HLA Typing in Uveitis: Use and Misuse

PURPOSE: To evaluate the role of HLA. typing as a diagnostic test in patients with uveitis. DESIGN: Perspective derived from a literature review and analysis of reported results. METHODS: Published data on the HLA associations of several uveitis entities and their prevalence among patients and the general population were used to calculate the positive predictive value of HLA testing as a diagnostic test for these disorders. RESULTS: For nearly all diagnostic entities evaluated (including multiple sclerosis-associated intermediate uveitis, birdshot chorioretinitis, sympathetic ophthalmic, Behcet disease, and Vogt-Koyanagi-Harada disease), the positive predictive value was low (< 0.50), indicating the limited usefulness of routinely applied HLA typing as a diagnostic test. HLA-B27 testing may be of value in identifying a previously undiagnosed or misdiagnosed spondyloarthropathy among patients with recurrent acute anterior uveitis. CONCLUSIONS: In general, HLA typing has limited usefulness as a diagnostic test in patients with uveitis. (Am J Ophthalmol 2010;149:189-193. (C) 2010 by Elsevier Inc. All rights reserved.)