Fuchs' uveitis syndrome: a 20-year experience in 466 patients.

Fuchs Uveitis Syndrome (FUS), also known as Fuchs Heterochromic Iridocyclitis, is a chronic form of uveitis characterized by mild inflammation primarily affecting one eye. This study aimed to investigate the clinical and epidemiological features of FUS in an Iranian population. A retrospective analysis was conducted on 466 patients diagnosed with FUS at an ophthalmology center affiliated with Isfahan University of Medical Sciences between 2003 and 2021. The Kimura et al. criteria were used for FUS diagnosis. Demographic data, clinical characteristics, misdiagnosed cases, concurrent diseases, and associated ocular findings were analyzed. The study included 507 eyes of 466 FUS patients, with a mean age of 34.01 ± 11.25 years. Iris atrophy, keratic precipitates, and vitritis were common clinical findings. Heterochromia was an infrequent feature. Initial misdiagnosis occurred in 13 patients, with pars planitis being the most common incorrect diagnosis. Toxoplasmosis and multiple sclerosis were common concurrent diseases. Pediatric FUS cases were noted, possibly attributed to early-onset manifestations. Differences in clinical characteristics were observed when compared to other populations. This study provides insights into the clinical and epidemiological aspects of FUS in an Iranian population. Variations in clinical features, misdiagnosis patterns, and concurrent diseases were noted. Attention to specific clinical parameters can aid in accurate FUS diagnosis. Understanding these differences contributes to a better understanding of FUS presentation and its relationship with other diseases.

Comparative analysis of optical coherence tomography angiography (OCTA) results between Behçet's disease patients and a healthy control group.

PURPOSE: This study aimed to compare optical coherence tomography angiography (OCTA) findings between patients with Behçet's disease (BD) and individuals with healthy eyes. DESIGN: A cross-sectional study. METHODS: This cross-sectional study was conducted on patients (67 eyes) with BD who were referred to Feiz Hospital and healthy eyes (43 eyes). All subjects underwent Snellen visual acuity, a slit-lamp examination, measuring intraocular pressure, conducting a dilated fundus examination, OCTA imaging, and spectral-domain (SD)-OCT imaging. OCTA retinal vascular measurements including optic nerve VD, macular-associated VD( superficial and deep), foveal avascular zone (FAZ) area, FAZ perimeter (PERIM), and vessel density within a 300-µm-wide region of the FAZ (FD) were compared between the groups. RESULTS: A significant difference was evident between the two groups (healthy one group and BD group) in terms of parafoveal and perifoveal total retinal thickness, total pRNFL VD in all quadrants except the inferior sector (P < 0.05), and macular superficial, and deep VD in all regions except temporal and superior perifoveal VD (P < 0.05) following adjustments for age, gender, and signal strength index. When comparing the two groups, ocular Behçet's disease (BD) and non-ocular BD, it was evident that peripapillary vessel density (VD) exhibited a significant decrease in ocular BD eyes in all sectors except for the superior and inferior ones, as compared to non-ocular BD eyes. In addition, the comparison of ocular BD and non-ocular BD showed superficial and deep VDs were lower in ocular BD than non-ocular BD in all regions. CONCLUSION: According to these findings, peripapillary and macular vessel density is affected in BD. Key Points • The study utilized OCTA to compare retinal features in Behçet's disease (BD) patients and healthy individuals, revealing significant differences in retinal thickness and vessel density. • Ocular BD demonstrated reduced peripapillary vessel density compared to non-ocular BD. • The demonstrated association between ADMA and cIMT in patients with early SSc may suggest a role of NO/ADMA pathway in the initiation of macrovascular injury in SSc.

Reactivation of Varicella-Zoster Virus Anterior Uveitis after YAG Peripheral Iridotomy.

PURPOSE: To describe the reactivation of Varicella-Zoster Virus Anterior Uveitis after YAG laser peripheral iridotomy. CASE REPORT: A 69-year-old woman referred with unilateral, anterior uveitis associated with decreased corneal sensation and increased intraocular pressure 5 days after YAG laser peripheral iridotomy. The impression of herpetic anterior uveitis reactivation followed by YAG PI confirmed by polymerase chain reaction of aqueous humor by detecting varicella zoster virus. Treatment with oral acyclovir and topical corticosteroid and cycloplegic resulted control of both the intraocular inflammation and pressure. CONCLUSION: YAG PI may be a risk factor for reactivation of herpetic anterior uveitis. Prophylaxis with acyclovir may be necessary after YAG PI to prevent reactivation of herpetic anterior uveitis.

Intravitreal diclofenac for treatment of refractory uveitis-associated cystoid macular oedema: A before and after clinical study.

BACKGROUND: Cystoid macular oedema (CME) is one of the important complications of uveitis leading to irreversible blindness. Currently, there is no gold standard treatment for this condition. The aim of this study was to investigate the effects of single intravitreal diclofenac (IVD) injection on short-term outcome of refractory uveitis-associated CME. METHODS: This was a prospective clinical study on 16 consecutive patients (16 eyes) with refractory uveitis-associated CME. Intravitreal injection of 500 µg/0.1 ml of diclofenac sodium was given to the patients. The clinical outcomes considered were best-corrected visual acuity (BCVA) change and central macular thickness (CMT) changes in the pre- and postinjection periods. Follow-up examinations were performed at 1 and 4 weeks after the injection. RESULTS: Age of the patients varied from 18 to 59 years (mean ± SD: 39.5 ± 13.2 years). Ten patients (62.5%) were females. Statistically significant differences were found in the decrease of mean BCVA (logMAR) (p = 0.043) and mean CMT (p = 0.003) during the study period. There was no significant difference in the intraocular pressure (IOP) increase at the end of the study (p = 0.94). CONCLUSION: Intravitreal diclofenac (IVD) may be a promising treatment for refractory uveitis-associated CME. Further clinical trials with a larger sample size should be conducted to confirm these findings and compare them with other treatments.