Fuchs’ heterochromic iridocyclitis: clinical manifestations in dark-eyed Mexican patients

Abstract

The more common clinical features in this group of patients were fine and stellate keratic precipitates, atrophy of the iris crypts, and iris nodules. Clinically evident iris heterochromia was present in only 25% of the affected eyes. FHI diagnosis in brown-eyed patients cannot rely on iris heterochromy only.

Clinical features and prognostic factors in Fuchs’ uveitis

“…In our series, iris heterochromia was clinically evident in only 13.9% of eyes and was not associated with a worse prognosis; however, diffuse iris stromal atrophy was present in all patients. Our findings are similar to those reports about patients with dark or brown irides [1,[11][12][13][14]; however, apparent heterochromia is very common in white patients ( Table 5). The low frequency of clinically evident heterochromia in dark-colored irides may be due to the presence of more pigment.…”

Clinical features and prognostic factors in Fuchs’ uveitis

“…In our series, iris heterochromia was clinically evident in only 13.9% of eyes and was not associated with a worse prognosis; however, diffuse iris stromal atrophy was present in all patients. Our findings are similar to those reports about patients with dark or brown irides [1,[11][12][13][14]; however, apparent heterochromia is very common in white patients ( Table 5). The low frequency of clinically evident heterochromia in dark-colored irides may be due to the presence of more pigment.…”

Fuchs′ uveitis: Failure to associate vitritis and disc hyperfluorescence with the disease is the major factor for misdiagnosis and diagnostic delay

“…Also the mean intraocular pressure was lower in most affected eyes when compared with the healthy eye despite a rate of 12.8% of hypertension or glaucoma. Similar to recent Swedish10 and Turkish11 studies, the rate of ocular hypertension or glaucoma was rather low and rarely needing filtering surgery when compared to other series that reported that filtering surgery was noted in more than 30% of cases 161719…”

Fuchs Uveitis Syndrome Clinical Features, Visual Outcome after Cataract Surgery and Complications

“…Regarding the clinical features of the condition ,the results showed that the more common clinical features of the patients are keratic precipitates in(100%) ,cataract in (80.2%) ,heterochromia in (63.1%) ,vitritis in (52.6%), Amsler sign in (53.9%) , iris atrophy in (43.4%) , mild AC reaction in (31.5%) and absence of posterior synechiae in all cases. These clinical features of our patients are similar to the common clinical features stated in many studies carried out in different parts of the world including USA, England, India, Saudi Arabia, Mexico, Spain and China (6,10,23,24,26,35,41,43) . This consistency supports the concept that FUS has a characteristic clinical appearance and the diagnosis of the disease can usually be made on clinical grounds alone (3,12,19) .…”

“…Other uncommon or rare clinical signs are iris nodules in only (6.5%) and this result is not consistent with results of other studies where it is reported to range from 28.0% to 50% of cases (23,43) , rubeosis iridis (which reflects ischemia)in only(2.6%) which is again not consistent with previous figures in other studies where it is reported to range from 6% to 22% of cases (5) and increased IOP in only (3.9%) .…”

“…The incidence of glaucoma in our FUS patients (3.9%) appears to be very low in comparism with its incidence in many parts of the world where it is reported to affect (20-30%) of cases (3,9,23,28,29) . This significant discrepancy is probably because low incidence of neovascularization in our patients which is usually the main cause of glaucoma in FUS (28,44) , but also there are other two studies held in India and Mexico (35,43) showed results which are consistent with our results. These studies reported that its incidence is (zero) in the first study and only (4%) in the second one, these different figures among different countries reflect some difference in the behavior of the disease among different populations probably due to different etiological factors or probably different immunological reactions.…”

Clinical features and prognostic factors in Fuchs’ uveitis

“…In our series, iris heterochromia was clinically evident in only 13.9% of eyes and was not associated with a worse prognosis; however, diffuse iris stromal atrophy was present in all patients. Our findings are similar to those reports about patients with dark or brown irides [1,[11][12][13][14]; however, apparent heterochromia is very common in white patients ( Table 5). The low frequency of clinically evident heterochromia in dark-colored irides may be due to the presence of more pigment.…”

Fuchs′ uveitis: Failure to associate vitritis and disc hyperfluorescence with the disease is the major factor for misdiagnosis and diagnostic delay

“…Also the mean intraocular pressure was lower in most affected eyes when compared with the healthy eye despite a rate of 12.8% of hypertension or glaucoma. Similar to recent Swedish10 and Turkish11 studies, the rate of ocular hypertension or glaucoma was rather low and rarely needing filtering surgery when compared to other series that reported that filtering surgery was noted in more than 30% of cases 161719…”

