An investigation on optic nerve head involvement in Fuchs uveitis syndrome using optical coherence tomography and fluorescein angiography

Zarei, Mohammad; Abdollahi, Ali; Darabeigi, Sahel; Ebrahimiadib, Nazanin; Roohipoor, Ramak; Ghassemi, Hamed; Moghaddam, Reza Soltani; Fard, Masoud Aghsaei

doi:10.1007/s00417-018-4125-3

Cited by 14 publications

(5 citation statements)

References 18 publications

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“…Recent studies demonstrated that FUS affects not only the anterior uvea and vitreous but also the retinal microvasculature and the peripapillary total retinal and nerve fiber layer in FUS eyes. [ 12 17 18 ] These findings regarding FUS suggest that FUS might be associated with inflammation involving the whole uveal.…”

Section: Discussionmentioning

confidence: 87%

Ultra-Widefield Fundus Fluorescein Angiography Findings in Patients with Fuchs’ Uveitis Syndrome

Nasrollahi¹,

Fazel²,

Mirjani³

et al. 2022

Advanced Biomedical Research

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Background:The aim of this study was to evaluate ultra-widefield (UWF) fundus fluorescein angiography (FFA) findings in patients with Fuchs’ uveitis syndrome (FUS).Materials and Methods:This cross-sectional study was conducted in patients with FUS. All the patients underwent a complete ophthalmologic examination, and FFA was carried out with Optos UWF retinal imaging. Standard FFA and image acquisition consisted of early phase (15–45 s) images, and late-phase (5–10 min) images were also obtained for both eyes.Results:Forty eyes from twenty unilateral FUS patients, including 11 females (55%), who had a mean age of 38.50 ± 6.97 years, were enrolled. Eighty-five percent of the FUS eyes had optic disc hyperfluorescence (ODH) in the FFA. A significant relationship was observed between ODH and iris heterochromia (P= 0.004). ODH was seen in all the patients with iris heterochromia (n= 16). Peripheral vascular leakage (PVL), capillary nonperfusion, chorioretinal scar, and vascular sheathing were observed in 3, 3, 2, and 8 of the patients’ eyes, respectively.Conclusion:UWF FFA imaging seemed to be mandatory for evaluating the prognosis of the FUS patients, and another investigation may require to be conducted to evaluate the effect of antivascular endothelial growth factor agents for the management of PVL in these patients.

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Section: Discussionmentioning

confidence: 87%

Ultra-Widefield Fundus Fluorescein Angiography Findings in Patients with Fuchs’ Uveitis Syndrome

Nasrollahi¹,

Fazel²,

Mirjani³

et al. 2022

Advanced Biomedical Research

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“…Therefore, it seems highly desirable to find ways to use the already available technology of OCT for monitoring inflammatory activity in Behcet’s retinal vasculitis. It has been already shown that peripapillary retinal thickness increases in uveitis entities even in the absence of clinical or angiographic involvement of optic nerve head 3 . Based on this background, we decided to investigate the correlation between FA-derived inflammatory activity (as the present gold standard method) and OCT retinal parameters to evaluate the potential application of OCT as a surrogate of FA in monitoring inflammation in Behcet retinal vasculitis.…”

Section: Discussionmentioning

confidence: 97%

“…Considering that optic disc hyperfluorescence or leakage in FA is a common sign for intraocular inflammation, evaluation of peripapillary retinal thickness with OCT may have the potential to be used as an index for inflammatory activity. We have already shown that despite normal clinical and even angiographic appearance of the optic disc, peripapillary retinal thickness is increased in Fuchs uveitis 3 . Based on this background, we decided to evaluate the potential of measurement of peripapillary retinal thickness as a non-invasive alternative of FA for monitoring the inflammatory activity in Behcet’s retinal vasculitis.…”

Section: Introductionmentioning

confidence: 92%

Peripapillary optical coherence tomography as an alternative to fluorescein angiography for monitoring Behcet’s retinal vasculitis

