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Barisani-Asenbauer Talin, Isabella Baumgartner, Alexandra Kautzky-Willer, Saskia Maca, Atrid Angel, Andreas W. Schiesser; HLA-B 27 Positive Anterior Uveitis: Role Of Gender In Disease Characteristics, Presence Of Co-morbidities And Psychosocial Status. Invest. Ophthalmol. Vis. Sci. 2011;52(14):4290.
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HLA-B 27 associated acute anterior uveitis (AAU) is a distinct uveitis entity, usually characterized by male predominance and often associated with seronegative arthropathies Women may also be affected. The aim of our study was to evaluate the role of gender and systemic comorbidities on uveitis burden and on psychosocial status of HLA-B27 AAU patients and question the hypothesis that HLA-B27AAU is a typically male disease.
A total of 165 adult patients with history of HLA-B27-AAU, aged 22-77 years and 86 healthy controls responded to a postal survey comprising standardized psychological questionnaires (FQCI, SF-36, BDI and SCI) and questionnaires on ocular history and socio-demographic factors. The study was independently reviewed and approved by the ethical board of the Medical University of Vienna, Austria.
The sample consisted of 102 men, 63 women; gender ratio, 1.6 M:1 F. The average age at onset of AAU was 37.5 years, with no statistically significant difference between males and females. 78 (47.27%) patients had a HLA-B27- associated additional comorbidity which was more frequent in male (65.4%) than in female subjects (34.6%). When comparing the 100 patient year score (100pyscore) between men and women a significant difference was found (m= 81.81 vs f=116.34, p=0.004). Females without systemic diseases showed even higher frequency of recurrences (100pyscore=150.6) than males or females with systemic diseases (100pyscore=81.81, 55.42; respectively). SF-36 scores were significantly lower for all subjects than for the age matched population norm, except in the subscales ‘vitality’ and ‘social functioning’. No significant differences could be noted in the subscores of the SF-36 when comparing men to women. With regard to the BDI, patients with comorbidities differed significantly from the normal population in the areas: 'sense of failure', 'dissatisfaction', 'social withdrawal', 'indecisiveness', change in 'body image', 'insomnia', 'fatigability' and 'somatic preoccupation'.
The data of our cohort suggest that women with HLAB27 AAU have a lower rate of co-morbidities but a higher frequency of relapses than men. Furthermore women preferentially use negative coping styles to a significant degree and a higher percentage of women presents clinically manifested depression when compared to men or sex- and age- matched healthy controls.
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