Peer-reviewed article
HLA-DRB1*15:01 Paediatric Uveitis: Ophthalmological Presentation and Follow-Up
Jytte Hendrikse, Viera Kalinina Ayuso, Annette Ossewaarde‐van Norel, Joke H. de Boer ·
Summary
Written by AI, not yet AICS's view · claude-sonnet-5-5This retrospective clinical study looked at 65 children with non-infectious non-anterior uveitis, an inflammatory eye condition. It compared children who carry the HLA-DRB1*15:01 gene variant with those who do not. Carriers were much more likely to have intermediate uveitis and showed different eye findings. One carrier developed multiple sclerosis 15 years after diagnosis. The study is a medical description of a rare eye condition and does not address wider child well-being topics.
Key points
- Intermediate uveitis was found in 70.0% of HLA-DRB1*15:01 positive patients versus 24.4% of negative patients (p = 0.001).
- Anterior chamber cells were seen less often in positive patients (55.0% versus 90.7%, p = 0.001).
- Vitreous floaters were more frequent in positive patients (80.0% versus 53.3%, p = 0.041).
- Fern-like capillary leakage was more common in positive patients (64.7% versus 34.1%, p = 0.032).
- One HLA-DRB1*15:01 positive patient (5.0%) developed multiple sclerosis 15 years after the uveitis diagnosis.
Limitations
The study is retrospective and covers a small cohort, with only 20 HLA-DRB1*15:01 positive patients implied by the reported percentages. It cannot show whether HLA typing is useful for predicting multiple sclerosis risk, and it does not evaluate an intervention.
Abstract
Purpose The purpose of this study is to describe the clinical presentation of the HLA-DRB1*15:01 positive non-anterior uveitis phenotype in paediatric uveitis and to determine if early markers that may indicate a possible risk of MS, white matter lesions on brain MRI and OCT RNFL or GCL thinning, are present in this subgroup.Methods In a cohort of 65 patients with non-infectious non-anterior paediatric uveitis patients we retrospectively characterized the uveitis phenotype based on underlying HLA-DRB1*15:01 genotype and described the clinical parameters on OCT and FA of 87 HLA-DRB1*15:01 negative and 37 HLA-DRB1*15:01 positive eyes.Results HLA-DRB1*15:01 positive patients had intermediate uveitis almost three times as often as HLA-DRB1*15:01 negative patients with uveitis (70.0% versus 24.4% respectively, p = 0.001). Cells in the anterior chamber were seen less often in HLA-DRB1*15:01 positive patients compared to in HLA-DRB1*15:01 negative patients (55.0% versus 90.7% respectively, p = 0.001). Meanwhile, vitreous floaters were found more frequently in HLA-DRB1*15:01-positive compared to -negative cases (80.0% versus 53.3% respectively, p = 0.041). Also, fern-like capillary leakage was almost twice as common in HLA-DRB1*15:01 positive compared to HLA-DRB1*15:01 negative patients (64.7% versus 34.1% respectively, p = 0.032). Multiple sclerosis developed in one HLA-DRB1*15:01 positive patient (5.0%), 15 years after intermediate uveitis was diagnosed.Conclusion The HLA-DRB1*15:01 allele is associated with intermediate uveitis in children, with absence of anterior chamber cells, presence of vitreous floaters and peripheral capillary fern-like leakage as distinct clinical features. At this point the usefulness of HLA-DRB1*15:01 typing for predicting the risk of multiple sclerosis is yet to be determined.