Abstract
Background: Anterior uveitis is the most common anatomical type of uveitis. Patients with noninfectious anterior uveitis may develop a variety of ocular complications that eventually lead to impaired vision. Appropriate identification of etiology can help clinicians predict prognosis, schedule clinical follow-up, and decide on treatment or prevention strategies. Appropriate treatment and effective preventive strategies can reduce the frequency of relapses and the risk of developing complications. Human leukocyte antigen (HLA)-B27 is the most common positive finding in noninfectious AAU patients in many countries, including Taiwan. Objective: To report the consensus of experienced uveitis specialists and rheumatologists in Taiwan. METHODS: On 16 January 2022, a comprehensive literature review was performed by a panel of 9 ophthalmologists with expertise in uveitis management and an experienced rheumatologist from 9 different referral centers. The differential diagnosis of etiology, general treatment, and prevention strategies are discussed. Each statement in the consensus can only be made if more than 70% of the experts agree. RESULTS: The consensus included a flowchart and seven-item statements on etiology, treatment and prevention, differential diagnosis, and co-management with a rheumatologist. Conclusions: This article discusses the general diagnosis, treatment, and prevention of noninfectious acute anterior uveitis (with or without HLA-B27) in adults by general ophthalmologists in order to improve the overall prognosis of these patients.
| original language | English |
|---|---|
| Magazine | Ocular Immunology and Inflammation |
| two | |
| publication status | Accepted/Printing -2023 |
All Science Journal Classification (ASJC) codes
- Immunology and Allergy
- ophthalmology
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Chao, Y. J., Hong, J. H., Lin, C. P., Kuo, H. K., Chen, S. N., Hwang, Y. S., Li, K. J., Lin, C. J., Hwang, D. K., & Sheu, S. J. (Accepted/in press).Diagnosis, treatment and prevention of noninfectious acute anterior uveitis with or without human leukocyte antigen B27 in adults - Taiwan expert consensus.Ocular Immunology and Inflammation.https://doi.org/10.1080/09273948.2023.2165113
Chao, Yu Jang; Hong Jiaherong; Lin, Chang Ping et al. /Diagnosis, treatment and prevention of noninfectious acute anterior uveitis with or without human leukocyte antigen B27 in adults - Taiwan expert consensus.exist:Ocular Immunology and Inflammation. 2023.
@Article{b6a6d5b2663548b7a9e71b4cd5f1f78e,
title = "Diagnosis, treatment and prevention of non-infectious acute anterior uveitis with or without human leukocyte antigen B27 in adults - Taiwan expert consensus",
abstract = "Background: Anterior uveitis is the most common anatomical type of uveitis. Patients with noninfectious anterior uveitis may develop a variety of ocular complications and eventually lead to visual impairment. Appropriate differentiation of etiologies can help clinicians predict As a result, clinical follow-up is arranged, and treatment or prevention strategies are decided. Proper treatment and effective prevention strategies can reduce the frequency of recurrence and the risk of complications. Human leukocyte antigen (HLA)-B27 is a non-infectious disease in many countries, including Taiwan Most common positive finding in patients with acute AAU. Objectives: To report the consensus reached by experienced uveitis specialists and rheumatologists in Taiwan. Methods: A panel with nine different referral centers was held on January 16, 2022. A panel of nine ophthalmologists and one experienced rheumatologist with expertise in uveitis management. A comprehensive literature review was conducted to discuss differential diagnosis of etiology, general treatment, and prevention strategies. Each of the consensus A statement could only be made if more than 70% of the experts agreed. Results: The consensus included a flowchart and seven statements on the differential diagnosis of etiology, treatment and prevention, and co-administration with rheumatologists. Conclusions: This article discusses General diagnosis, treatment, and prevention of noninfectious acute anterior uveitis (with or without HLA-B27) in adults for general ophthalmologists to improve overall outcomes in these patients.",
