Posner-Schlossman Syndrome in Common Variable Immunodeficiency

Area of Science:

• Ophthalmology
• Immunology

Background:

• Posner-Schlossman syndrome (PSS) is a rare condition characterized by recurrent episodes of unilateral elevated intraocular pressure.
• The etiology of PSS is uncertain, with proposed links to autoimmune and infectious causes.
• Common variable immunodeficiency (CVID) is an autoimmune disorder associated with various systemic and ocular conditions.

Observation:

• A 62-year-old female with a history of CVID and ulcerative colitis presented with acute vision changes in her right eye.
• Initial examination revealed elevated intraocular pressure (IOP) of 34 mmHg in the right eye and decreased visual acuity.
• Despite initial IOP-lowering treatment, subsequent examination showed anterior uveitis and significantly elevated IOP (41 mmHg) in the right eye, confirming a PSS diagnosis.

Findings:

• This report documents the first case of PSS diagnosed in a patient with known common variable immunodeficiency (CVID).
• The patient presented with classic symptoms of PSS, including unilateral elevated IOP and anterior uveitis.
• The co-occurrence suggests a potential association between PSS and autoimmune conditions like CVID.

Implications:

• This case expands the known spectrum of ocular manifestations associated with CVID.
• It highlights the importance of considering PSS in patients with CVID who present with glaucomatocyclitic crises.
• Further research may elucidate the underlying mechanisms linking CVID and PSS, potentially improving diagnostic and therapeutic strategies.