Immune recovery uveitis in an HIV-negative individual

Abstract

Immune recovery uveitis (IRU) is an intraocular inflammatory disorder originally described in individuals with human immunodeficiency virus (HIV) and inactive cytomegalovirus retinitis following highly active antiretroviral therapy. Although relatively common in individuals with acquired immune deficiency syndrome in the United States it is an extremely uncommon presentation in Australia. IRU also occurs in iatrogenically immunosuppressed individuals with a similar incidence to HIV-infected individuals. We report one case of IRU in an HIV-negative individual following a volunteer unrelated donor allogeneic stem cell transplant for non-Hodgkin's lymphoma. In the context of tapering the immunosuppression the patient developed bilateral IRU, consisting of panuveitis and macular oedema. The visual acuity (VA) at presentation of IRU was limited to counting fingers bilaterally. The IRU resolved with the re-intensification of the immunosuppression. VA restored to right 6/18 and left 6/12.