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, Behçet 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.