Immunogenetic factors in inflammatory eye disease. influence of hla–b27 and alpha1‐antitrypsin phenotypes on disease expression

Abstract

The relationship between the nature and severity of inflammatory eye disease was analyzed with respect to HLA antigens and alpha₁-antitrypsin phenotypes. Using standard ophthalmologic criteria, we divided patients with anterior uveitis into acute, chronic (>3-month duration), bilateral, or recurrent disease. There was a significantly increased incidence of alpha₁-antitrypsin–deficient phenotypes in anterior uveitis, especially in those patients with severe (chronic, bilateral, or recurrent) disease. HLA–B27 acts as an independent predisposing factor: it was present in 22% of patients with their first attack of acute uveitis compared with 51% of patients with recurrent disease. Together, these genetic factors are present in 63% of patients with severe anterior uveitis and represent the most significant predisposing and prognostic factors so far detected.