Fuchs' Heterochromic Iridocyclitis in Blacks

Tabbut, Byron R.; Tessler, Howard H.; Williams, D. L.

doi:10.1001/archopht.1988.01060140860027

Cited by 50 publications

(40 citation statements)

References 10 publications

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“…This misorientation can be additionally strengthened and the clinician further misled by the presence of disc hyperfluorescence and the less frequent peripheral retinal vasculitis on fluorescein angiography. In the literature of the last 2-3 decades, Fuchs' uveitis is mostly identified as an anterior uveitis, and it is the anterior involvement that is described and analysed in detail leaving posterior segment involvement in the background, although it is cited in most of the papers [13,15,[17][18][19][20].…”

Section: Discussionsupporting

confidence: 40%

“…In most instances the condition is benign and does not require any anti-inflammatory therapy [16]. Although vitreous changes were clearly identified by Fuchs as a major sign in this condition along with typical KPs, iris atrophy and lens opacification, most of the attention has been given to the anterior clinical signs and vitreous involvement has been neglected in many studies over the years [13][14][15][17][18][19][20]. Although vitritis is cited in most studies, it does not usually appear in the abstracts of these articles nor is it put forward as a major element and is therefore not perceived by the average clinician to be characteristic of the condition.…”

Section: Introductionsupporting

confidence: 44%

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Fluorescein angiographic findings and clinical features in Fuchs’ uveitis

Bouchenaki

Herbort

2010

Int Ophthalmol

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Fuchs' uveitis is very often diagnosed with substantial delay, which is at the origin of deleterious effects such as unnecessary treatment and its consequences. The aim of this study was to analyse the type and frequency of posterior inflammatory and fluorescein angiographic signs in Fuchs' uveitis in conjunction with other clinical signs. Patients seen at the Centre for Ophthalmic Specialised Care (COS) in Lausanne and the Memorial A. de Rothschild, Clinique Générale-Beaulieu in Geneva between 1995 and 2008 with the diagnosis of Fuchs' uveitis and who had undergone a fundus fluorescein angiography (FFA) were analysed. In addition to FFA signs, the data collected included age, gender, initial and final visual acuities, clinical findings at presentation, mean diagnostic delay and ocular complications. Between 1995 and 2008, 105 patients seen in our centres in Lausanne and Geneva were diagnosed with Fuchs' uveitis. Forty of them (38.1%) had undergone at least one FFA. One patient was excluded because of a concomittant diagnosis of multiple sclerosis. In 28 of 39 patients (71.2%) diagnosis was not reached at presentation with a mean diagnosis delay of 3.67 ± 4.86 years (range: 1 month-24 years). The original erroneous diagnosis was intermediate uveitis in 16 patients (57.1%), posterior uveitis in two patients (7.1%), panuveitis in four patients (14.3%) and anterior granulomatous uveitis in six patients (21.4%). Fluorescein angiography demonstrated the presence of disc hyperfluorescence in 43/44 eyes (97.7%), sectorial peripheral retinal vascular leaking in 6/44 eyes (13.6%) and cystoid macular oedema in 4/44 eyes (9.1%), all of which were seen in eyes having undergone cataract surgery. Fuchs' uveitis was bilateral in 5/39 patients (12.8%). The most frequent clinical signs were vitritis in 42/44 eyes (95.5%), stellate keratic precipitates in 41 eyes (93.2%), posterior subcapsular opacities or cataract in 19 eyes (43.2%), and heterochromia in 19 eyes (43.2%). Fuchs' uveitis is a largely underdiagnosed uveitis, probably because the predominant vitreous involvement is ignored by many ophthalmologists. In addition, the nearly constant inflammatory fluorescein angiography findings reported here such as disc hyperfluorescence and, more rarely, peripheral retinal vascular leaking, are not well known and are not usually associated with Fuchs' uveitis but represent an additional factor leading to misdiagnosis. These findings need to be recognised in order to reduce diagnostic delay.

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Section: Discussionsupporting

confidence: 40%

Section: Introductionsupporting

confidence: 44%

Fluorescein angiographic findings and clinical features in Fuchs’ uveitis

Bouchenaki

Herbort

2010

Int Ophthalmol

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“…In this study, glaucoma occurred in 27.6% of the eyes. Our analysis identified a significant Dernouchamps [15] Tabbut et al [16] Jones [11] La Hey et al [5] Fearnley and Rosenthal [17] Velilla et al [18] Arellanes-Garcīa et al [12] Yang et al [13] Bouchenaki and…”

Section: Discussionmentioning

confidence: 40%

Clinical features and prognostic factors in Fuchs’ uveitis

et al. 2010

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To identify clinical features and prognostic factors in patients with Fuchs' uveitis (FU). All patients diagnosed with FU at King Khaled Eye Specialist Hospital between 1983 and 2005 were reviewed. Data collected included age, gender, initial and final visual acuities, clinical findings at presentation and during follow-up visits, interval between onset of symptoms and presentation to our institute, ocular complications, details of surgical procedures, and duration of follow-up. One hundred and sixty-six patients (174 eyes) were identified. There were 92 (55.4%) males and 74 (44.6%) females with a mean age of 35.2 ± 10.5 years (range 10-70 years). The mean follow-up period was 57.3 ± 96.7 months (range 1-146 months). The most common presenting symptom was decreased vision (79.9%). Characteristic keratic precipitates (90.2%), diffuse iris stromal atrophy (100%), heterochronmia (13.9%), iris nodules (13.8%), vitreous opacity (50%) (not including sparse vitreous infiltration), cataract (85.6%) and glaucoma (27.6%) were the major clinical findings. The following factors were significantly associated with final visual acuity of 20/40 or better by univariate analysis: shorter interval between onset of symptoms and presentation (p = 0.0087), good initial visual acuity of 20/40 or better (p = 0.0356), absence of glaucoma at presentation (p = 0.0264), no glaucoma surgery (p = 0.0035), and absence of glaucoma and cataract at last visit (p = 0.0126). Logistic regression analysis revealed that final visual acuity of 20/40 or better was negatively correlated with a longer interval between onset of symptoms and presentation (odds ratio (OD) 0.201; 95% confidence interval (CI) 0.0734-0.548), and glaucoma surgical intervention (OD 0.247; 95% CI 0.0796-0.766). Initial visual acuity of 20/40 or better was positively associated with final visual acuity of 20/40 or better (OD 3.34; 95% CI 1.13-9.90). A shorter interval between onset of symptoms and presentation to our institute, better initial visual acuity, and no glaucoma surgery were significantly associated with better final visual acuity.

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“…43.1. and 43.2.). In brown irides (in whites, 5 blacks, 15 or Asians 16) , the heterochromia can be subtle or absent because both layers of the iris (anterior and posterior) are of the same color and texture. 17 In some individuals, there is more atrophy of the anterior iris layer such that the iris can appear darker in the affected eye (reversed heterochromia) from the pigmentation of the posterior iris layer.…”

Section: History and Clinical Featuresmentioning

confidence: 47%