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

Purpose: 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. Methods: Retrospective review of patients with HLA-B27-associated uveitis that presented initially at ≥70 years of age. Results: 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. Conclusions: 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.