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Anterior uveitis
Published in Gwyn Samuel Williams, Mark Westcott, Carlos Pavesio, Bushra Thajudeen, Practical Uveitis, 2017
Gwyn Samuel Williams, Mark Westcott
Sometimes anterior uveitis is part of a local syndrome where the diagnosis is clinical. There are three main diagnoses here: Fuchs heterochromic iridocyclitis, also called Fuchs uveitis syndrome, Posner-Schlossman syndrome and herpetic uveitis, and an anterior segment ischaemia syndrome. There are some very simple questions that can be asked that can help you differentiate between these three classes of disease: Are the irises different colours? If so think of Fuchs heterochromic iridocyclitis. Note here however that although heterochromia is indeed incorporated into the very name of this condition this sign itself is considered increasingly unreliable in the uveitis community.Is the intraocular pressure unusually high? If so think of Posner-Schlossman syndrome.Is there any other ocular pathology present such as severe diabetic retinopathy, vein occlusion, previous muscle surgery or ocular ischaemic syndrome? If so consider that the uveitis is secondary to this.
Iris Manifestations in Inadequately Treated Chronic Recurrent Vogt-Koyanagi-Harada Disease
Published in Ocular Immunology and Inflammation, 2022
Soon-Phaik Chee, May Zun Aung Win
Bilateral iris depigmentation may also be seen in bilateral acute depigmentation of the iris (BADI) and bilateral acute iris transillumination (BAIT) syndromes. Reversal of depigmentation of the iris stroma may occur in BADI over time, but not the iris transillumination in BAIT which results from loss of the epithelial iris pigment,10 nor the iris atrophy in VKH in spite of immunosuppression.6 BAIT causes paralysis of the iris sphincter, resulting in semi-mydriatic pupils10 whereas VKH with iris depigmentation is associated with seclusio pupillae.4–7 However, the absence of preceding antibiotic ingestion,10 pattern of iris transillumination starting from the periphery, absence of ocular hypertony at presentation, recurrent uveitis and the presence of posterior segment signs and skin features help to differentiate VKH from BADI and BAIT. Viral anterior uveitis associated with herpes virus can cause iris atrophy but unlike VKH, it is unilateral and sectoral.11 Fuchs heterochromic iridocyclitis on the other hand causes diffuse iris atrophy predominantly of the iris stroma, with depigmentation of the anterior border layer of the iris. Pigment epithelium atrophy when present, occurs near the pupil, involving in particular the pigment at the pupillary ruff.12
Chronic Unilateral Uveitis as a Manifestation of Leprosy: A Case Report and Literature Review
Published in Ocular Immunology and Inflammation, 2021
Claudia Eugenia Duran Merino, María Camila Ortiz Úsuga, María Jaramillo Jaramillo, Ana María Rodríguez
A 65-year-old man, who worked as a distributor of agricultural products, was referred to our clinic by a rheumatologist as he was diagnosed with chronic anterior uveitis in his right eye. During the previous 3 years, he had been under multidisciplinary management by specialists in rheumatology, neurology, dermatology, and ophthalmology due to the following diagnoses: Demyelinating polyneuropathy in upper and lower limbs;Urticarial vasculitis, treated with azathioprine (50 mg bid) and cyclosporine (50 mg qd), without improvement.Chronic uveitis in right eye, initially diagnosed as Fuchs heterochromic iridocyclitis, treated with steroids, without improvement. Subsequently was diagnosed as cystoid macular edema and treated with intravitreal dexamethasone implant, without improvement, then, was referred to our service for further evaluation.
PCR Multiplex for CMV Detection in Patients with Anterior Uveitis
Published in Ocular Immunology and Inflammation, 2019
Alexandra Martín Ramírez, Laura Cardeñoso Domingo, J. Jacobo González Guijarro
Based on clinical findings criteria, the different eyes were included in four groups: 1) Posner–Schlossman syndrome (PSS), diagnosed by the presence of recurrent episodes of elevated IOP associated with mild AC reaction, and a few KPs in which the eye returns to normal state after attacks; 2) Fuchs heterochromic iridocyclitis (FHI) was diagnosed if there was chronic iridocyclitis, with diffuse characteristic stellate KPs and no posterior synechiae; 3) keratouveitis (KU) was considered if there was concomitant or previous corneal epithelial, stromal and/or endothelial involvement; and 4) group in which we included the acute, recurrent or chronic anterior uveitis which did not meet the previous group diagnosis criteria. No local or systemic antiviral therapies were used 3 months before AH taps. Serum CMV IgG was positive in every patient.