Fuchs’ Uveitis in Iranian Patients: A Review of 89 Eyes

Zarei, Mohammad; Darabeigi, Sahel; Mehrpour, Mohammad; Roohipoor, Ramak; Ghassemi, Hamed; Ebrahimiadib, Nazanin

doi:10.1080/09273948.2018.1500612

Cited by 14 publications

(16 citation statements)

References 27 publications

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“…However, the presenting speci c signs and symptoms may be subtle and misdiagnosis of FU remains a common clinical problem. [4][5][6][7] Even though heterochromia is a common characteristic nding in patients from Western European descent, it is much less common in patients from other ethnicities. However, regardless of ethnic differences, characteristic iris atrophic changes, other than heterochromia, are common in FU and are key to the correct diagnosis in many cases.…”

Section: Introductionmentioning

confidence: 99%

“…However, regardless of ethnic differences, characteristic iris atrophic changes, other than heterochromia, are common in FU and are key to the correct diagnosis in many cases. 7 With the advent of anterior segment optical coherence tomography (AS-OCT), some investigators attempted to quantitatively study these atrophic changes; mostly by introducing various methods to measure iris thickness in AS-OCT images. However, the results are mixed.…”

Section: Introductionmentioning

confidence: 99%

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Automated Measurement of Iris Surface Smoothness Using Anterior Segment Optical Coherence Tomography  

Zarei

Mahmudi

Riazi-Esfahani

et al. 2021

Preprint

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Fuchs uveitis (FU) is a chronic and often unilateral ocular inflammation and characteristic iris atrophic changes, other than heterochromia, are common in FU and are key to the correct diagnosis in many cases. With the advent of anterior segment optical coherence tomography (AS-OCT), some investigators attempted to quantitatively study these atrophic changes; mostly by introducing various methods to measure iris thickness in AS-OCT images. We aimed to present an automated method in a observational case series to measure the smoothness index (SI) of iris surface in AS-OCT images. The ratio of the length of the straight line connecting the most peripheral and central points of the anterior iris border (in nasal and temporal sides) to the actual length of this border on AS-OCT images, was defined as SI. In a uveitis referral center twenty-two eyes of 11 patients with unilateral Fuchs uveitis (FU) (7 female) and 22 eyes of 11 healthy control subjects underwent AS-OCT imaging. Image J and a newly developed MATLAB algorithm were used for manual and automated SI measurements, respectively. Agreement between manual and automated measurements was evaluated with Bland-Altman analysis and interclass correlation coefficient. The inter-eye difference of SI was compared between FU group and control group. Automated mean overall SI was 0.868 ± 0.037 and 0.840 ± 0.039 in FU and healthy fellow eyes, respectively (estimated mean difference = -0.028, 95% CI [-0.038, -0.018], p<0.001). Bland- Altman plots showed good agreement between two methods in both healthy and FU eyes. Interclass correlation coefficient between the manual and automated measurements in the FU and healthy fellow eyes was 0.958 and 0.964, respectively. Inter-eye difference of overall SI was 0.029 ± 0.015 and 0.012 ± 0.008 in FU group and control group, respectively (p=0.01). We concluded that he automated algorithm can rapidly and conveniently measure SI with results comparable to manual method.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Automated Measurement of Iris Surface Smoothness Using Anterior Segment Optical Coherence Tomography  

Zarei

Mahmudi

Riazi-Esfahani

et al. 2021

Preprint

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“…14 Whereas clinical FUS landmarks (heterochromia) can be missed in adult, especially those with dark irides, 15,16 or with bilateral diseases. 17 Furthermore, corticosteroids are ineffective and deleterious, hastening the occurrence of cataract and glaucoma. 8 Thus, FUS and RVAU misdiagnoses lead to inappropriate management and iatrogenic complications.…”

Section: Introductionmentioning

confidence: 99%

Rubella Virus-associated Uveitis: The Essentiality of Aqueous Humor Virological Analysis

