Acute Anterior Uveitis with HLA-B27 Positivity after Corneal Cross-Linking with Previous Intrastromal Corneal Ring Segment

Purpose. To describe a case of acute anterior uveitis (AAU) with HLA-B27 positivity following epithelium-off corneal cross-linking (CXL) in a patient with a previous intrastromal corneal ring segment. Observations. A 28-year-old male with keratoconus (KCN) developed ophthalmalgia, perilimbal injecti...

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Main Authors: Asher Khan, Charles D. McGuffey, Andrew T. Melson, Kamran M. Riaz
Format: Article
Language:English
Published: Wiley 2022-01-01
Series:Case Reports in Ophthalmological Medicine
Online Access:http://dx.doi.org/10.1155/2022/2014549
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author Asher Khan
Charles D. McGuffey
Andrew T. Melson
Kamran M. Riaz
author_facet Asher Khan
Charles D. McGuffey
Andrew T. Melson
Kamran M. Riaz
author_sort Asher Khan
collection DOAJ
description Purpose. To describe a case of acute anterior uveitis (AAU) with HLA-B27 positivity following epithelium-off corneal cross-linking (CXL) in a patient with a previous intrastromal corneal ring segment. Observations. A 28-year-old male with keratoconus (KCN) developed ophthalmalgia, perilimbal injection, hypopyon, and decline in corrected distance visual acuity (CDVA) 3 days after CXL. A working diagnosis of inflammatory versus infectious AAU was made, and the patient was treated with topical tobramycin, polymyxin B/trimethoprim, prednisolone, and oral valacyclovir. Clinical appearance and CDVA improved, ultimately returning to baseline by two weeks postoperatively. Diagnostic laboratory workup revealed HLA-B27 positivity. Conclusions and Importance. A comprehensive laboratory workup is helpful to identify potential causative and associated systemic conditions when encountering AAU after CXL. Given the overlap in patient demographics for KCN and HLA-B27 positivity, clinicians should consider this entity in the differential diagnosis and treatment of such cases.
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spelling doaj-art-4526c4eb251a4845bafa422051ec6d072025-08-20T03:36:44ZengWileyCase Reports in Ophthalmological Medicine2090-67302022-01-01202210.1155/2022/2014549Acute Anterior Uveitis with HLA-B27 Positivity after Corneal Cross-Linking with Previous Intrastromal Corneal Ring SegmentAsher Khan0Charles D. McGuffey1Andrew T. Melson2Kamran M. Riaz3Dean McGee Eye InstituteDean McGee Eye InstituteDean McGee Eye InstituteDean McGee Eye InstitutePurpose. To describe a case of acute anterior uveitis (AAU) with HLA-B27 positivity following epithelium-off corneal cross-linking (CXL) in a patient with a previous intrastromal corneal ring segment. Observations. A 28-year-old male with keratoconus (KCN) developed ophthalmalgia, perilimbal injection, hypopyon, and decline in corrected distance visual acuity (CDVA) 3 days after CXL. A working diagnosis of inflammatory versus infectious AAU was made, and the patient was treated with topical tobramycin, polymyxin B/trimethoprim, prednisolone, and oral valacyclovir. Clinical appearance and CDVA improved, ultimately returning to baseline by two weeks postoperatively. Diagnostic laboratory workup revealed HLA-B27 positivity. Conclusions and Importance. A comprehensive laboratory workup is helpful to identify potential causative and associated systemic conditions when encountering AAU after CXL. Given the overlap in patient demographics for KCN and HLA-B27 positivity, clinicians should consider this entity in the differential diagnosis and treatment of such cases.http://dx.doi.org/10.1155/2022/2014549
spellingShingle Asher Khan
Charles D. McGuffey
Andrew T. Melson
Kamran M. Riaz
Acute Anterior Uveitis with HLA-B27 Positivity after Corneal Cross-Linking with Previous Intrastromal Corneal Ring Segment
Case Reports in Ophthalmological Medicine
title Acute Anterior Uveitis with HLA-B27 Positivity after Corneal Cross-Linking with Previous Intrastromal Corneal Ring Segment
title_full Acute Anterior Uveitis with HLA-B27 Positivity after Corneal Cross-Linking with Previous Intrastromal Corneal Ring Segment
title_fullStr Acute Anterior Uveitis with HLA-B27 Positivity after Corneal Cross-Linking with Previous Intrastromal Corneal Ring Segment
title_full_unstemmed Acute Anterior Uveitis with HLA-B27 Positivity after Corneal Cross-Linking with Previous Intrastromal Corneal Ring Segment
title_short Acute Anterior Uveitis with HLA-B27 Positivity after Corneal Cross-Linking with Previous Intrastromal Corneal Ring Segment
title_sort acute anterior uveitis with hla b27 positivity after corneal cross linking with previous intrastromal corneal ring segment
url http://dx.doi.org/10.1155/2022/2014549
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