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AB0667 Hlab27 Associated Uveitis Trends and Patterns of A Multiethnicity Cohort: Need for Combined Rheumatology and Eye Services?
  1. A. Pradeep1,
  2. P. Kumar1,
  3. A. Moorthy2
  1. 1ophthalmology
  2. 2Rheumatology, university hospitals of leicester, leicester, United Kingdom

Abstract

Background Uveitis is associated with systemic autoimmune disease and often present to Eye Department as an emergency. Uveitis can be a first presenting symptom of systemic autoimmune disease and often not followed up in Rheumatology services. Approximately 40% of patients with acute anterior uveitis (AAU) have undiagnosed spondyloarthritis (1). Previous studies in UK by Hamilton et al showing delay in diagnosing spondyloarthropathy (SpA) up to 8 years (2). Delay in referral of HLA B27 positive Uveitis by primary care and secondary care physicians to Rheumatology may be a reason for the delayed diagnosis (3,4).This can be better avoided if inter-speciality referral and pathways are established. To enable the best effective care delivered for Uveitis patients,we attempted to review the current trends of our own cohort of patients with HLAB27 Associated Uveitis

Objectives - To review the cohort of HLA B27 positive uveitis in a busy tertiary care hospital serving multi ethnic patients.

- To observe the pattern and association of systemic autoimmune disease particularly spondyloarthropathy.

- To see how many cases been referred to Rheumatology services and how best they are managed with systemic immunosuppressive therapy.

Methods The methodology includes retrospective analysis of data captured from the Uveitis Data Base maintained by ophthalmology department. The consecutive new cases of HLAB27 uveitis were identified for three-year period from 2011 to 2014. The clinical records, ophthalmology examination records, demographic details, ethnicity were reviewed. The type of uveitis, presenting symptoms and systemic associations were explored. Modes of treatment, complications and pattern of referral and input from other specialties were assessed as well treatment plans were collected. The data were captured by using standardized proforma. The captured data was analysed using excel spreadsheet.

Results Total of 624 Uveitis patients 73 cases (105 eyes) of HLAB27 positive uveitis (11.7%) were identified.The most common systemic association in our cohort was Ankylosing Spondylitis (31.8%). 34%of the affected eyes did not develop anycomplications.88% had anterior uveitis with 38% showing chronicity.79% of the patients had better than 0.3LogMar acuity in the affected eye on presentation.

Conclusions The data collected emphasizes the higher incidence of Ankylosing Spondylitis in patients, who presents with uveitis associated with positive HLA B27. Our result reiterates the need for establishing combined clinics to avoid delay in referrals enhancing patient management and experience.

Disclosure of Interest None declared

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