Fuchs Uveitis Syndrome Clinical Features, Visual Outcome after Cataract Surgery and Complications

“…Regarding the clinical features of the condition ,the results showed that the more common clinical features of the patients are keratic precipitates in(100%) ,cataract in (80.2%) ,heterochromia in (63.1%) ,vitritis in (52.6%), Amsler sign in (53.9%) , iris atrophy in (43.4%) , mild AC reaction in (31.5%) and absence of posterior synechiae in all cases. These clinical features of our patients are similar to the common clinical features stated in many studies carried out in different parts of the world including USA, England, India, Saudi Arabia, Mexico, Spain and China (6,10,23,24,26,35,41,43) . This consistency supports the concept that FUS has a characteristic clinical appearance and the diagnosis of the disease can usually be made on clinical grounds alone (3,12,19) .…”

“…Other uncommon or rare clinical signs are iris nodules in only (6.5%) and this result is not consistent with results of other studies where it is reported to range from 28.0% to 50% of cases (23,43) , rubeosis iridis (which reflects ischemia)in only(2.6%) which is again not consistent with previous figures in other studies where it is reported to range from 6% to 22% of cases (5) and increased IOP in only (3.9%) .…”

“…The incidence of glaucoma in our FUS patients (3.9%) appears to be very low in comparism with its incidence in many parts of the world where it is reported to affect (20-30%) of cases (3,9,23,28,29) . This significant discrepancy is probably because low incidence of neovascularization in our patients which is usually the main cause of glaucoma in FUS (28,44) , but also there are other two studies held in India and Mexico (35,43) showed results which are consistent with our results. These studies reported that its incidence is (zero) in the first study and only (4%) in the second one, these different figures among different countries reflect some difference in the behavior of the disease among different populations probably due to different etiological factors or probably different immunological reactions.…”

Clinical features and prognostic factors in Fuchs’ uveitis

“…In our series, iris heterochromia was clinically evident in only 13.9% of eyes and was not associated with a worse prognosis; however, diffuse iris stromal atrophy was present in all patients. Our findings are similar to those reports about patients with dark or brown irides [1,[11][12][13][14]; however, apparent heterochromia is very common in white patients ( Table 5). The low frequency of clinically evident heterochromia in dark-colored irides may be due to the presence of more pigment.…”

Fuchs′ uveitis: Failure to associate vitritis and disc hyperfluorescence with the disease is the major factor for misdiagnosis and diagnostic delay

“…Also the mean intraocular pressure was lower in most affected eyes when compared with the healthy eye despite a rate of 12.8% of hypertension or glaucoma. Similar to recent Swedish10 and Turkish11 studies, the rate of ocular hypertension or glaucoma was rather low and rarely needing filtering surgery when compared to other series that reported that filtering surgery was noted in more than 30% of cases 161719…”

Fuchs Uveitis Syndrome Clinical Features, Visual Outcome after Cataract Surgery and Complications

“…Regarding the clinical features of the condition ,the results showed that the more common clinical features of the patients are keratic precipitates in(100%) ,cataract in (80.2%) ,heterochromia in (63.1%) ,vitritis in (52.6%), Amsler sign in (53.9%) , iris atrophy in (43.4%) , mild AC reaction in (31.5%) and absence of posterior synechiae in all cases. These clinical features of our patients are similar to the common clinical features stated in many studies carried out in different parts of the world including USA, England, India, Saudi Arabia, Mexico, Spain and China (6,10,23,24,26,35,41,43) . This consistency supports the concept that FUS has a characteristic clinical appearance and the diagnosis of the disease can usually be made on clinical grounds alone (3,12,19) .…”

“…Other uncommon or rare clinical signs are iris nodules in only (6.5%) and this result is not consistent with results of other studies where it is reported to range from 28.0% to 50% of cases (23,43) , rubeosis iridis (which reflects ischemia)in only(2.6%) which is again not consistent with previous figures in other studies where it is reported to range from 6% to 22% of cases (5) and increased IOP in only (3.9%) .…”

“…The incidence of glaucoma in our FUS patients (3.9%) appears to be very low in comparism with its incidence in many parts of the world where it is reported to affect (20-30%) of cases (3,9,23,28,29) . This significant discrepancy is probably because low incidence of neovascularization in our patients which is usually the main cause of glaucoma in FUS (28,44) , but also there are other two studies held in India and Mexico (35,43) showed results which are consistent with our results. These studies reported that its incidence is (zero) in the first study and only (4%) in the second one, these different figures among different countries reflect some difference in the behavior of the disease among different populations probably due to different etiological factors or probably different immunological reactions.…”