Fuchs' heterochromic iridocyclitis: A review of 26 cases

Velilla, Sara; Dios, E.; Herreras, José M.; Calonge, Margarita

doi:10.1076/ocii.9.3.169.3964

Cited by 56 publications

(46 citation statements)

References 14 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: Discussionmentioning

confidence: 99%

“…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: Introductionmentioning

confidence: 99%

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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: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Fluorescein angiographic findings and clinical features in Fuchs’ uveitis

Bouchenaki

Herbort

2010

Int Ophthalmol

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“…Common clinical manifestations are: (1) chronic low-grade iridocyclitis including keratic precipitates, (2) iris heterochromia, atrophy or both, (3) absence of synechiae, and (4) early cataract [3,4]. Complications such as glaucoma and vitreous opacities have been reported in 14.8% of patients with FHI [5]. Patients may remain asymptomatic for years, and diagnosis is often made by a decrease in visual acuity secondary to cataract which was observed in 77.8% at presentation.…”

Section: Introductionmentioning

confidence: 97%

Rubella virus as a possible etiological agent of Fuchs heterochromic iridocyclitis

Suzuki

Gotô

Komase

et al. 2010

Graefes Arch Clin Exp Ophthalmol

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Section: Methodsmentioning

confidence: 99%

“…The incidence of cataract ranges from 15% to 75%, with most studies reporting an incidence of approximately 50% [3,4]. Following cataract surgery, the crucial problems that threaten vision are ocular inflammation, glaucoma, posterior capsular opacification (PCO) and vitreous haze [5].In this study, we performed core vitrectomy and ciliary sulcus intraocular lens (IOL) implantation following posterior capsulorhexis with the aim of removing hazy vitreous to improve the visual outcomes of patients. …”

mentioning

confidence: 99%

Phacoemulsification and Core Vitrectomy in Fuchs’ Heterochromic Uveitis

et al. 2017

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Objective: To evaluate the efficacy of phacoemulsification combined with posterior capsulorhexis, core vitrectomy and ciliary sulcus intraocular lens (IOL) implantation in patients with Fuchs' heterochromic uveitis (FHU). Materials and Methods:A total of 18 eyes of 18 patients with FHU underwent cataract surgery were included in the study. 18 eyes with FHU underwent posterior capsulorhexis, core vitrectomy and poly (methyl methacrylate) (PMMA) IOL implantation in the ciliary sulcus. Subjects were chosen for this procedure based on an intraoperative vitreous haziness assessment, performed by indirect ophthalmoscopy. Patients with +2 or more vitreous haziness qualified for this procedure.Results: Of the 83 eyes with FHU that underwent cataract surgery, 18 eyes (21.6%) of 18 patients were employed in the study. There were 11 (61.1%) men and 7 (38.9%) women in the study; ages ranged from 23 to 47, with a mean of 32.06 years. Follow-up ranged from 8 months to 49 months. There were no intraoperative complications except for peripheral iris bleeding in 7 eyes. There was no severe intraocular inflammation in any patient postoperatively. All patients had 0.05 or better logMAR visual acuity after corneal suture removal. Glaucoma developed in 2 patients. For the short term period, the main vision threatening problem was suture-induced astigmatism.Conclusion: Cataract surgery combined with posterior capsulorhexis, core vitrectomy and IOL implantation in the ciliary sulcus is safe and leads to good visual outcome due to the removal of the hazy vitreous in patients with FHU.Keywords: Phacoemulsification, Fuchs' heterochromic uveitis, core vitrectomy ÖZ Amaç: Bu çalışmada Fuchs' heterokromik üveiti (FHÜ) olan hastalarda arka kapsüloreksis, kor vitrektomi ve silier sulkusa intraoküler lens (İOL) implantasyonu ile kombine fakoemülsifikasyon cerrahisinin etkinliğini değerlendirmek amaçlanmıştır.Gereç ve Yöntem: Fuchs' heterokromik uveiti olan ve katarakt cerrahisi uygulanan 18 hastanın 18 gözü çalışmaya alındı. FHÜ olan 18 göze; arka kapsüloreksis, kor vitrektomi ve silier sulkusa polimetilmetakrilat (PMMA) İOL implantasyonu uygulandı. İntraoperatif, indirekt oftalmoskop ile vitreusta bulanıklık derecesi değerlendirilerek; +2 veya daha fazla vitreus bulanıklığı olan hastalar bu prosedüre dahil edildi.Bulgular: Fuchs' heterokromik üveiti olan ve katarakt cerrahisi uygulanan 83 gözün 18'i (%21,6) çalışmaya dahil edildi. 23 ile 47 yaş aralığında (ortalama 32.06 yıl) olan hastaların 11'i (%61,1) erkek, 7' si (%38,9) kadın idi. Hastaların takip süresi 8 ay ile 49 ay arasında değişmekteydi. 7 gözde gelişen iris periferinde kanama dışında; intraoperatif herhangi bir komplikasyon görülmedi. Hiçbir hastada postoperatif şiddetli intraoküler inflamasyon görülmedi. Korneal sütürler alındıktan sonra, tüm hastalar logMAR' a göre 0,05 veya daha iyi seviyede görme keskinliğine sahipti. 2 hastada glokom gelişti. Kısa dönemde görme seviyesini etkileyen ana problem sütüre bağlı astigmatizma idi.Sonuç: Fuchs' heterokromik uveiti olan hastala...

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Fuchs' heterochromic iridocyclitis: A review of 26 cases

Abstract: Posterior capsule opacification, glaucoma, and vitreous opacity were the major obstacles to visual rehabilitation after cataract surgery in patients with this type of uveitis.

Cited by 56 publications

References 14 publications

Fluorescein angiographic findings and clinical features in Fuchs’ uveitis

Fluorescein angiographic findings and clinical features in Fuchs’ uveitis

Rubella virus as a possible etiological agent of Fuchs heterochromic iridocyclitis

Phacoemulsification and Core Vitrectomy in Fuchs’ Heterochromic Uveitis

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