In vivo confocal microscopic evaluation of keratic precipitates and endothelial morphology in Fuchs’ uveitis syndrome

Abstract

Purpose To evaluate the endothelial cell layer in patients with Fuchs' uveitis syndrome (FUS) with respect to the type and distribution of keratic precipitates (KP), endothelial cell morphology, and endothelial cell density (ECD), using in vivo confocal microscopy (IVCM). Methods Forty eyes of 40 patients (mean age of 32.2 ± 12.5 years) with the clinical diagnosis of FUS were evaluated with IVCM (Confoscan 3.0, Vigonza, Italy). KP were classified as type I (small, round), type II (stippled), type III (dendritiform), and type IV (globular). When 41 KP type was present, differentiation between the predominant and less frequent KP was made as 'primary' and 'secondary'. ECD was measured and compared with age-matched 60 control subjects. Endothelial blebs were classified as small (3-10 lm) or large (410 lm). Results In 36 (90.0%) cases with FUS, more than one KP type was observed with IVCM. Type III (dendritiform) KP was the most frequently observed primary KP type (85.0%), followed by type II (stippled) KP (15.0%). Secondary KP included type II (58.3%), type IV (globular) (27.8%), and type III (13.9%). The mean endothelial cell density of eyes with FUS (2588±396 cells/mm 2 ) was significantly lower than that of control subjects (2930 ± 364 cells/mm 2 ) (t-test; Po0.001). Eyes with FUS had lower proportion of hexagonal cells and higher percentage of polymegethism compared with the uninvolved contralateral eyes. Endothelial blebs (21 small, 16 large blebs) were observed in 37 (92.5%) eyes.Conclusions FUS is characterized by dendritiform KP and is associated with decreased ECD and altered endothelial cell morphology.

Acute transient corneal endothelial changes following selective laser trabeculoplasty

“…The endothelial changes were also not typical of keratitic precipitates. Proteinaceous deposits have been seen in patients with uveitis such as those with Fuchs’ endothelial dystrophy as well as in patients with PXF . There did not appear to be a direct correlation between PXF and the changes we saw in our small study.…”

In vivo confocal microscopy of inflammatory cells in the corneal subbasal nerve plexus in patients with different subtypes of anterior uveitis

“…We found no correlation between amount of inflammatory cells in the AC and numbers of DLCs (the four-step grading system may be too rough to detect a correlation). Mocan et al 20 reported that the eight patients with keratouveitis had ≥2 cells in the AC, but do not show mean or maximum AC cell readings and no correlation with presence and numbers of inflammatory cells in the cornea.…”

In vivo confocal microscopy of the inflamed anterior segment: A review of clinical and research applications

“…The mean density of these keratic precipitates was 16.01 ± 6.54 keratic precipitates/mm 2 . Subsequent studies using slit scanning IVCM showed multiple morphologies, the most common being dendritiform (85%, 77.5%), stippled (67.5%, 58.3) and globular (85%, 27.8%).…”