Estimation of hla-b27 positivity by peripapillary retinal nerve fibre layer thickness in patients with acute anterior uveitis

Abstract

Purpose: To compare the thickness of retinal nerve fi ber layer (RNFL) in HLA-B27 positive and HLA-B27 negative acute anterior uveitis (AAU) patients with active infl ammation. Methods: Thirty-seven patients with HLA-B27-positive AAU and 32 patients with HLA-B27-negative AAU were analyzed. Clinical characteristics, HLAB27 typing and retinal nerve fi ber layer thickness measurements were recorded. All data were compared with 35 age and sex matched healthy subjects. ROC analysis was used to determine the RNFL threshold in patients with HLA B27 positive AAU. Results: There was no signifi cant difference between the HLA-B27 (-) group and the control group in terms of RNFL thickness in the temporal, temporal inferior and nasal inferior quadrants. (P = 0.293, p = 0.064, p = 0.033, respectively) In all other quadrants, RNFL thickness of the HLA-B27 (+) and HLA-B27 (-) groups was thicker than the control group. RNFL thicknesses in temporal superior, nasal superior and nasal inferior quadrants were signifi cantly thicker in the HLA-B27 (+) group compared to the HLA-B27 (-) group. (P = 0.008, p = 0.012, p = 0.016, respectively) According to ROC analysis, RNFL thresholds were 139 μm, 111.50 μm and 110.50 μm in temporal superior, nasal superior and nasal inferior quadrants, respectively. A signifi cant and positive correlation was found between RNFL and anterior chamber cell counts in all quadrant AAU patients. Conclusion: RNFL thickness increases more in HLA-B27 positive patients than in negative patients. RNFL thickness above the threshold values determined by ROC analysis may indicate HLA-B27 positivity.