A case of HLA-B27 positive acute anterior uveitis with preceded by severe periodontitis
Accept poster if oral is not possible ?
Yes
Purpose
To report a case of HLA-B27 positive acute anterior uveitis (AAU) preceded by severe periodontitis.
Methods
A 26-year-old woman complaining of hyperemia and ocular pain was referred for new-onset uveitis in the right eye. At presentation, slit-lamp examination revealed severe anterior chamber inflammation with hypopyon and synechia. A tentative diagnosis of AAU was made, and treatment was initiated with topical corticosteroids plus subconjunctival injections of betamethasone. At day 5 after the initial visit, there were increased hypopyon and fibrinous material in the anterior chamber. Systemic investigation revealed that the patient had severe periodontitis with an abscessed tooth and HLA-B27 testing came back positive.
Results
For the presumptive diagnosis of HLA-B27 positive AAU, aggressive topical corticosteroids were continued, and gargling with mouthwash was also performed for the periodontitis. The inflammatory reaction in the anterior segment of the right eye subsided markedly by day 13.
Conclusion
Severe oral cavity infection preceded the onset of AAU in our HLA-B27 positive patient, suggesting possible role for antecedent infection triggering intraocular inflammation in genetically predisposed individuals.
Conflict of interest
No
Author 1
Last name
ANDO
Initials of first name(s)
Y
Department
Department of Ophthalmology, Kyorin University School of Medicine
City
Tokyo
Country
Japan
Author 2
Last name
Keino
Initials of first name(s)
H
Department
Department of Ophthalmology, Kyorin University School of Medicine
City
Tokyo
Country
Japan
Author 3
Last name
Nakayama
Initials of first name(s)
M
Department
Department of Ophthalmology, Kyorin University School of Medicine
City
Tokyo
Country
Japan
Author 4
Last name
Watanabe
Initials of first name(s)
T
Department
Department of Ophthalmology, Kyorin University School of Medicine
City
Tokyo
Country
Japan
Author 5
Last name
Hirakata
Initials of first name(s)
A
Department
Department of Ophthalmology, Kyorin University School of Medicine
City
Tokyo
Country
Japan
Author 6
Last name
Okada
Initials of first name(s)
A.A
Department
Department of Ophthalmology, Kyorin University School of Medicine
City
Tokyo
Country
Japan
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