Abstract
Purpose:
To identify the morphologic appearance of keratic precipitate (KP) with RTVue-100 fourier-domain corneal anterior module optical coherence tomography (OCT) system (RTVue) (optovue, USA) for the diagnosis of uveitic eyes of various etiologies.
Methods:
RTVue OCT scan was performed on consecutive 23 eyes of 19 patients with different types of uveitis to investigate the morphologic appearance of KPs. The study included sarcoidosis in 5 eyes, herpetic iridocyclitis in 8, Fuchs heterochromic iridocyclitis (FHI) in 3, idiopathic granulomatous uveitis in 2, tubulointerstitial nephritis and uveitis in 1, and masquerade syndrome with primary vitreoretinal lymphoma in 4. RTVue was used to analyze the differences in types of KPs between various uveitic groups.
Results:
Mean age of the patients was 58.0 ± 19.9 (range, 23-96) years, and 11 (52.6 %) were female. Bilateral involvement was observed in 4 cases (21.0 %). In all cases, the slit-lamp examination revealed various pattern such as whitish and/or brownish KPs. Those KPs also showed various morphologies such as vaguely-outlined, round, and dendriform appearance. In RTVue examination, intensity of KPs demonstrated various patterns. Morphologic features of KPs also showed various patterns such as globular, dome-shaped, saw-edged, rectangle-shaped appearance protruded from the retrocornea. Especially, stippled, small and dendriform KPs were observed in FHI cases. In contrast, round, big and high intensity KPs were observed in cytomegalovirus (CMV) positive iridocyclitis cases. In herpetic iridocyclitis cases, KPs were diffusely scattered over the corneal endothelium, but, through the course of antiviral treatment, they aggregated each other and deposited dispersedly. By the limitation of number of cases, no significant difference was observed, however; RTVue images in various type of disease showed characteristic and specific morphological patterns.
Conclusions:
The morphology of KPs in various uveitic eye diseases showed characteristic images in slit-lamp and RTVue examination. RTVue examination is non-invasive and repeatable methods for diagnosis of uveitis by evaluating the KPs morphologies.