ArticleFrontiers in immunology2026
Recurrent unilateral anterior uveitis in an HLA-B27-positive ankylosing spondylitis patient: varicella-zoster virus etiology case report.
Article in Frontiers in immunology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: A 28-year-old Chinese woman with human leukocyte antigen (HLA)-B27-positive ankylosing spondylitis (AS) for 5 years experienced recurrent left-eye blurred vision and redness for 4 years (2-3 episodes/year). This was previously attributed to AS without etiologic testing. Her father and brother had AS but without ocular involvement. The patient received no systemic disease-modifying therapy for AS throughout her clinical course. Methods: Ophthalmic examinations [visual acuity, intraocular pressure (IOP), slit-lamp, and dilated fundus] and 100-µL left-eye aqueous humor testing [via paracentesis: varicella-zoster virus (VZV) immunoglobulin G (IgG), Goldmann-Witmer coefficient (GWC), and herpes simplex virus (HSV)-1/2/cytomegalovirus (CMV) antibodies/DNA] were performed. Targeted stepwise topical anti-inflammatory and IOP-lowering regimens were administered. Results: For the left eye, the following were observed: 20/30 visual acuity, 36-mmHg IOP, mutton fat keratic precipitates (KP), and iris atrophy. Findings for the right eye: were normal. Aqueous testing revealed elevated VZV IgG (1,227.02 U/mL) and a positive GWC (114.03), whereas HSV/CMV markers were negative. After treatment, visual acuity in the left eye improved to 20/20, IOP normalized, and symptoms resolved. No corneal sensation assessment was performed at any visit, and the patient denied any subjective corneal sensory discomfort during follow-up. Conclusion: Defaulting to AS-related uveitis in HLA-B27-positive patients should be avoided, and aqueous testing is recommended because it enables targeted management. Clinicians should adopt rational, stepped topical hypotensive combination therapy.
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