Retinitis pigmentosa and HLA-B27 associated uveitis

Abstract

Abstract Background. The topic of an inflammatory process (of various types and localization) occurring in Retinitis pigmentosa (RP)-affected eyes can be found in literature. Recent studies suggest the importance of chronic inflammation in the pathogenesis of neurodegenerative diseases such as Alzheimer’s disease, Parkinson’s disease and retinal degenerative diseases. Uveitis can develop independently of RP, and it`s important to distinguish true uveitis from inflammatory manifestations of RP. Purpose. In present study we report of RP associated with uveitis and suggest our consolidated thoughts and experience on this topic. Materials and methods. This study was a prospective non-controlled case series. 7 RP patients (14 eyes) with coexisted uveitis signs were enrolled the study. Results. Among 173 RP patients 7 patients (4 males, 3 females) had signs of intermediate uveitis and 3 of them also have signs of slight anterior uveitis. We found no sexual predilection. Mean age at the time of diagnosing uveitis was 26,9 years (19 to 37 years). Diagnosis of RP was preexisted our study more than 10 years in 4 patients, 3 years in 1patient, and 2 years in one patient. Only one patient was diagnosed RP and uveitis simultaneously in current study. In addition to classic picture of RP, patients had vitreous cells 1 + or 2+, and for vitreous haze 0,5 + or 1+. 5 patients had cystoids macular edema (CME). All patients had no acute onset of a floaters, blurred vision and deterioration in central vision. They had no systemic complaints. Additional examination revealed HLA-B27 positivity in 5 patients (2 males, 3 females). After appointment to rheumatologist 2 patients were made diagnosis ankylosing spondylitis of low activity, other cases were considered as HLA-B27 positive uveitis. Remaining two cases we considered as either idiopathic uveitis or pronounced inflammatory component of RP. Patients with uveitis were prescribed anti-inflammatory treatment (either local or systemic). Conclusions Possibility of HLA-B27 association should be considered in RP patients with anterior and intermediate uveitis signs in spite of sex, absence of acute onset of uveitic complaints and systemic complaints. Anti-inflammatory treatment (either local or systemic) is required in RP patients with inflammation signs.