Analysis of iris structure and iridocorneal angle parameters with anterior segment optical coherence tomography in Fuchs’ uveitis syndrome

Abstract

To evaluate the differences in the biometric parameters of iridocorneal angle and iris structure measured by anterior segment optical coherence tomography (AS-OCT) in Fuchs' uveitis syndrome (FUS). Seventy-six eyes of 38 consecutive patients with the diagnosis of unilateral FUS were recruited into this prospective, cross-sectional and comparative study. After a complete ocular examination, anterior segment biometric parameters were measured by Visante(®) AS-OCT. All parameters were compared between the two eyes of each patient statistically. The mean age of the 38 subjects was 32.5 ± 7.5 years (18 female and 20 male). The mean visual acuity was lower in eyes with FUS (0.55 ± 0.31) than in healthy eyes (0.93 ± 0.17). The central corneal thickness did not differ significantly between eyes. All iridocorneal angle parameters (angle-opening distance 500 and 750, scleral spur angle, trabecular-iris space (TISA) 500 and 750) except TISA 500 in temporal quadrant were significantly larger in eyes with FUS than in healthy eyes. Anterior chamber depth was deeper in the eyes with FUS than in the unaffected eyes. With regard to iris measurements, iris thickness in the thickest part, iris bowing and iris shape were all statistically different between the affected eye and the healthy eye in individual patients with FUS. However, no statistically significant differences were evident in iris thickness 500 μm, thickness in the middle and iris length. There were significant difference in iris shape between the two eyes of patients with glaucoma. AS-OCT as an imaging method provides us with many informative resultsin the analysis of anterior segment parameters in FUS.

In vivo analysis of the iris thickness by spectral domain optical coherence tomography

“…Anterior segment OCT analysis of the iris in Fuchs’ uveitis patients was previously proposed by Basarir et al 13 by using a time domain AS-OCT. In the eyes affected by Fuchs’ uveitis, the authors demonstrated several changes in shape and configuration of the anterior chamber structure, reporting a thinning of the iris in its thickest part compared with the FEs.…”

Optical coherence tomography and optical coherence tomography angiography in uveitis: A review

“…Mahendradas et al described the use of AS‐OCT to monitor the response to treatment of an iris granuloma in a patient with leprosy. Independent groups reported a thinning of the iris assessed through OCT scans in patients with Fuchs uveitis . Finally, AS‐OCT can be used to evaluate the presence of posterior synechia (Figure C) or peripheral anterior synechia in uveitic patients and help in assessing the risk to develop angle closure glaucoma …”

“…Independent groups reported a thinning of the iris assessed through OCT scans in patients with Fuchs uveitis. 24,25 Finally, AS-OCT can be used to evaluate the presence of posterior synechia ( Figure 6C) or peripheral anterior synechia in uveitic patients and help in assessing the risk to develop angle closure glaucoma. 26 In AU, the inflammatory process is mainly localized in the anterior chamber; nevertheless, recent evidence suggests that the choroidal blood flow may also be affected.…”

Demystifying viral anterior uveitis: A review

“…Advanced, patchy atrophy of the posterior pigment epithelium can cause irregular transillumination defects . In later stages of the disease, loss of iris tone from diffuse atrophy and loss of sphincter muscle may cause flattening or even concavity of the iris, resulting in a widened iridocorneal angle and increased anterior chamber depth …”