Provost

Labétoulle

Bouthry

et al. 2020

Preprint

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Aims / background: Rubella virus-associated uveitis (RVAU) classically presents with the clinical features of Fuchs uveitis syndrome (FUS). We report a series RVAU, and discuss the relevance of available diagnostic strategies, and vaccination to prevent disease. Methods: We retrospectively included patients with RV-positive aqueous humor (AH) with RT-PCR and/or intraocular RV-IgG production, between January 2014 and December 2019. RV-IgG titers from AH and serum were compared with other virus-specific IgG titers (VZV and/or CMV and/or HSV-1), to determine the derived Goldmann-Witmer coefficient (GWC’). Clinical findings at presentation and during follow-up are reported, as well as the anti-RV vaccination status.Results: All 13 included patients demonstrated intraocular synthesis of RV-IgG (median GWC’: 9.5; 3.2-100). RV-RNA was detected in one patient while PCR results were negative for other HSV1, VZV and CMV. The mean delay in diagnosis was 13 ± 12.6 years, with an initial presentation of FUS in only 3 patients (23%). Only four patients had been vaccinated, but all after the recommended age. Conclusion: As RVAU is a pleiomorphic entity, virological analysis (RV RT-PCR and GWC’) of aqueous humor is essential to improve the diagnosis and management of this entity. Improper vaccination against RV appears to be implicated in RVAU.

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“…Most cases manifest with characteristic fine stellate keratic precipitates (Fuchs KPs), mild anterior chamber reaction, iris atrophic changes, vitreous cells and debris, posterior subcapsular cataract, glaucoma, absence of macular edema, and absence of posterior synechiae. [4, 5] Despite the well-known clinical picture, incorrect diagnosis of FU is still a frequent problem. [4, 5]…”

Section: Introductionmentioning

confidence: 99%

“…[4, 5] Despite the well-known clinical picture, incorrect diagnosis of FU is still a frequent problem. [4, 5]…”

Section: Introductionmentioning

confidence: 99%

Quantitative analysis of the iris surface smoothness by spectral domain optical coherence tomography in Fuchs uveitis

Zarei

Pour

Ebrahimiadib

et al. 2020

Preprint

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Purpose: To demonstrate the value of smoothness index as a novel tool for quantitative analysis of iris surface findings in unilateral Fuchs uveitis (FU). Methods: In this observational study, both phakic eyes from patients with the diagnosis of unilateral FU were enrolled. All eyes underwent a complete ophthalmic examination and anterior segment optical coherence tomography(AS-OCT). The images were extracted and exported to the ImageJ software for calculating the smoothness index (SI). The SI was defined as ratio of length of the straight line connecting the most peripheral and the most central points of anterior iris surface to actual length of this boundary. Results: Forty eyes from 20 patients with unilateral FU were enrolled. Mean age of patients was 40+/-10 years. Mean overall SI was 0.876+/- 0.030 in eyes with FU that was significantly more than fellow control eyes (0.841+/-0.041). (p=0.005) The mean temporal and nasal SI were 0.878+/- 0.035 and 0.874+/- 0.033 in eyes with FU, compared to 0.843+/- 0.041 and 0.838+/- 0.047 in control fellow eyes, respectively. (p = 0.008 and p = 0.009, respectively) Conclusion: Iris smoothness index is a novel index to quantitatively document diffuse smoothness of iris anterior surface in eyes with FU. This index may facilitate diagnosis of subtle iris atrophic changes in these eyes, especially when heterochromia is absent.

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Fuchs’ Uveitis in Iranian Patients: A Review of 89 Eyes

Abstract: Heterochromia is an infrequent clinical feature in Iranian FU patients, however, vitreous involvement is common. Intermediate uveitis is a usual misdiagnosis.

Cited by 14 publications

References 27 publications

Automated Measurement of Iris Surface Smoothness Using Anterior Segment Optical Coherence Tomography

Automated Measurement of Iris Surface Smoothness Using Anterior Segment Optical Coherence Tomography

Rubella Virus-associated Uveitis: The Essentiality of Aqueous Humor Virological Analysis

Quantitative analysis of the iris surface smoothness by spectral domain optical coherence tomography in Fuchs uveitis

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Fuchs’ Uveitis in Iranian Patients: A Review of 89 Eyes

Abstract: Heterochromia is an infrequent clinical feature in Iranian FU patients, however, vitreous involvement is common. Intermediate uveitis is a usual misdiagnosis.

Cited by 14 publications

References 27 publications

Automated Measurement of Iris Surface Smoothness Using Anterior Segment Optical Coherence Tomography&nbsp;&nbsp;

Automated Measurement of Iris Surface Smoothness Using Anterior Segment Optical Coherence Tomography&nbsp;&nbsp;

Rubella Virus-associated Uveitis: The Essentiality of Aqueous Humor Virological Analysis

Quantitative analysis of the iris surface smoothness by spectral domain optical coherence tomography in Fuchs uveitis

Contact Info

Product

Resources

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Automated Measurement of Iris Surface Smoothness Using Anterior Segment Optical Coherence Tomography

Automated Measurement of Iris Surface Smoothness Using Anterior Segment Optical Coherence Tomography