Bilateral Posterior Uveitis with Retinitis Revealing Primary Sjögren’s Syndrome

Abstract

Introduction: Ocular manifestations are frequent during primary Sjögren's syndrome (PSS) and largely dominated by the signs of xerophthalmia. The extra-glandular ocular involvement is, on the contrary, exceptional and unusual. We are reporting an original case of bilateral posterior uveitis with retinitis inaugural of PSS. Case report: A 48-year-old Tunisian woman, with no notable pathological history, was explored for progressive decline in visual acuity, bilateral visual blur, and moderate eye pain. The examination noted a visual acuity at 6/10 on the left and 5/10 on the right, without redness of the eyes or irritative signs. The anterior segment of both eyes was normal. Ophthalmologic exam (slit lamp, fundus, and retinal angiography) revealed bilateral, non-granulomatous posterior uveitis associated with retinitis and retinal vasculitis. Further investigations concluded to PSS and treatment with intravenous pulse methylprednisolone followed by oral prednisone was introduced. The evolution was rapidly favorable and ophthalmological exam with eye fundus was totally normal at two months. Conclusion: PSS remains an exceptional and unusual cause of uveitis. It is therefore appropriate to evoke it in front of any uveitis that does not prove itself, especially if recidivating.