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In vivo analysis and comparison of anterior segment structures of both eyes in unilateral Fuchs’ uveitis syndrome

  • Inflammatory Disorders
  • Published:
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Abstract

Purpose

To compare corneal endothelial cell density (ECD), iris stromal thickness (IST), iris pigment epithelium optical density (IPE OD), and Schlemm’s canal (SC) measurements in patients having unilateral Fuchs’ uveitis syndrome (FUS).

Methods

This is a randomized, prospective study. Currently, diagnosed unilateral FUS and phakic cases were defined to be the inclusion criteria to the study. The specular microscope was used to measure ECD. Anterior segment images were acquired by using SD-OCT. The images were extracted and uploaded to the ImageJ program for further analysis. Two blinded investigators analyzed the IST, IPE OD, and SC area in both healthy (N) and affected eyes (FUS) and the comparative analysis was made by using SPSS program.

Results

Of twenty-one participants, 13 were female (62%). The mean age of the participants was 30 ± 9 (18–47) years. ECD was 2228 ± 365 and 2513 ± 209 cells/mm2 in the FUS and N, respectively (p < 0,001). In FUS, the mean nasal and temporal (n-t) IST was measured as 380 ± 44 and 347 ± 41 μm, compared to 393 ± 61 and 355 ± 62 μm in N, respectively (p = 0.3 and p = 0.4 respectively). The mean n-t IPE OD was measured as 1110 ± 499 and 937 ± 370 in FUS, compared to 1147 ± 528 and 1267 ± 428 in N, respectively (p = 0.008 temporal). The mean n-t SC area was measured as 5479 ± 1951 and 5624 ± 2722 μm2 in FUS, compared to 5736 ± 2574 and 5633 ± 1835 μm2 in N, respectively (p = 0.9 and p = 0.7 respectively).

Conclusion

Decreased ECD in FUS may lead to serious complications after cataract surgery. Temporal IPE depigmentation occurs prior to the nasal side in FUS.

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References

  1. Kazokoglu H, Onal S, Tugal-Tutkun I et al (2008) Demographic and clinical features of uveitis in tertiary centers in Turkey. Ophthalmic Epidemiol 15:285–293

    Article  PubMed  Google Scholar 

  2. Rathinam SR, Namperumalsamy P (2007) Global variation and pattern changes in epidemiology of uveitis. Indian J Ophthalmol 55:173–183

    Article  CAS  PubMed  Google Scholar 

  3. Basarir B, Altan C, Pinarci EY, Celik U, Satana B, Demirok A (2013) Analysis of iris structure and iridocorneal angle parameters with anterior segment optical coherence tomography in Fuchs’ uveitis syndrome. Int Ophthalmol 33:245–250

    Article  PubMed  Google Scholar 

  4. Kimura SJ, Hogan MJ, Thygeson P (1955) Fuchs’ syndrome of heterochromic cyclitis. Arch Ophthalmol 54(2):179–186

    Article  CAS  Google Scholar 

  5. Bonfioli AA, Curi AL, Orefice F (2005) Fuchs’ heterochromic cyclitis. Semin Ophthalmol 20(3):143–146

    Article  PubMed  Google Scholar 

  6. Mohamed Q, Zamir E (2005) Update on Fuchs’ uveitis syndrome. Curr Opin Ophthalmol 16:356–363

    Article  PubMed  Google Scholar 

  7. Kardes E, Akcay BIS, Unlu C, Ergin A (2017) Choroidal thickness in eyes with Fuchs uveitis syndrome. Ocul Immunol Inflamm 25(2):259–266

    Article  PubMed  Google Scholar 

  8. Toledo de Abreu M, Belfort R, Hirata P (1982) Fuchs’ heterochromic cyclitis and ocular toxoplasmosis. Am J Ophthalmol 93:739–744

    Article  CAS  PubMed  Google Scholar 

  9. Schwab IR (1991) The epidemiologic association of Fuchs’ heterochromic iridocyclitis and ocular toxoplasmosis. Am J Ophthalmol 111:356–362

