A 35-year-old HLA-B27 positive man presents with recurrent acute anterior uveitis. The CHARACTERISTIC slit-lamp finding distinguishing HLA-B27 associated uveitis from other causes is:
- A Fibrinous exudate in the anterior chamber forming a plastic iritis with posterior synechiae ✓
- B Mutton-fat keratic precipitates on the inferior corneal endothelium
- C Koeppe and Busacca iris nodules
- D Stellate keratic precipitates distributed across the entire corneal endothelium
Correct answer: A. Fibrinous exudate in the anterior chamber forming a plastic iritis with posterior synechiae
Explanation
HLA-B27 associated acute anterior uveitis is characteristically severe and fibrinous, with a plastic quality due to heavy fibrinous exudate. It tends to be unilateral, alternating, and recurrent. Fine white stellate KPs (distributed across the endothelium) are seen in Fuchs heterochromic iridocyclitis. Mutton-fat KPs in an inferior triangular distribution are classic for granulomatous uveitis (sarcoid, TB). Koeppe (pupillary margin) and Busacca (iris stroma) nodules are granulomatous features.
Reference: Khurana Comprehensive Ophthalmology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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