Acute anterior uveitis in a patient with ankylosing spondylitis
This is a rare condition of an acute anterior uveitis in a patient with ankylosing spondylitis. Ankylosing spondylitis is an inflammatory disease that can cause some of the vertebrae in your spine to fuse together. This fusing makes the spine less flexible and can result in a hunched-forward posture.So what uveitis has to do with this? HLA (or Human Leukocyte Antigen) halotype association with different diseases, in this case HLA-B27. The HLA system is the locus of genes that encode for proteins on the surface of cells that are responsible for regulation of the immune system in humans. People with certain HLA antigens are more likely to develop certain autoimmune diseases, with more than 100 diseases already associated with different alleles of HLA gene. A classic example is that HLA-B27 allele increases the risk of developing an inflammatory joint disease called ankylosing spondylitis. HLA-B27 appears in 80-90% of patients with ankylosing spondylitis, and an HLA-B27 positive individual is approximately 87 times more susceptible to developing ankylosing spondylitis compared to the general population.In ophthalmology, HLA associations are strongest in diseases of the uvea. Of patients with uveitis, 20-90% have the HLA-B27 phenotype, depending upon the study population. Acute anterior uveitis as depicted in the image above, is the inflammation of the middle layer of the eye (I.e. The uvea), which is made up of the iris, the colored part of the eye (causes iritis) and the ciliary body (causes iridocyclitis). It may occur as a distinct clinical entity or in conjunction with a group of autoimmune rheumatic diseases called seronegative spondyloarthropathies. Patients with these diseases have a negative rheumatoid factor, hence the term seronegative.
Eye muscles and innervationEye innervation