Severe HLA B27-associated uveitis complicated by hypotony, serous retinal detachment, and ciliochoroidal effusion.
OBJECTIVE
To report on severe HLA B27-associated anterior uveitis complicated by vitritis, hypotony, and serous retinal detachment.


METHODS
Retrospective case series.


RESULTS
Five patients with HLA B27-associated uveitis presented with an acute anterior uveitis complicated by vitritis, hypotony, serous retinal detachment, and ciliochoroidal effusion. Two patients had previously acute anterior uveitis and two suffered from HLA B27-associated systemic disease. Laboratory and imaging examinations did not reveal another cause of uveitis. Despite the aggressive treatment a prolonged and slow recovery followed. Four patients developed macular edema and one additional patient developed a macular pucker. Finally, 3 eyes improved, 2 eyes developed atrophy, and 1 was lost at 4-month follow-up with visual acuity of hand movements.


CONCLUSIONS
The authors conclude that severe uveitis with a serous retinal detachment might develop in HLA B27-positive patients and may be complicated by protracted hypotony, macular edema, and poor visual outcome.
Department of Ophthalmology, Academic Medical Centre , Amsterdam , The Netherlands .
Eline G
EG
van der Veer
Jan E
JE
Keunen
Aniki
A
Rothova
D000208:Acute Disease; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use; D005122:Exudates and Transudates; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D015796:HLA-B27 Antigen / Q000276:immunology*; D006801:Humans; D000069285:Infliximab; D007429:Intraocular Pressure; D008297:Male; D033401:Microscopy, Acoustic; D008875:Middle Aged; D015814:Ocular Hypotension / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D012163:Retinal Detachment / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D012189:Retrospective Studies; D044967:Serum; D014603:Uveal Diseases / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D014606:Uveitis, Anterior / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology; D055815:Young Adult
D000894:Anti-Inflammatory Agents, Non-Steroidal; D000911:Antibodies, Monoclonal; D005938:Glucocorticoids; D015796:HLA-B27 Antigen; D000069285:Infliximab