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Abstract
Background: An HLA-DQ1 association has been suspected in patients who develop Propionibacterium acnes endophthalmitis following cataract surgery. New techniques exist which may help to define this association. Materials and Methods: Patients with culture-proven P. acnes endophthalmitis following cataract surgery were HLA-typed with new sera able to detect fine specificities in the HLA-DQ1 region and compared to a large number of racially-matched controls. Sequence-specific oligonucleotide typing with probes and primers designed to amplify and define the HLA-DQ1 region was then performed. P. acnes patients were compared to HLA-DQ1-matched controls who had undergone cataract surgery but had no evidence of chronic post-operative inflammation. Results: Thirteen of 15 P. acnes patients (87%) were serologically defined as carrying a split of DQw1 (DQw5 or DQ26). HLA DQw5 was increased to a statistically significant degree (p < 0.014) with an odds ratio of 3.72 (95% confidence interval 1.34 to 10.31). Sequence-specific oligonucleotide typing confirmed the DQw5 predominance: Seventy-three percent of P. acnes patients had DQB1 *0501 or DQB1 *0503 vs. 33% of DQw1-matched cataract patients without inflammation (not significant). Conclusion: HLA-DQ2w5 is associated with the development of P. acnes endophthalmitis following cataract surgery. The molecular mechanism of this association is unknown.