author = "Chao, {Yu Jang} and Hung, {Jia Horung} and Lin, {Chang Ping} and Kuo, {Hsi Kung} and Chen, {San Ni} and Hwang, {Yih Shiou} and Li, {Ko Jen } and Lin, {Chun Ju} and Hwang, {De Kuang} and Sheu, {Shwu Jiuan}",
Note = "Publisher Copyright: {\textcopyright} 2023 Taylor & Francis Group, LLC.",
Year = "2023",
doi = "10.1080/09273948.2023.2165113",
Language = "English",
journal = "Eye Immunology and Inflammation",
issn = "0927-3948",
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Zhao Yaojie, Hong Jinghua, Lin, CP, Kuo, HK, Chen, SN, Hwang, YS, Li, KJ, Lin, CJ, Hwang, DK & Sheu, SJ 2023, 'Diagnosis, treatment and prevention of noninfectious acute anterior uveitis with or without human leukocyte antigen B27 in adults - Taiwan expert consensus',Ocular Immunology and Inflammation.https://doi.org/10.1080/09273948.2023.2165113
Diagnosis, treatment, and prevention of noninfectious acute anterior uveitis in adults with or without human leukocyte antigen B27—Taiwan expert consensus./ Chao, Yu Jang; Hong Jiaherong; Lin, Chang Ping et al.
exist:Ocular Immunology and Inflammation, 2023.
Research results:Contributions to Journals›article›peer review
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T1 - Diagnosis, treatment and prevention of noninfectious acute anterior uveitis in adults with or without human leukocyte antigen B27 - Taiwan expert consensus
AU - Chao, Yu Jang
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AU - Lin, Chang Ping
European Saigon
AU - Chen, San Ni
AU - Hwang, Yih Shiou
ME - Lee, Ko Jen
AU - Lin, Chun Ju
AU - Hwang, De Kuang
AU - Sheu, Shwu Jiuan
N1 - Publisher Copyright: © 2023 Taylor & Francis Group, LLC.
Fiscal Year - 2023
Y1 - 2023
N2 - Background: Anterior uveitis is the most common anatomical type of uveitis. Patients with noninfectious anterior uveitis may develop a variety of ocular complications that eventually lead to impaired vision. Appropriate identification of etiology can help clinicians predict prognosis, schedule clinical follow-up, and decide on treatment or prevention strategies. Appropriate treatment and effective preventive strategies can reduce the frequency of relapses and the risk of developing complications. Human leukocyte antigen (HLA)-B27 is the most common positive finding in noninfectious AAU patients in many countries, including Taiwan. Objective: To report the consensus of experienced uveitis specialists and rheumatologists in Taiwan. METHODS: On 16 January 2022, a comprehensive literature review was performed by a panel of 9 ophthalmologists with expertise in uveitis management and an experienced rheumatologist from 9 different referral centers. The differential diagnosis of etiology, general treatment, and prevention strategies are discussed. Each statement in the consensus can only be made if more than 70% of the experts agree. RESULTS: The consensus included a flowchart and seven-item statements on etiology, treatment and prevention, differential diagnosis, and co-management with a rheumatologist. Conclusions: This article discusses the general diagnosis, treatment, and prevention of noninfectious acute anterior uveitis (with or without HLA-B27) in adults by general ophthalmologists in order to improve the overall prognosis of these patients.
