Huq Madiha, Sanan Neha, Daniels Phuong, Hostoffer Robert
University Hospitals Parma Medical Center, Cleveland, Ohio, USA.
University Hospitals, Cleveland Medical Center, Cleveland, Ohio, USA.
Case Rep Ophthalmol Med. 2020 Oct 15;2020:8843586. doi: 10.1155/2020/8843586. eCollection 2020.
Posner-Schlossman syndrome (PSS) is a rare glaucomatocyclitic crisis with clinical features including recurrent episodes of unilateral elevated intraocular pressure. Autoimmune and infectious causes have been proposed as potential etiologies of PSS. We report the first case of PSS in the setting of common variable immunodeficiency (CVID). . A sixty-two-year-old Caucasian female with a medical history of CVID and ulcerative colitis presented to the emergency room with complaints of acute right-sided vision changes. She reported image distortion, blurriness, and loss of central vision. Physical exam was significant for mildly injected right conjunctiva, visual acuity of 20/70 in right eye, and 20/25 in left eye. The right intraocular pressure was measured at 34 mmHg and left at 12 mmHg. The gonioscopy and dilated fundus examination were unremarkable. Cup to disc ratio was within normal limits, and no afferent pupillary defects were recorded. The patient was acutely treated with three rounds of dorzolamide/timolol and 0.2% brimonidine which decreased the right eye intraocular pressure to 24 mmHg. On follow-up exam with an ophthalmologist, anterior uveitis including an elevated pressure of 41 mmHg on the right and 18 mmHg on the left eye was noted and a PSS diagnosis was confirmed.
PSS remains a rare condition with uncertain etiology and no associated systemic conditions. PSS has been postulated to be linked to autoimmune conditions. CVID is associated with many autoimmune disorders including Sjogren's, rheumatoid arthritis, and colitis. There have been a few reported CVID-associated ocular diseases including granulomatous uveitis and conjunctivitis, chronic anterior uveitis, and birdshot retinopathy. We describe the first case of PSS in a patient with CVID.
波斯纳-施洛斯曼综合征（PSS）是一种罕见的青光眼睫状体炎危象，其临床特征包括单侧眼压反复升高。自身免疫和感染原因被认为是PSS的潜在病因。我们报告了首例患有常见可变免疫缺陷（CVID）的PSS病例。一名62岁的白种女性，有CVID和溃疡性结肠炎病史，因急性右侧视力变化到急诊室就诊。她报告有图像扭曲、视物模糊和中心视力丧失。体格检查显示右侧结膜轻度充血，右眼视力为20/70，左眼视力为20/25。右眼眼压测量为34 mmHg，左眼为12 mmHg。房角镜检查和散瞳眼底检查无异常。杯盘比在正常范围内，未记录到传入性瞳孔缺陷。患者接受了三轮多佐胺/噻吗洛尔和0.2%溴莫尼定的紧急治疗，右眼眼压降至24 mmHg。在眼科医生的随访检查中，发现前葡萄膜炎，包括右眼眼压升高至41 mmHg，左眼眼压升高至18 mmHg，并确诊为PSS。
PSS仍然是一种病因不明且无相关全身疾病的罕见病症。PSS被推测与自身免疫性疾病有关。CVID与许多自身免疫性疾病相关，包括干燥综合征、类风湿性关节炎和结肠炎。已有一些关于CVID相关眼部疾病的报道，包括肉芽肿性葡萄膜炎和结膜炎、慢性前葡萄膜炎以及霰粒肿性视网膜病变。我们描述了首例患有CVID的PSS患者。