    Article  CAS  PubMed  Google Scholar 

  10. Birnbaum AD, Tessler HH, Schultz KL et al (2007) Epidemiologic relationship between Fuchs heterochromic iridocyclitis and the United States rubella vaccination program. Am J Ophthalmol 144:424–428

    Article  PubMed  Google Scholar 

  11. Quentin CD, Reiber H (2004) Fuchs heterochromic cyclitis: rubella virus antibodies and genome in aqueous humor. Am J Ophthalmol 138:46–54

    Article  Google Scholar 

  12. Chee SP, Jap A (2008) Presumed Fuchs heterochromic iridocyclitis and Posner-Schlossman syndrome: comparison of cytomegalovirus-positive and negative eyes. Am J Ophthalmol 146:883–889

    Article  PubMed  Google Scholar 

  13. Liesegang TJ (1982) Clinical features and prognosis in Fuchs’ uveitis syndrome. Arch Ophthalmol 100(10):1622–1626

    Article  CAS  PubMed  Google Scholar 

  14. Fearnley IR, Rosenthal AR (1995) Fuchs’ heterochromic iridocyclitis revisited. Acta Ophthalmol Scand 73(2):166–170

    Article  CAS  PubMed  Google Scholar 

  15. Jones NP (1991) Fuchs’ heterochromic uveitis: a reappraisal of the clinical spectrum. Eye (Lond) 5:649–661

    Article  Google Scholar 

  16. Ivernizzi A, Cigada M, Savoldi L, Cavuto S, Fontana L, Cimino K (2014) In vivo analysis of the iris thickness by spectral domain optical coherence tomography. Br J Ophthalmol 98(9):1245–1249

    Article  Google Scholar 

  17. Fischer CA (1973) Affinity for retinal pigment epithelium by certain viruses. Am J Ophthalmol 75(1):164–166

    Article  CAS  PubMed  Google Scholar 

  18. Wang X, Xiong K, Lu L, Gu D, Wang S, Chen J, Xiao H, Zhou G (2015) Developmental origin of the posterior pigmented epithelium of iris. Cell Biochem Biophys 71(2):1067–1076

    Article  CAS  PubMed  Google Scholar 

  19. Imamoglu S, Sevim MS, Alpogan O, Ercalik NY, Kumral ET, Pekel G, Bardak H (2016) In vivo biometric evaluation of Schlemm’s canal with spectral-domain optical coherence tomography in pseudoexfoliation glaucoma. Acta Ophthalmol 94(8):688–692

    Article  Google Scholar 

  20. Benedikt O, Roll P, Zirm M (1978) The glaucoma in heterochromic cyclitis Fuchs. Gonioscopic studies and electron microscopic investigations of the trabecular meshwork. Klin Monatsbl Augenheilkd 173(4):523–533

    CAS  PubMed  Google Scholar 

  21. Kagemann L, Nevins JE, Jan NJ, Wollstein G, Ishikawa H, Kagemann J, Sigal IA, Nadler Z, Ling Y, Schuman JS (2014) Characterisation of Schlemm’s canal cross-sectional area. Br J Ophthalmol 98(Suppl 2):ii10–ii14

    Article  PubMed  PubMed Central  Google Scholar 

  22. Szepessy Z, Toth G, Barsi A, Kranitz K, Nagy ZZ (2016) Anterior segment characteristics of Fuchs uveitis syndrome. Ocul Immunol Inflamm 24(5):594–598

    Article  PubMed  Google Scholar 

  23. Huang Z, Wang XY, Liu L, Han W (2014) Corneal decompensation in bilateral Fuchs heterochromic uveitis. Can J Ophthalmol 49(1):e11–e14

    Article  PubMed  Google Scholar 

  24. Alfawaz AM, Holland GN, Yu F et al (2016) Corneal endothelium in patients with anterior uveitis. Ophthalmology. 123(8):1637–1645

