Abstract
Abstract: :
Purpose: To analyze clinical features of Fuchs Heterochromic Uveitis (FHU) and the extent of heterogeneity of the disease Methods: Constant and variable findings were studied retrospectively in a series of 52 patients (Duong and Brezin, ARVO 2000). A prospective analysis was continued in 38 cases, between November 2000 and November 2002. Patients were seen in a tertiary reference center for uveitis. Inclusion criteria were: chronic uveitis, the absence of ocular redness, no posterior synechiae, the presence of stellate keratic precipitates (KP), the discrepancy between the number of KP and the low grade of anterior chamber inflammation, no response to topical steroid treatment (if applied), no systemic disease or other cause of uveitis. The frequency and the association of variable findings: iris heterochromia, unilaterality, diffuse KP distribution, lens opacities, vitritis and Amsler's sign were studied. Results: Ninety patients (50 women and 40 men) with 98 affected eyes, were included. The disease was unilateral in 82 (91.1%) patients and bilateral in 8 (8.9 %) patients. One patient with unilateral disease had an unaffected homozygous twin. The average age at the time of the first presentation of ocular signs was 29.1 ± 13.6 years, while the mean age at the time of diagnosis of FHU was 38.8 ± 13.4 years. Initial symptoms were: decreased vision in 30 eyes, floaters in 15 eyes and pain in 7 eyes. In 18 (20 %) patients, a diagnosis of FHU was made on a routine ophthalmic examination. The frequency of variable findings were, vitritis in 90 eyes, iris heterochromia in 72 eyes, lens opacities in 72 eyes, and diffuse KP distribution in 88 eyes. Cataract surgery was performed on 13 eyes and Amsler's sign was observed in 6 cases. The average number of variable findings was 4.19 ±1.07 (median 4). All patients had at least 2 variable findings. Conclusions: No international definition of FHU has been determined so far. Our study’s inclusion criteria could be used for the definition of FHU with the addition of variable findings as minor criteria. The specificity and sensitivity of a definition based on our inclusion criteria and the presence of at least 2 minor criteria will be further tested.
Keywords: autoimmune disease • clinical research methodology • inflammation