AB - Background: Anterior uveitis is the most common anatomical type of uveitis. Patients with noninfectious anterior uveitis may develop a variety of ocular complications that eventually lead to impaired vision. Appropriate identification of etiology can help clinicians predict prognosis, schedule clinical follow-up, and decide on treatment or prevention strategies. Appropriate treatment and effective preventive strategies can reduce the frequency of relapses and the risk of developing complications. Human leukocyte antigen (HLA)-B27 is the most common positive finding in noninfectious AAU patients in many countries, including Taiwan. Objective: To report the consensus of experienced uveitis specialists and rheumatologists in Taiwan. METHODS: On 16 January 2022, a comprehensive literature review was performed by a panel of 9 ophthalmologists with expertise in uveitis management and an experienced rheumatologist from 9 different referral centers. The differential diagnosis of etiology, general treatment, and prevention strategies are discussed. Each statement in the consensus can only be made if more than 70% of the experts agree. RESULTS: The consensus included a flowchart and seven-item statements on etiology, treatment and prevention, differential diagnosis, and co-management with a rheumatologist. Conclusions: This article discusses the general diagnosis, treatment, and prevention of noninfectious acute anterior uveitis (with or without HLA-B27) in adults by general ophthalmologists in order to improve the overall prognosis of these patients.
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Zhao Yingjie, Hong Jianhua, Lin CP, Kuo HK, Chen SN, Hwang YS 等。Diagnosis, treatment and prevention of noninfectious acute anterior uveitis with or without human leukocyte antigen B27 in adults - Taiwan expert consensus.Ocular Immunology and Inflammation. 2023.doi: 10.1080/09273948.2023.2165113
FAQs
How do you treat HLA-B27 anterior uveitis? ›
Current first line therapy for acute episodes of HLA B27 AAU is a cycloplegic, typically atropine 1%, and very frequent administration of potent topical corticosteroids (1–2 hourly) which are then slowly tapered over 8–10 weeks (65).
What does it mean when you are HLA-B27 positive? ›A positive result means HLA-B27 was found in your blood. You may have a higher-than-average risk of certain autoimmune diseases, such as ankylosing spondylitis and reactive arthritis. If you are white, you are more likely to test positive for the HLA-B27 antigens.
Is HLA-B27 related to eye disease? ›Complications like high intraocular pressure, glaucoma, cataract, posterior synechiae and dry eyes are seen in HLA-B27 associated AU. [2] The visual acuity (VA) can decrease temporarily or permanently because of recurrent inflammation and complications of AU.
What are the symptoms of HLA-B27? ›- joint pain.
- stiffness or swelling of your spine, neck, or chest.
- inflammation of your joints or urethra accompanied by skin lesions.
- recurring inflammation in your eye.
Sulfasalazine Treatment Suppresses the Formation of HLA-B27 Heavy Chain Homodimer in Patients with Ankylosing Spondylitis - PMC. The .
How serious is HLA-B27? ›A positive test means HLA-B27 is present. It suggests a greater-than-average risk for developing or having certain autoimmune disorders. An autoimmune disorder is a condition that occurs when the immune system mistakenly attacks and destroys healthy body tissue.
What are 3 diseases associated with HLA-B27? ›With lower frequency, the presence of the HLA-B27 allele has correlated with inflammatory bowel disease, psoriatic arthritis, and reactive arthritis.
What is the most common disease associated with HLA-B27? ›HLA-B27 and Ankylosing Spondylitis
One gene, HLA-B27, is strongly associated with a big family of rheumatic diseases called spondyloarthropathies. It includes: Axial spondyloarthritis. Axial psoriatic arthritis.
It's estimated 8 in every 100 people in the general population have the HLA-B27 gene variant, but most do not have AS. It's thought having this gene variant may make you more vulnerable to developing AS. The condition may be triggered by 1 or more environmental factors, although it's not known what these are.
Is HLA-B27 linked to leukemia? ›It has been suggested that those with HLA-B27 have an increased risk of acute leukemia and patients with AS may be predisposed to lymphoid malignancies [6].
Is HLA-B27 associated with lupus? ›
[14,15] This study, designed to investigate the frequency of IBP and sacroiliitis in SLE, revealed that IBP was increased in lupus patients compared to the healthy population. Human leukocyte antigen B27 and spondylitis susceptibility is one of the strongest known HLA-disease associations.
What immune disorders are HLA-B27? ›People with HLA-B27 have an increased likelihood of developing autoimmune diseases such as ankylosing spondylitis (AS), juvenile rheumatoid arthritis (JRA), reactive arthritis (of which one subset is Reiter syndrome), and isolated acute anterior uveitis.
