Posner-Schlossman Syndrome

Lippert, Jason H; Falgiani, Michael; Ganti, Latha

doi:10.7759/cureus.6584

Cited by 3 publications

(2 citation statements)

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“…The functional variant conferred a higher risk for elevated IOP ( P = 0.001) and higher frequency of recurrence ( P = 0.026). Clinically, patients with higher IOP and more recurrent episodes have more visual complications and are at risk of developing permanent complications such as optic nerve atrophy and loss of vision ( 26 ). Therefore, rs800292 identified in this study might be a useful genetic biomarker for the prediction of severe courses and may provide guidance for the frequency of follow-up.…”

Section: Discussionmentioning

confidence: 99%

CFH I62V as a Putative Genetic Marker for Posner-Schlossman Syndrome

et al. 2021

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Objective: Posner-Schlossman syndrome (PSS), also known as glaucomatocyclitic crisis, is an ocular condition characterized by recurrent attacks of anterior uveitis and raised intraocular pressure. Previous studies by our team and others have identified the genetic association of complement pathway genes with uveitis and glaucoma. This study aimed to investigate the complement genes in PSS patients with the view of elucidating the genetic background of the disease.Methods: A total of 331 subjects (56 PSS patients and 275 controls) were recruited for this study. We selected 27 variants in six complement pathway genes (SERPING1, C2, CFB, CFH, C3, and C5) and detected them using TaqMan single nucleotide polymorphism (SNP) Genotyping Assays. Univariate SNP association analysis, haplotype-based association analysis, gene-gene interaction analysis among complement genes, and genotype-phenotype correlation analysis were performed.Results: Among the 27 variants of six complement pathway genes, the functional variant I62V (rs800292) at the CFH gene was found to be significantly associated with PSS; there was a significant increase in the frequency of A allele and AA homozygosity in PSS patients than in controls (P = 1.79 × 10−4; odds ratio (OR) 2.18, 95% CI: 1.44–3.29; P = 4.65 × 10−4; OR 3.66, 95% CI: 1.70–7.85, respectively). The additive effect of CFH-rs800292 and SERPING1-rs3824988 was identified with an OR of 12.50 (95% CI: 2.16–72.28). Genotype-phenotype analysis indicated that the rs800292 AA genotype was associated with a higher intraocular pressure and higher frequency of recurrence. Unlike a high proportion of human leukocyte antigen (HLA)-B27 positivity in anterior uveitis, only 3 in 56 (5.36%) PSS patients were HLA-B27 positive. In addition, one haplotype block (GC) in the SERPING1 gene showed a nominal association with PSS with an increased risk of 2.04 (P = 0.01; 95% CI: 1.18–3.53), but the P-value could not withstand the Bonferroni correction (Pcorr > 0.05).Conclusion: This study revealed a genetic association of a CFH variant with PSS as well as its clinical parameters, implying that the alternative complement pathway might play an important role in the pathogenesis of PSS. Further studies to enrich the understanding of the genetic background of PSS and the role of the complement system in ocular inflammation are warranted.

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Section: Discussionmentioning

confidence: 99%

CFH I62V as a Putative Genetic Marker for Posner-Schlossman Syndrome

et al. 2021

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“…PSS remains a rare condition with uncertain etiology and no associated systemic conditions. It has been proposed to be linked to autoimmune conditions [ 7 ]. A study performed in Japan involving 22 patients with PSS showed HLA-Bw54 positive in nine (approximately 41%) patients implicating a possible CD8 T-cell immunogenic role [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Posner-Schlossman Syndrome in Common Variable Immunodeficiency

Huq

Sanan

Daniels

et al. 2020

Case Reports in Ophthalmological Medicine

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Introduction. 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). Case Report. 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. Conclusion. 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.

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Prevalence and clinical characteristics of uveitic glaucoma: multicentric study in Bogotá, Colombia

Rojas-Carabali,

Mejía-Salgado,

Cifuentes-González

et al. 2023

Eye

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Objectives To describe the clinical features of patients diagnosed with uveitic glaucoma (UG) and ocular hypertension secondary to uveitis (OHT-SU). Methods A multicentric cross-sectional study using medical records of patients with uveitis between 2013 and 2021. Uveitis and glaucoma specialists examined all patients. Variables were analyzed using the chi-square or Fisher’s exact test for categorical variables. Additionally, t test, Mann–Whitney, and Kruskal–Wallis variance analysis were used for continuous variables. Finally, a Kaplan–Meier survival analysis for UG and OHT-SU development over time was done. Results Of the 660 clinical records reviewed of patients with uveitis, 191 (28.9%) had OHT-SU in at least one visit, and 108 (16.4%) of them developed UG. In all ages, females were more affected than males. Anterior uveitis was the main anatomic localisation, and non-granulomatous, recurrent, and inactive uveitis were the most frequent clinical features. The mean final visual acuity was 0.3 (0.0–1.0) LogMAR. Also, 95.8% of the patients had additional sequelae related to uveitis regardless of UG and OHT-SU. Interestingly, males had earlier affection, with statistical significance in OHT for adults (P = 0.036) and UG for children (P = 0.04). Of all patients, 81.1% received topical hypotensive treatment and 29.8% required a surgical procedure. Conclusions UG and OHT-SU are common complications of uveitis in the Colombian population. These sight-threatening conditions were more common and appeared sooner in men at any age. Our results suggest that earlier and more aggressive treatment with topical hypotensive agents could positively influence the visual outcomes and the requirement of surgical procedures.

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Posner-Schlossman Syndrome

Cited by 3 publications

References 8 publications

CFH I62V as a Putative Genetic Marker for Posner-Schlossman Syndrome

CFH I62V as a Putative Genetic Marker for Posner-Schlossman Syndrome

Posner-Schlossman Syndrome in Common Variable Immunodeficiency

Prevalence and clinical characteristics of uveitic glaucoma: multicentric study in Bogotá, Colombia

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