Ophthalmological significance of HLA associated uveitis


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The association between HLA-A29 and birdshot chorioretinopathy is the strongest association between HLA and disease ever described. The determination of HLA-A29 is therefore of diagnostic


significance.


The association between HLA-B27 and acute anterior uveitis (AAU) is much weaker. However, it is evident that B27+AAU is clinically different from B27−AAU. Half of the B27+AAU patients have


or will have ankylosing spondylitis or Reiter's syndrome. The determination of HLA-B27 is therefore of clinical significance and should be determined in each case of AAU. The B27+ patients


should be referred to a rheumatologist.


The determination of HLA-Bw51 is of limited but significant diagnostic value for the diagnosis of Behçet's disease in countries around the Mediterranean Sea or Japan. In Northern Europe


HLA-Bw51 determination will not give much practical information.


The structure and function of HLA class I molecules is now known. It is probable that HLA-A29 and HLA-B27 molecules are directly involved in the pathogenesis of respectively birdshot


chorioretinopathy and AAU


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