J Korean Ophthalmol Soc.  2013 Dec;54(12):1945-1949.

A Case of Acute Anterior Uveitis Associated with HLA-B27 Positivity after Intravitreal Injection of Bevacizumab

• Seo JW
• Kwon YH

Abstract

PURPOSE
Intravitreal injection of bevacizumab (Avastin(R)) can lead to several intraocular complications including endophthalmitis, hemorrhage and inflammation. We present one case of acute anterior uveitis with hypopyon in an HLA-B27(+) patient following intravitreal injection of bevacizumab.
CASE SUMMARY
A 40-year-old male with known central retinal vein occlusion presented with redness and decreased visual acuity in the left eye. Symptoms had developed 4 days earlier after the sixth intravitreal injection of bevacizumab in that eye. The patient had a marked anterior chamber reaction with hypopyon and posterior synechiae. Nine days after onset, similar symptoms in the left eye occurred in the uninjected right eye. Through examination and clinical manifestations, we diagnosed acute anterior uveitis associated with HLA-B27 positivity. The patient was treated with 1% prednisolone acetate, 0.5% moxifloxacin and 1% atropine in both eyes and all symptoms had resolved after 6 weeks.

Keyword

Acute anterior uveitis; Bevacizumab; HLA-B27 positive; Hypopyon; Intravitreal injection

MeSH Terms

Adult
Anterior Chamber
Atropine
Endophthalmitis
Hemorrhage
HLA-B27 Antigen*
Humans
Inflammation
Intravitreal Injections*
Male
Prednisolone
Retinal Vein
Uveitis, Anterior*
Visual Acuity
Bevacizumab
Atropine
HLA-B27 Antigen
Prednisolone

Figure

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  Figure 1. Photograph of the left eye 4 days after sixth intravitreal injection of bevacizumab. (A) Hyperemia of conjunctival vessel, anterior chamber reaction (4+ cells) and posterior synechia with hypopyon. (B, C) Cotton wool spot, and photocoagulation scar was detected. Slightly decreased clearance due to anterior chamber reaction with hypopyon.

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  Figure 2. Slit-lamp photograph of the left eye at 1 week after treatment: anterior chamber reaction (1+ cells) and posterior synechia without hypopyon.

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  Figure 3. Photograph of the uninjected right eye. (A) Anterior chamber reaction (3+ cells) and posterior synechia with hypopyon. (B, C) Slightly decreased clearance due to anterior chamber reaction with hypopyon.

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  Figure 4. Slit-lamp photograph of the right eye at 1 week after treatment: anterior chamber reaction (1+ cells) and posterior synechia without hypopyon.

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  Figure 5. Photograph of the left eye 6 weeks after treatment, hypopyon and anterior chamber reaction had resolved and but posterior synechiae remained.

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  Figure 6. Photograph of the right eye 6 weeks after treatment, hypopyon and anterior chamber reaction had resolved and but posterior synechiae remained.

Reference

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