Zarei

Pesarakli

Yaseri

et al. 2021

Sci Rep

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To study the correlation of OCT parameters including central subfield macular thickness (CSMT), peripapillary retinal thickness (PRT), and peripapillary retinal nerve fiber layer thickness (PNFLT) with fluorescein angiography (FA) in evaluation of inflammatory activity in Behcet’s retinal vasculitis. In this case-series, concurrent FA and OCT were performed. A scoring system was devised for FA. PNFLT in 3.4-mm-diameter circle as well as PRT in doughnut shaped regions between the 1-mm- and 2.2-mm-diameter and between the 2.2-mm- and 3.45-mm-diameter circles was measured. The correlation of FA and OCT parameters was analyzed. A total of 105 sets of FA from 28 eyes (15 patients) were reviewed. Four (26.6%) were female and mean age was 31.6 ± 8.49 years. Each micron increase in CSMT, PRT2.2, PRT3.45, and PNFLT, caused a rise of 0.018 (95% CI 0.008–0.027, P < 0.001, r = 0.413), 0.053 (95% CI 0.035–0.070, P < 0.001, r = 0.443), 0.086 (95% CI 0.065–0.108, P < 0.001, r = 0.707), and 0.185 (95% CI 0.152–to 0.218, P < 0.001, r = 0.850) unit in FA score, respectively. Parameters having significant correlation with angiographic inflammatory activity, were CSMT, PRT2.2, PRT3.45 and RNFLT. Those with the strongest correlation, PRT3.45 and PNFLT, may be considered as quantitative non-invasive alternatives to FA for monitoring Behcet’s retinal vasculitis.

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“…Zarei et al [17] evaluated the optic nerve head involvement in 43 eyes of Fuchs uveitis without clinical optic disc edema and obtained a fluorescein angiogram. 71% of those eyes showed optic nerve head hyperfluorescence.…”

Section: Discussionmentioning

confidence: 99%

Great imitator — ocular syphilis

2023

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We examined a 44-year-old woman without any known systemic disease with a decreased vision of a month duration in her left eye. She had undergone left uneventful cataract surgery with intraocular lens implantation elsewhere 14 years ago. On examination, her Snellen visual acuity was 1.0 (with the correction of -0.50-0.25 × 120) in the right eye and 0.4 (with the correction of +0.75-2.25 × 115) in the left. There was left hypochromic heterochromia. While the right anterior segment was unremarkable, there were small to medium-sized keratic precipitates, 3+ anterior chamber cells, a posterior chamber intraocular lens with an intact posterior capsule, and a few vitreous cells in the left eye. Fundus autofluorescence imaging revealed peripapillary hyperautofluorescence in the left eye, and fluorescein angiography revealed a marked optic nerve head and perivascular leakage at the posterior pole. The findings were not compatible with Fuchs uveitis, so the full infectious panel was worked out. Serologic investigations yielded the presence of syphilis, and the patient was treated successfully with systemic antibiotics. Our case demonstrates the mimicking nature of ocular syphilis and the importance of high clinical suspicion when reaching the correct diagnosis.

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An investigation on optic nerve head involvement in Fuchs uveitis syndrome using optical coherence tomography and fluorescein angiography

Abstract: OCT demonstrates peripapillary total retinal and nerve fiber layer thickening in FUS eyes without clinical swelling of optic disc that is not always associated with optic nerve head leakage.

Cited by 14 publications

References 18 publications

Ultra-Widefield Fundus Fluorescein Angiography Findings in Patients with Fuchs’ Uveitis Syndrome

Ultra-Widefield Fundus Fluorescein Angiography Findings in Patients with Fuchs’ Uveitis Syndrome

Peripapillary optical coherence tomography as an alternative to fluorescein angiography for monitoring Behcet’s retinal vasculitis

Great imitator — ocular syphilis

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