Systemic associations of anterior uveitis in a tertiary care ophthalmic centre in south India.
Summary of "Systemic associations of anterior uveitis in a tertiary care ophthalmic centre in south India."
Anterior uveitis is the most common form of uveitis in most regions of the world. A recent study reported that 50 % of patients with anterior uveitis have a related systemic illness. The most common cause of anterior uveitis to date remains idiopathic (45-50 %), followed by HLA-B27-positive acute anterior uveitis. Ours is a retrospective study of the clinical records of 42 patients with anterior uveitis seen at a tertiary care eye hospital in south India. To diagnose the associated systemic disease, the investigations carried out were erythrocyte sedimentation rate, red and white blood cell counts, anti-nuclear antibody (ANA) analysis and HLA-B27 antigen determination. Based on clinical features, patients were also investigated for serum angiotensin-converting enzyme, high-resolution computed tomography scan, Mantoux test and QuantiFERON-TB Gold test. American College of Rheumatology criteria were followed to diagnose spondyloarthropathies and juvenile idiopathic arthritis (JIA). Of the 42 patients, 14 (33.33 %) were HLA-B27-positive and the remaining 28 (66.66 %) HLA-B27-negative. Overall, 32 of the 42 had no causative association, three patients were diagnosed with JIA, two with ankylosing spondylitis, two were associated with systemic tuberculosis, two with sarcoidosis and one with Vogt-Koyanagi-Harada syndrome. Our case series shows the incidence of various systemic diseases associated with anterior uveitis. Though the overall incidence of HLA-B27-positive acute anterior uveitis in our series (33 %) is similar to that in the Western literature, only 14 % of such patients were positive for a spondyloarthropathy. A few interesting cases like HLA-B27-positive, ANA-negative JIA presenting with chronic persisting anterior uveitis were also seen.
Affiliation
Shri Bhagwan Mahavir Vitreoretinal Services, Sankara Nethralaya, 18, College Road, Chennai, 600 006, Tamil Nadu, India, gaurav36vaishali@gmail.com.
Journal Details
This article was published in the following journal.
Name: International ophthalmology
ISSN: 1573-2630
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/22570117
- DOI: http://dx.doi.org/10.1007/s10792-012-9580-y
Medical and Biotech [MESH] Definitions
Hla-b27 Antigen
Human histocompatibility (HLA) surface antigen encoded by the B locus on chromosome 6. It is strongly associated with acute anterior uveitis (UVEITIS, ANTERIOR); ANKYLOSING SPONDYLITIS; and REACTIVE ARTHRITIS.
Uveitis, Anterior
Inflammation of the anterior uvea comprising the iris, angle structures, and the ciliary body. Manifestations of this disorder include ciliary injection, exudation into the anterior chamber, iris changes, and adhesions between the iris and lens (posterior synechiae). Intraocular pressure may be increased or reduced.
Vitreoretinal Surgery
Specialized ophthalmic technique used in the surgical repair and or treatment of disorders that include retinal tears or detachment; MACULAR HOLES; hereditary retinal disease; AIDS-related retinal infections; ocular tumors; MACULAR DEGENERATION; DIABETIC RETINOPATHY; and UVEITIS.
Ophthalmic Assistants
Persons academically trained to care for patients with eye diseases or structural defects of the eye, under the supervision of an ophthalmologist.
Progressive Patient Care
Organization of medical and nursing care according to the degree of illness and care requirements in the hospital. The elements are intensive care, intermediate care, self-care, long-term care, and organized home care.
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