A literature-based meta-analysis was carried out to look at the various clinical features associated with HLA- B27 acute anterior uveitis (AAU). After an extensive search of literature for HLA B27 uveitis was conducted, 735 results were obtained. Twenty-nine articles were found to be relevant for analysis, of which 22 articles were analysed and a relative risk (RR) was calculated for various characteristics: one systemic disease; two sex distribution; three laterality; four visual acuity; five hypopyon; six anterior chamber fibrin; seven elevated intraocular pressure; eight posterior synechiae; nine cataract; cystoid macular oedema; 10 papillitis. The observational studies, which were reviewed, divided their study population into two groups – B27+ve and B27-ve. As expected the relative risk of anterior segment involvement was higher compared to posterior segment. Association with systemic diseases or ankylosing spondylitis (AS) was found to be high (RR for systemic disease was 6.8 and for AS was 9.9). Other features, which had higher RR, were male preponderance, alternating laterality, occurrence of hypopyon, fibrin in anterior chamber and papillitis. Secondary glaucoma was found to be more in HLA B27-ve patients. There was no significant difference in the visual outcome in the two groups. This meta-analysis gives us a clear guidance in clinical features of HLA-B27 associated AAU and the guides the clinician to get rheumatology involved at an early stage to tackle joint related issues.

Clinical features and complications of the HLA- B27 associated acute anterior uveitis: a metanalysis.
D’Ambrosis EM, La Cava M, Tortorella P, et al.
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Mrinal Rana

University Hospital Coventry, Coventry, UK.

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