Fuchs’ Heterochromic Iridocyclitis in an Italian Tertiary Referral Centre: Epidemiology, Clinical Features, and Prognosis

Abstract

Purpose. To study epidemiology, clinical findings and visual prognosis of patients with Fuchs' Heterochromic Iridocyclitis (FHI). Methods. A retrospective analysis was performed on 158 patients with FHI. Thirty-five patients were observed only once; the remaining 123 had a mean follow-up of 30.7 months (50 of them had a mean follow-up of 63.5 months) and in those we assessed complications, medical and surgical treatment, and long-term visual prognosis. Results. Average age at uveitis diagnosis was 27.2 years and 18.3% of patients were children. Blurred vision (54.5%) and floaters (40.5%) were the most frequent presenting symptoms. Small to medium-sized keratic precipitates (95.6%), iris atrophy (86.8%), and vitreous opacities (91.2%) were the most common signs; the prevalence of cataract and IOP increase was 63.5% and 20.1%, respectively, and their incidence was 0.1 and 0.06 eye/year. Significant risk factor for visual loss was IOP increase at presentation (p = 0.02). At final examination 98% of the eye had a visual acuity ≥ 0.6, and topical (p < 0.001) and systemic (p < 0.001) corticosteroids therapy were used less frequently than before referral. Conclusions. FHI has a good visual prognosis, despite the significant incidence of cataract and glaucoma. A correct and prompt diagnosis might avoid unnecessary therapies and provide excellent visual outcomes.

A case of bilateral acute depigmentation of the Iris in one of two identical twins

“…This condition can be mistaken for Fuchs' heterochromic iridocyclitis, pigment dispersion syndrome, pseudoexfoliation syndrome, and viral iridocyclitis due to varicella zoster virus, herpes simplex Virus, and cytomegalovirus. Fuchs' heterochromic iridocyclitis is characterized by unilateral presentation in all but a few cases, and is also characterized by white-stellate keratic precipitates and low-grade anterior chamber inflammation [5], which our patient did not have. Pigment dispersion syndrome, as well as pseudoexfoliation, are conditions characterized by loss of pigment from the posterior iris pigmented epithelium, with transillumination defects, and accumulation of pigment in the anterior chamber angle, along the zonules and on the anterior lens capsule [6], all of which were absent in our patient as well.…”

Erworbene Katarakte

“…Literaturangaben zu ihrer Inzidenz variieren allerdings in Abhängigkeit von der genauen Ätiologie. So ist sie im Rahmen der Skleritis mit 7 – 17% angegeben 2 , etwa 57% im Rahmen der Pars-Planitis 3 und bis zu 64 – 78% bei der Fuchs heterochromen Iridozyklitis 4 , 5 . Die Kataraktbildung bei Patienten mit Uveitis wird in der Regel durch eine unkontrollierte und anhaltende Entzündung, aber auch durch eine längere Anwendung von hochdosierten topischen, periokulären und/oder systemischen Kortikosteroiden verursacht 6 , 7 .…”

Non-infectious pediatric uveitis

“…Синдромът на увеит на Фукс често е безсимптомно заболяване, особено при по-млади пациенти. Най-честите белези на заболяването са атрофия на ириса, роговични преципитати, опацитати в стъкловидното тяло, по-рядко се наблюдава катаракта [7].…”