Clinical and Epidemiologic characteristics of Fuchs Heterochromic Iridocyclitis in Hispanic population

Abstract

Purpose: Report clinical features and epidemiologic characteristics of the disease in a Hispanic population attending a Uveitis Service in an Ophthalmology Center in Mexico

Methods: Retrospective case series study.We reviewed electronicrecords from patients attending Uvea and Ocular Inflammation Department at Instituto de Oftalmologia Fundacion Conde de Valenciana in Mexico City from January 1^st 2001 to December 1^st 2014 with diagnosis of Fuchs Heterochromic Iridocyclitis. Records had to comply with clinical data based on criteria of Kimura. Other causes of infectious or noninfectious uveitis were excluded

Results: We reviewed a total of 209 electronic records.We enrolled 142 eyes of 136 patients with the diagnosis of Fuch’s Heterochromic Iridocyclitis who completed a minimum of 6 months follow up.The mean follow up was 16±14.5 months (range 6- 60 months).Males predominated (72/136,52.9%).The most common form of presentation was unilateral (95.6%).The age at presentation was 35.8±11.6 (range 12-64) years. On the clinical findings, 25.4%(36/142) showed heterochromia.All patients showed fine stellate filamentary keratic precipitates and 70.4% (100/142) showed mild (1-2+ cellularity and flare) anterior chamber inflammation.Iris atrophy was seen in 67.6% (96/142) eyes. Koeppe and Bussaca nodules were seen in 36.6%(52/142).Iris vessels were present in 3.5%(5/142).Vitreous opacities were found in 90 eyes (63.4%). 31 eyes presented elevated intraocular pressure (21.8%). 120 eyes (84.5%) had developed cataracts, of which 38.5% (43/120) were posterior subcapsular cataracts and 31.7% total opacities (38/120).Best corrected visual acuity was hand movement in the majority of cases (33.1%) at the moment of first consultation.93 eyes (65%) underwent cataract surgery.Best corrected visual acuity was 0.5 or better in 120/142(84.5%) of eyes at the final follow up

Conclusions: Based on the predominant clinical findings, unilateral cataracts, fine keratic precipitates, subtle iris atrophy and mild anterior chamber inflammation along with vitreous opacities could lead to the diagnosis of Fuch’s Heterochromic Iridocyclitis in our population. As a predominantly brown eyed population, heterochromia is not the most prevalent feature. Recognition of this disease in any patient of any complexion is important. This is the first report of clinical and epidemiological features of the disease in Hispanic Mexican population