Shuo Zhao1, Huanfen Zhou2, Xudong Peng3, Jian Zhu4, Wei Wang5, Hao Kang2, Tingjun Chen2, Quangang Xu6, Shihui Wei7. 1. Department of Neuro-Ophthalmology, The Chinese People's Liberation Army General Hospital, Beijing, China; School of Medicine, Nankai University, Tianjin, China. 2. Department of Neuro-Ophthalmology, The Chinese People's Liberation Army General Hospital, Beijing, China. 3. Department of Health Care, The Chinese People's Liberation Army General Staff Department Guard Bureau, Beijing, China. 4. Department of Rheumatology, The Chinese People's Liberation Army General Hospital, Beijing, China. 5. School of Medicine, Sun Yat-Sen University, Guangzhou, China. 6. Department of Neuro-Ophthalmology, The Chinese People's Liberation Army General Hospital, Beijing, China. Electronic address: xuquangang@126.com. 7. Department of Neuro-Ophthalmology, The Chinese People's Liberation Army General Hospital, Beijing, China. Electronic address: dr_weishihui@163.com.
Abstract
PURPOSE: This study retrospectively reviewed the clinical features of optic neuritis (ON) with positive HLA-B27. METHOD: Clinical data were reviewed for HLA-B27-positive ON in the Chinese People's Liberation Army General Hospital from January 2009 through June 2015. The prevalence of HLA-B27 and spondyloarthropathies was analyzed. Clinical features of HLA-B27-positive ON based on serum aquaporin 4-antibody (AQP4-Ab) were compared. RESULTS: A total of 22 ON patients (14 female/8 male, 38 involved eyes) with positive HLA-B27 were collected from 410 ON patients. Recurrent episodes were observed in 14/22 patients, and seven patients presented as bilateral simultaneous ON. A total of 68.4% (22/38) of involved eyes exhibited severe visual impairment (<0.1) at onset. A total of 8/22 patients were seropositive for AQP4-Ab, and clinical features did not differ based on AQP4-Ab status. Bilateral sacroiliitis was revealed in over 50% (7/13) of patients screened using pelvic computed tomography. Three patients were diagnosed with ankylosing spondylitis (AS), and one patient experienced co-occurrence of active AS and bilateral ON. CONCLUSIONS: HLA-B27-positive ON may presented recurrent episodes and severe visual impairment at onset. The co-occurrence of ON and AS, and the frequent presence of bilateral sacroiliitis may indicate an underlying alternation of autoimmune background in this condition.
PURPOSE: This study retrospectively reviewed the clinical features of optic neuritis (ON) with positive HLA-B27. METHOD: Clinical data were reviewed for HLA-B27-positive ON in the Chinese People's Liberation Army General Hospital from January 2009 through June 2015. The prevalence of HLA-B27 and spondyloarthropathies was analyzed. Clinical features of HLA-B27-positive ON based on serum aquaporin 4-antibody (AQP4-Ab) were compared. RESULTS: A total of 22 ON patients (14 female/8 male, 38 involved eyes) with positive HLA-B27 were collected from 410 ON patients. Recurrent episodes were observed in 14/22 patients, and seven patients presented as bilateral simultaneous ON. A total of 68.4% (22/38) of involved eyes exhibited severe visual impairment (<0.1) at onset. A total of 8/22 patients were seropositive for AQP4-Ab, and clinical features did not differ based on AQP4-Ab status. Bilateral sacroiliitis was revealed in over 50% (7/13) of patients screened using pelvic computed tomography. Three patients were diagnosed with ankylosing spondylitis (AS), and one patient experienced co-occurrence of active AS and bilateral ON. CONCLUSIONS:HLA-B27-positive ON may presented recurrent episodes and severe visual impairment at onset. The co-occurrence of ON and AS, and the frequent presence of bilateral sacroiliitis may indicate an underlying alternation of autoimmune background in this condition.