A Rare Case of Anti Phospholipid Syndrome Associated Intermediate and Posterior Uveitis

Abstract

Introduction: Autoimmune disorders are often associated with Uveitis. Anti-Phospholipid syndrome(APS) is characterized by increased hypercoagulability and divergent ocular features. Case Presentation: A 45-year-old male patient presented with complaints of headache for 2 days. The patient gives a history of fever and loss of consciousness 20 days back and was treated symptomatically. On examination Visual acuity was 6/6 in the right eye and 6/12 in the left eye. On slit-lamp examination, the anterior segment was normal, vitreous cells were 2+ suggestive of vitritis in the left eye. Dilated fundus examination showed exudates in both eyes with macular parafoveal edema in the left eye. Laboratory investigations showed Antiphospholipid Antibody Immunoglobulin M (IgM) and Beta 2 glycoprotein IgM positive and raised ESR, PTT, and triglycerides. MRI brain showed acute embolic infarcts in multiple areas. Management: Topical Steroids and cycloplegic for uveitis and systemic steroids and anticoagulants for systemic manifestations were given and the patient's vision improved to 6/6 and macular edema reduced in the left eye during the follow-up. Conclusion: APS is a life and vision-threatening multisystem disorder, needs monitoring for INR and Anti phospholipid antibodies. A rare manifestation of uveitis is noted and prompt treatment with topical, oral steroids resolves the uveitis. But to prevent recurrences and further thrombotic events long-term immunosuppression, anticoagulation treatment is required.