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D Monnet, M Breban, C Hudry, M Dougados, AP BREZIN; UVEITIS AND HLA-B27 : Prospective Study of 175 Cases . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4252.
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Purpose: To assess the systemic manifestations associated with HLA-B27 uveitis. To analyze the characteristics of ocular inflammation. Methods: Monocentric, prospective study of 175 patients seen between January 1996 and March 2001 with acute anterior uveitis and HLA-B27 allele. Patients were systematically referred for a rheumatologic evaluation and diagnosis were based on criteria from the European Spondylarthropathy Study Group. Results: There were 99 males and 76 females. The mean age was 40.4 ± 13.3 years at the time of the study and 34.5 ± 13.9 years at the time of the first episode of uveitis. The average time between the first episode of uveitis and the last visit during the study period was 7.5 ± 7.2 years (median : 5.1). The mean number of episodes of uveitis since the onset of the disease was 4.9 ± 7.9 (median : 3). The mean frequency of recurrences was 0.8 ± 0.6 per year. Posterior segment involvement was observed in 45 (25.7%) patients. Final visual acuity was unchanged in 125 (71%) cases. A systemic disease was present in 136 (77.7%) cases, which was diagnosed on the occasion of the uveitis in 88 (64.7%) cases. Ankylosing spondylitis was the most frequent associated disease, presumed in 17 (9.7%) cases and definite in 81 (46.3%) cases. Other forms of spondylarthropathies were diagnosed in 29 (17%) cases. Reactive arthritis (6 cases), psoriasic rheumatism (2 cases) and isolated Crohn’s disease (1 case) were also observed. The mean delay between the first systemic manifestations and the first episode of uveitis was 7.6 10.5 years (range -6.0 to 56.1 years). No age difference at the time of the study were observed in patients with or without systemic disease : respectively 40.5 ± 12.3 and 39.8 ± 16.4 years (p=0.81). However, patients with associated systemic diseases had a greater total number of recurrences than patients with uveitis only : respective average 5.4 ± 8.8 and 3.1 ± 3.3 (p=0.016). Conclusion: The visual prognosis of B27 uveitis was favorable in most cases. Uveitis was frequently a manifestation leading to a previously undiagnosed spondylarthropathy.
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