Background/aims To explore and characterise the clinical phenotype of acute anterior uveitis flares with delayed severity in patients with human leucocyte antigen B27 (HLA-B27)-associated anterior uveitis. Methods Retrospective chart review of patients with HLA-B27-associated anterior uveitis. Demographic and clinical data were recorded, as well as the clinical characteristics of acute anterior uveitis flares. A flare was considered to have delayed severity if any of the following criteria were met within 3–21 days of symptomatic onset: a two-step increase in anterior chamber inflammation on consecutive exams; a new development of hypopyon or fibrinoid aqueous reaction on consecutive examinations or a significant worsening of symptoms. Results A total of 371 patient charts were identified, of which 137 were included. 321 acute anterior uveitis flares were documented, with 36 (11.2%) meeting the criteria for a delayed severity flare. The average time from symptomatic onset was 10.2 days, and patients presented with an average anterior chamber cell grade of 3.5 in delayed severity flares compared with 1.6 in non-delayed severity flares. No significant difference in frequency of delayed severity presentation was noted based on the presence or absence of systemically associated rheumatological disease, papillitis on initial presentation and retinal vasculitis on initial presentation. The frequency of topical steroid therapy after symptomatic onset was not significantly different between the two flare phenotypes. Conclusions Our study presents the novel characterisation of a delayed severity phenotype of HLA-B27-associated acute anterior uveitis flares. Data are available upon reasonable request.

中文翻译：

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HLA-B27 相关前葡萄膜炎患者延迟严重发作的特征


背景/目的 探索和表征人类白细胞抗原 B27 (HLA-B27) 相关前葡萄膜炎患者急性前葡萄膜炎发作的临床表型，其严重程度延迟。方法 对 HLA-B27 相关前葡萄膜炎患者进行回顾性图表回顾。记录人口统计学和临床​​数据，以及急性前葡萄膜炎发作的临床特征。如果在症状出现后 3-21 天内满足以下任何标准，则认为耀斑的严重程度有所延迟：连续检查时前房炎症出现两步加重；连续检查时出现新的前房积脓或纤维蛋白样房水反应，或症状显着恶化。结果 共识别出患者病历 371 份，其中纳入 137 份。记录了 321 例急性前葡萄膜炎发作，其中 36 例 (11.2%) 符合延迟严重发作的标准。症状出现的平均时间为 10.2 天，延迟严重发作患者的平均前房细胞等级为 3.5，而非延迟严重发作患者的平均前房细胞等级为 1.6。根据是否存在系统性相关风湿病、初次就诊时的乳头炎和初次就诊时的视网膜血管炎，延迟严重程度表现的频率没有显着差异。症状出现后局部类固醇治疗的频率在两种耀斑表型之间没有显着差异。结论 我们的研究提出了 HLA-B27 相关急性前葡萄膜炎发作的延迟严重表型的新特征。数据可根据合理要求提供。