Aggressive Initial Presentation of HLA-B27 Uveitis in Older Individuals: A Case Series

HLA-B27-associated uveitis is classically thought to be a disease of the young, with a median age of onset in the 30s. There is a paucity of literature reporting on older individuals with HLA-B27 uveitis. Here, we describe cases of HLA-B27 uveitis presenting initially at age ≥70.

Retrospective review of patients with HLA-B27-associated uveitis that presented initially at ≥70 years of age.

Three patients were identified. All presented with aggressive inflammation (hypopyon in two cases) and two were treated for suspected endophthalmitis. All cases were controlled sufficiently with prolonged topical anti-inflammatory therapy. One patient who was lost to follow-up demonstrated one recurrence over a 3-year period.

This series highlights the aggressive initial presentation of HLA-B27-associated uveitis in the older population, and demonstrates the favorable response, and limitation of recurrences, with topical immunosuppressive therapy.