, III
    Ophthalmology,
    Emory University, Atlanta, Georgia
  • Scott Lambert
    Ophthalmology,
    Emory University, Atlanta, Georgia
  • Steven Yeh
    Ophthalmology,
    Emory University, Atlanta, Georgia
  • Footnotes
    Commercial Relationships  Harpreet Walia, None; Sheila Angeles-Han, None; Larry Vogler, None; Sampath Prahalad, None; Christine Kennedy, None; Sunil Srivastava, None; G. B. Hubbard, III, None; Scott Lambert, None; Steven Yeh, None
  • Footnotes
    Support  Supported by an unrestricted grant from Research to Prevent Blindness
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 4285. doi:
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      Harpreet Walia, Sheila Angeles-Han, Larry Vogler, Sampath Prahalad, Christine Kennedy, Sunil Srivastava, G B. Hubbard, III, Scott Lambert, Steven Yeh; Ocular Complications And Treatment Of HLA-B27-associated Uveitis: Comparison Of Pediatric And Adult Patients. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4285.

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Abstract
 
Purpose:
 

To compare the baseline clinical ophthalmic features, systemic disease associations, and steroid-sparing immunomodulatory therapy (IMT) required in adult and pediatric patients with HLA-B27+ uveitis.

 
Methods:
 

Retrospective review of HLA-B27+ uveitis patients from a university-based academic practice. Medical records were reviewed for demographics, visual acuity (VA), IMT, and the presence of cataract, posterior synechiae, cystoid macular edema (CME), epiretinal membrane (ERM), ocular hypertension (OHTN) and hypotony.

 
Results:
 

Nine eyes from 7 pediatric patients and 26 eyes from 16 adult patients with HLA-B27+ uveitis were evaluated (Table 1). Two of 7 pediatric patients and 12 of 16 adult patients were female. In pediatric eyes, VA was 20/50 or worse in 44% and 20/200 or poorer in 11%. In adult eyes, VA was 20/50 or worse in 23% and 20/200 or worse in 12%. Anterior/intermediate uveitis was found in 57% of pediatric patients while anterior uveitis was seen in 94% of adults (p=0.067). Secondary complications in pediatric eyes included cataract (55%), posterior synechiae (33%), OHTN (33%), and CME (22%). In adults, cataract (54%), posterior synechiae (46%), OHTN (33%) and CME (8%) were seen with similar frequencies. The most common systemic disease association was spondyloarthropathy in pediatric patients (29%) and anklyosing spondylitis in adult patients (31%). Steroid-sparing IMT was required in 57% of pediatric patients and 13% of adults (p=0.045).

 
Conclusions:
 

Moderate-severe visual loss was more common in pediatric patients compared to adults with HLA-B27+ uveitis but the difference was not statistically significant. Anterior/intermediate uveitis was more common in pediatric patients than adults, prompting steroid-sparing IMT in the majority of cases.  

 
Keywords: uveitis-clinical/animal model • autoimmune disease 
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