Survey of Ophthalmology
Volume 50, Issue 4 , Pages 364-388, July 2005

Acute Anterior Uveitis and HLA-B27

  • John H. Chang, BSc(Med), MBBS(Hons)

      Affiliations

    • Laboratory of Ocular Immunology, Inflammatory Diseases Research Unit, School of Medical Sciences, University of New South Wales, Sydney
    • Department of Ophthalmology, St. Vincent's Hospital, Sydney
    • ,
  • Peter J. McCluskey, MD, FRANZCO, FRACS

      Affiliations

    • Laboratory of Ocular Immunology, Inflammatory Diseases Research Unit, School of Medical Sciences, University of New South Wales, Sydney
    • Department of Ophthalmology, St. Vincent's Hospital, Sydney
    • Department of Ophthalmology, Royal Prince Alfred Hospital, Sydney, Australia
    • ,
  • Denis Wakefield, MD, FRACP, FRCPA

      Affiliations

    • Laboratory of Ocular Immunology, Inflammatory Diseases Research Unit, School of Medical Sciences, University of New South Wales, Sydney
    • Department of Ophthalmology, St. Vincent's Hospital, Sydney
    • Corresponding Author InformationReprint address: Prof. Denis Wakefield, MD, FRACP, FRCPA, School of Medical Sciences, University of New South Wales, Sydney, NSW 2052, Australia.

EDWARD COTLIER AND ROBERT WEINREB, EDITORS

Abstract 

Acute anterior uveitis is the most common form of uveitis. HLA-B27-associated acute anterior uveitis is a distinct clinical entity that has wide-ranging medical significance due to its ocular, systemic, immunologic, and genetic features. The association between HLA-B27 and the spectrum of HLA-B27-associated inflammatory diseases remains one of the strongest HLA-disease associations known to date. This review examines acute anterior uveitis with particular focus on HLA-B27-associated acute anterior uveitis, including the epidemiology, immunopathology, association with HLA-B27 and its subtypes, clinical features, complications, prognosis, and potential new therapies such as anti-TNFα therapy and oral HLA-B27-peptide tolerance. There have been substantial recent advances in both clinical and basic scientific research in this field, including studies of the various animal models of acute anterior uveitis and the HLA-B27 transgenic animals, and these are summarized in this review. To the ophthalmologist, HLA-B27-associated acute anterior uveitis is an important clinical entity that is common, afflicts relatively young patients in their most productive years, and is associated with significant ocular morbidity due to its typically recurrent attacks of inflammation and its potentially vision-threatening ocular complications. Furthermore, to the ophthalmologist and the internist, HLA-B27-associated acute anterior uveitis is also of systemic importance due to its significant association with extraocular inflammatory diseases.

Key words: acute anterior uveitis, animal models, epidemiology, genetic, HLA-B27, immunopathology

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 Dr John H. Chang is a recipient of the NH&MRC Medical Postgraduate Research Scholarship (grant 222928). The authors reported no proprietary or commercial interest in any product mentioned or concept discussed in this article.

PII: S0039-6257(05)00041-X

doi:10.1016/j.survophthal.2005.04.003

Survey of Ophthalmology
Volume 50, Issue 4 , Pages 364-388, July 2005

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