Is HLA-B27 treatable? ›It does not disappear even after treatment. HLA B27 positivity is associated with a variety of diseases like ankylosing spondylitis, psoriasis, inflammatory bowel disease, reactive arthritis etc.
What are the 4 body areas affected by ankylosing spondylitis? ›Ankylosing spondylitis may affect more than the spine. The disease may inflame joints in the pelvis, shoulders, hips and knees, and between the spine and ribs.
Will I end up in a wheelchair with ankylosing spondylitis? ›It is a rare disease, there is no cure, and you will end up in a wheelchair.
What is the life expectancy of someone with ankylosing spondylitis? ›Life expectancy for people with ankylosing spondylitis is the same as that of the general population, except for patients with severe symptoms and complications. Ankylosing spondylitis is a chronic, inflammatory autoimmune disease.
What is HLA-B27 a risk factor for? ›HLA-B27: an important genetic risk factor for lone aortic regurgitation and severe conduction system abnormalities.
What percentage of people with HLA-B27 have AS? ›The HLA-B27 gene marker is found in approximately 3% to 8% of the population, but it is found in more than 90% of patients with ankylosing spondylitis and in 50% to 80% of patients with other SpAs.
Is HLA-B27 a rheumatoid factor? ›HLA-B27, a valuable genetic marker for spondyloarthritis, offers a means for improved definition of rheumatoid factor negative (seronegative) peripheral arthritis.
What are the triggers for ankylosing spondylitis? ›Ankylosing spondylitis is a chronic, inflammatory disorder and a rare form of arthritis. Triggers for ankylosing spondylitis include infections (gastrointestinal infections, urinary tract infections [UTIs], and respiratory infections), heavy physical activity, work stress, emotional stress, and pregnancy.
What ethnicity has the HLA B27 gene? ›
In the United States, however, among African Americans, because there is about a 20% white gene admixture, the frequency of HLA-B27 is about 1% in the general population. In the U.S. Caucasian population, the gene is found in 7.6% of the general population. In Hispanics, it's found in 4.6% of the general population.
What cancers are HLA-B27 positive? ›Besides the role of inflammation, HLA B27 has been associated with increased risk of malignancies such as lymphoma and colorectal cancer [6, 7].
Can HLA-B27 cause kidney problems? ›In summary, this study demonstrated that the absence of HLA-B27 is related to a higher level of uric acid and a higher percentage of globally sclerotic glomeruli. In addition, HLA-B27 negativity was significantly associated with renal function decline during follow-up.
Does HLA-B27 cause back pain? ›Ankylosing spondylitis has no known specific cause, though genetic factors seem to be involved. In particular, people who have a gene called HLA-B27 are at a greatly increased risk of developing ankylosing spondylitis. However, only some people with the gene develop the condition.
What is the first line treatment for anterior uveitis? ›Steroid eyedrops are usually the first treatment used for uveitis that affects the front of the eye and is not caused by an infection. Depending on your symptoms, the recommended dose can range from having to use eyedrops every hour to once every 2 days. You may have temporary blurred vision after using the drops.
What is the drug of choice for anterior uveitis? ›Corticosteroids are the drug of choice in the treatment of anterior uveitis. Steroids act by modifying and decreasing the inflammatory response in the eye. They inhibit both the cycloxygenase pathways of inflammatory response.
What triggers anterior uveitis? ›Anterior uveitis can result from a trauma to the eye, such as being hit in the eye or having a foreign body in the eye.
What should I eat if I have anterior uveitis? ›Choose green, leafy vegetables and peppers, and fruits such as blueberries, tomatoes, and cherries. These supplements may also help: A multivitamin daily, containing the antioxidant vitamins A, C, E, the B vitamins, and trace minerals, such as magnesium, calcium, zinc, and selenium.