    Article  PubMed  Google Scholar 

  25. Dastiridou A, Marion K, Niemeyer M et al (2018) Pilot study of the effects of ambient light level variation on spectral domain anterior segment OCT-derived angle metrics in Caucasians versus Asians. Curr Eye Res 43(7):955–959

    Article  PubMed  Google Scholar 

  26. Tugal-Tutkun I, Guney-Tefekli E, Kamaci-Duman F, Corum I (2009) A cross-sectional and longitudinal study of Fuchs uveitis syndrome in Turkish patients. Am J Ophthalmol 148(4):510–515

    Article  PubMed  Google Scholar 

  27. Goldberg N, Chou J, Moore A, Tsang S (2009) Autofluorescence imaging in rubella retinopathy. Ocul Immunol Inflamm 17(6):400–402

    Article  PubMed  PubMed Central  Google Scholar 

  28. Mehta N, Lavinsky F, Gattoussi S et al (2018) Increased inner retinal layer reflectivity in eyes with acute CRVO correlates with worse visual outcomes. Invest Ophthalmol Vis Sci 59(8):3503–3510

    Article  PubMed  Google Scholar 

  29. Berger BB, Tessler HH, Kottow MH (1980) Anterior segment ischemia in Fuchs’ heterochromic cyclitis. Arch Ophthalmol 98(3):499–501

    Article  CAS  PubMed  Google Scholar 

  30. Usui T, Tomidokoro A, Mishima K, Mataki N, Mayama C, Honda N, Amano S, Araie M (2011) Identification of Schlemm’s canal and its surrounding tissues by anterior segment fourier domain optical coherence tomography. Invest Ophthalmol Vis Sci 52:6934–6939

    Article  PubMed  Google Scholar 

  31. Kagemann L, Wang B, Wollstein G et al (2014) IOP elevation reduces Schlemm’s canal cross-sectional area. Invest Ophthalmol Vis Sci 55:1805–1809

    Article  PubMed  PubMed Central  Google Scholar 

  32. Hong J, Xu J, Wei A, Wen W, Chen J, Yu X, Sun X (2013) Spectral-domain optical coherence tomographic assessment of Schlemm’s canal in Chinese subjects with primary open-angle glaucoma. Ophthalmology 120:709–715

    Article  PubMed  Google Scholar 

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Acknowledgments

Special thanks are given to Tuba, my beloved friend, for editing our manuscript.

Availability of data and materials

The data supporting our findings can be found at the Van Yuzuncu Yil University, Dursun Odabas Faculty of Medicine, Ophthalmology Department, Uveitis section secretary.

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Authors and Affiliations

  1. Faculty of Medicine, Ophthalmology Department, Van Yuzuncu Yil University, 65080, Tusba, VAN, TR, Turkey

    Muhammet Derda Ozer, Fatih Kebapci, Muhammed Batur, Erbil Seven & Serek Tekin

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  1. Muhammet Derda Ozer
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  2. Fatih Kebapci
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  3. Muhammed Batur
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  4. Erbil Seven
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Contributions

M.D.O and F.K performed the data collection; M.D.O and M.B were involved in planning and supervised the work; M.D.O, F.K, M.B, E.S, and S.T processed the experimental data, performed the analysis, drafted the manuscript, and designed the figures. All authors discussed the results and commented on the manuscript.

Corresponding author

Correspondence to Muhammet Derda Ozer.

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Ethics approval and consent to participate

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The study was approved by the Van Yuzuncu Yil University, Dursun Odabas Faculty of Medicine, and Surgical and Pharmaceutical Research Ethics Board.

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Written informed consent for publication was obtained from all of the participants.

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The authors declare that they have no conflict of interest.

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Ozer, M.D., Kebapci, F., Batur, M. et al. In vivo analysis and comparison of anterior segment structures of both eyes in unilateral Fuchs’ uveitis syndrome. Graefes Arch Clin Exp Ophthalmol 257, 1489–1498 (2019). https://doi.org/10.1007/s00417-019-04351-w

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  • DOI: https://doi.org/10.1007/s00417-019-04351-w

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