Very severe HLA B27-associated panuveitis mimicking endophthalmitis: a case series.
OBJECTIVE
To report rare but important instances of very severe, hyperacute HLA B27-associated panuveitis, mimicking infective endophthalmitis and providing challenges to both diagnosis and management.


METHODS
Retrospective case review.


METHODS
Four patient records were reviewed. Demographic features, clinical findings, course of uveitis, diagnostic/therapeutic measures, and outcomes are reported.


RESULTS
All cases presented with severe panuveitis with visual acuities below 6/60 and poor fundal views. Three patients underwent intraocular fluid sampling for microbiology. All required systemic high-dose corticosteroid treatment, and two also needed oral immunosuppression. All eventually required cataract extraction. Final visual acuity varied from 6/12 to 6/6.


CONCLUSIONS
HLA B27-associated uveitis may be unusually severe and may cause a panuveitis, mimicking infective endophthalmitis. The course may be prolonged and difficult with frequent complications including cataract.
Sanghvi
Chintan
C
Manchester Royal Eye Hospital, Manchester, UK. casanghvi1@googlemail.com
Mercieca
Karl
K
Jones
Nicholas P
NP
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D002387:Cataract Extraction; D003937:Diagnosis, Differential; D009877:Endophthalmitis / Q000175:diagnosis*; D005260:Female; D015796:HLA-B27 Antigen / Q000032:analysis*; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D019654:Lens Implantation, Intraocular; D008297:Male; D015864:Panuveitis / Q000175:diagnosis* / Q000188:drug therapy* / Q000382:microbiology; D012189:Retrospective Studies; D016896:Treatment Outcome
D000305:Adrenal Cortex Hormones; D015796:HLA-B27 Antigen; D007166:Immunosuppressive Agents