Probiotic Supplementation Improved Acute Anterior Uveitis of 3-Year Duration: A Case Report

Patient: Female, 18-year-old Final Diagnosis: Autoimmune uveitis Symptoms: Anterior phlogosis • recurrent eye redness Medication: — Clinical Procedure: Best-corrected visual acuity • fundus examination • intraocular pressure measurment • slit lamp examination • spectral domain OCT (SD-OCT) Specialty: Ophthalmology OBJECTIVE: Unusual setting of medical care BACKGROUND: Uveitis is a clinical condition characterized by acute blurry vision related to an inflammation of the uvea. Gut microbiome dysbiosis can influence the prognosis of uveitis by inducing a loss of intestinal immune homeostasis leading to a lower activation threshold of the immune cells. This promotes a pro-inflammatory response resulting in reactivation of the disease. This is the case report of a 21-year-old woman with a 3-year history of acute anterior uveitis (AAU) of the right eye, who responded favorably to probiotic dietary supplementation. CASE REPORT: A 21-year-old woman, previously unknown to our Ophthalmology Unit, presented with ocular pain and redness. Three years ago, she had been diagnosed with monolateral AAU in the right eye. Her medical and family histories were unremarkable. After a complete clinical evaluation, we decided to start a combination treatment protocol with continuous use of probiotics and the use of ocular steroids only during an exacerbation of the condition. To monitor the trend of the disease, she underwent a monthly clinical examination for the following year. During this period, we observed a decrease in ocular inflammation with a gain in the primary outcome (best-corrected visual acuity), and the steroids and atropine were discontinued for the following months. CONCLUSIONS: This case report describes a patient with a 3-year history of AAU, who responded well to a combination treatment of dietary probiotic supplementation and steroids, demonstrating that probiotics can reduce recurrences of AAU.