FP1347 : Can Hla B27 Uveitis Mimic Endophthalmitis with a Granular Hypopyon

Dr. Anushri Agrawal, Dr. Kirandeep Kaur, Dr. S Bala Murugan, Dr. Annamalai O

Purpose: To present a case of suspected HLA B27 presenting as endophthalmitis.

Method: A 25/M patient presented with painful decrease in vision in RE since 1 week. His BCVA was HM+ in RE and 6/12 in LE. RE IOP was 42mm Hg. On examination, seeing acute anterior non granulomatous uveitis with hypopyon and secondary pupillary block, we initiated topical steroids, cycloplegics and pressure lowering medication. B-Scan showed vitritis. Investigations showed raised ESR, Mantoux and TPHA negative. Vitreous tap for PCR TB was negative. We adviced for HLA B27 typing. RE cataract extraction was done. Suspecting endophthalmitis, RE vitreous tap with intravitreal vancomycin+ ceftazidime were given. The hypopyon became granular. After core vitrectomy with intravitreal antibiotics, we added oral steroids. Bullous RD was noted for which RE PPV+PFCL+FAE+EL+SOI were done. We continued on tapering dose of oral steroids. Final BCVA in RE was 6/36.

Conclusion: HLA B27 can present rarely as endophthalmitis.

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