Fluffy white iris precipitates in Fuchs uveitis: a new sign for an old disease.

To describe particular iris precipitates in a series of five eyes from six patients with Fuchs uveitis (FU). Iris precipitates were noted by four independent examiners during routine physical examination of the angle by gonioscopy with Goldmann's three-mirror lens in patients with FU. The result was confirmed by examination, using the same method, of five other consecutive patients with FU and compared to 10 normal control eyes from five healthy individuals. Other causes of anterior uveitis were excluded. There were no iris precipitates in the healthy eyes. In eyes with FU, there were fluffy white iris precipitates, not visible by full-face examination or by classic slit-lamp examination. They were similar to keratic precipitates described in FU: starry, blurry and transparent with a tendency towards the white. Situated on the surface of the iris, they were visible only with the particular diffusion of the light from the gonioscopy's glass on the darkly pigmented iris of patients from North Africa. Fluffy white iris precipitates, seen in FU patients, appear to represent an additional clinical sign and may improve our diagnostic accuracy in this disease. Its visibility requires a specific technique during clinical examination. The validity of this new clinical sign based on this fact is yet to be determined.

Bilateral retinal pigment epithelium tears in acute Vogt-Koyanagi-Harada disease.

PURPOSE: To report an original case of retinal pigment epithelial (RPE) tears in acute Vogt-Koyanagi-Haradadisease. METHODS: Observational case report of a patient who presented with RPE tears in acute Vogt-Koyanagi-Harada disease, who underwent clinical examination, fluorescein and infracyanine green angiographies, and optical coherence tomography evaluation. RESULTS: A 42-year-old woman presented with bilateral serous retinal detachment related to Vogt-Koyanagi-Harada disease. Eight days after high-dose systemic corticosteroids, she developed bilateral RPE tears. At the 15-month follow-up, visual acuity was 20/20 in both eyes. CONCLUSION: The RPE tears are rarely observed in acute Vogt-Koyanagi-Harada disease. The RPE tears were likely caused by acute inflammation of the choroidal stroma.