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Purpose: Uveitis is the third leading cause of blindness worldwide. This study aimed to summarize the pattern of uveitis in Iran through a systematic review. Methods: This review was conducted according to the guidelines for systematic reviews in the following four steps: literature search, study selection and assessment, inclusion and exclusion criteria, and statistical analysis. Results: One hundred and fifteen articles were identified by an encyclopedic literature search, and three independent investigators examined them according to the defined inclusion and exclusion criteria. Eventually, 109 manuscripts were retrieved and six cross-sectional studies covering 3,567 patients were included and reviewed. According to the results, the mean age of patients was 40 years, and sex was not a statistically significant predisposing factor. The most common anatomical pattern of involvement was anterior uveitis, and the prevalence of the other three types of uveitis, including middle, posterior, and pan-uveitis, were almost equal. Overall, the most common etiologies of uveitis in the Iranian population were idiopathic uveitis, toxoplasmosis, Behcet’s syndrome, and Fuchs heterochromic iridocyclitis. Conclusion: This study depicted the pattern of uveitis in Iranian society; this can help physicians in the diagnostic approach, management, and treatment of patients.

The spontaneous change of eyes’ color is a quite rare complain in ophthalmological clinical practice for young and middle-aged patients. We consulted the 18-year-old patient complained that a month ago she noticed a change of the iris’ color. It was symmetrical in both eyes, which had lightened and acquired a “spotty appearance”. Before the appearance of these complaints, the patient had eyes of a rich dark brown color. After a comprehensive examination, the bilateral acute iris depigmentation (BADI) was diagnosed. BADI is bilateral symmetrical iris depigmentation followed by focal or diffuse stromal atrophy and pigment dispersion in the anterior segment. It is more common for young and middle-aged women, and is often asymptomatic. BADI has bilateral symmetrical iris depigmentation followed by focal or diffuse stromal atrophy and pigment dispersion in the anterior eye segment of the eye, which may affect the trabecular network. A feature of this disease is the absence of transillumination, changes in the shape of the pupil, and an inflammatory reaction. In some cases, repigmentation may occur spontaneously during the next few years. Therefore, from a prognostic point this disease has a favorable prognosis. However, patients with BADI syndrome should undergo regular ophthalmological examinations, including measurement of intraocular pressure to exclude the development of secondary open-angle pigmented glaucoma, and use sunglasses when the sun is bright. BADI syndrome must be differentiated with the following diseases: Fuchs heterochromic iridocyclitis, viral iridocyclitis caused by HSV and CMV, pigment dispersion syndrome and pseudo exfoliative glaucoma, as well as bilateral acute iris transillumination (BAIT) syndrome to make a correct diagnosis and apply adequate treatment tactics.

Purpose To evaluate macular capillary perfusion in patients with fuchs heterochromic iridocyclitis (FHI) by using optical coherence tomography angiography (OCTA). Material and Method A total of 19 eyes of 19 patients with unilateral FHI underwent detailed eye examination. OCTA (RTVue-XR Avanti) images were obtained from both eyes. OCTA parameters, including foveal avascular zone, superficial capillary plexus and deep capillary plexus vessel densities, were compared between the involved and fellow control eyes. Results The median age of the patients (11 females, 8 males) was 42.0 +/- 9.63 (range 24-57) years. DCP and SCP densities at the parafoveal and perifoveal area were significantly lower in the FHI eyes compared to the control eyes (44.80 +/- 5.24% vs. 54.70 +/- 3.76% and 43.30 +/- 5.10% vs. 53.70 +/- 2.73%, respectively; p < 0.05). The median FAZ was 0.29 +/- 0.12 (0.11-0.42) mm(2) in the FHI eyes and 0.26 +/- 0.09 (0.10-0.40) mm(2) in the control eyes. This difference did not reach statistical significance (p = 0.199). Conclusion Macular capillary perfusion was significantly reduced in both SCP and DCP in the eyes with FHI. FHI, which is known to affect the choroid layer, could also compromise macular capillary perfusion of the retina.

PURPOSE The aim of the study was to describe the phenotype and molecular genetic causes of X-linked megalocornea (MGC1). We recruited four British, one New Zealand, one Vietnamese and four Czech families. METHODS All probands and three female carriers underwent ocular examination and Sanger sequencing of the CHRDL1 gene. Two of the probands also had magnetic resonance imaging (MRI) of the brain. RESULTS We identified nine pathogenic or likely pathogenic and one variant of uncertain significance in CHRDL1, of which eight are novel. Three probands had ocular findings that have not previously been associated with MGC1, namely pigmentary glaucoma, unilateral posterior corneal vesicles, unilateral keratoconus and unilateral Fuchs heterochromic iridocyclitis. The corneal diameters of the three heterozygous carriers were normal, but two had abnormally thin corneas, and one of these was also diagnosed with unilateral keratoconus. Brain MRI identified arachnoid cysts in both probands, one also had a neuroepithelial cyst, while the second had a midsagittal neurodevelopmental abnormality (cavum septum pellucidum et vergae). CONCLUSION The study expands the spectrum of pathogenic variants and the ocular and brain abnormalities that have been identified in individuals with MGC1. Reduced corneal thickness may represent a mild phenotypic feature in some heterozygous female carriers of CHRDL1 pathogenic variants.

Purpose To assess the corneal endothelium in patients with Fuchs heterochromic iridocyclitis (FHI) and compare it with the normal fellow eye. Methods Retrospective, observational, cross-sectional study of 31 patients seen between Jan 2016 to Dec 2018, with clinical diagnosis of Fuchs heterochromic iridocyclitis, was performed. Specular microscopic examination was documented in both eyes. The affected eyes formed the study group and the fellow healthy eyes served as controls. Results The mean age of the patients was 29.9 ± 8.2 years. The endothelial cell density (P = 0.0001) was significantly lower, whereas average cell size (P = 0.0001), coefficient of variation (P = 0.004), and maximum cell area (P = 0.01) were significantly higher in the affected eye compared to the control eye. In three patients, the affected eye showed guttae, while the healthy fellow eye revealed a normal specular mosaic. Conclusion Specular microscopic analysis shows endothelial alterations in the affected eyes in FHI.

International audience; Objective: To report the clinical features and treatment outcomes in immunocompetent patients with anterior segment inflammation (ASI) related to human cytomegalovirus (HCMV) depending on their ethnic origin.Material and Methods: Multicenter retrospective study of 38 patients with at least one test, either HCMV-positive PCR or GWc.Results: Features of Posner-Schlossman syndrome were observed in 50% of the eyes, Fuchs heterochromic iridocyclitis in 13% of the eyes, chronic nonspecific anterior uveitis in 21% of the eyes, and corneal endotheliitis in 18% of the eyes. PCR and GWc were positive for HCMV in 50% and 96.2% of the eyes, respectively. Glaucoma was diagnosed in 50% of eyes. Treatment was oral valganciclovir in about half of the patients. Other treatments were intravenous ganciclovir and/or ganciclovir topical ointment and/or intravitreal ganciclovir.Conclusions: No obvious association of specific clinical features with individual ethnicity could be identified. We found a high rate of glaucoma in all ethnic groups. There was a delay in diagnosis and specific treatment of HCMV in most patients.

To study the effects of topical ganciclovir 0.15% gel on cytomegalovirus (CMV) anterior uveitis in a tertiary uveitis referral center in Brussels, Belgium.A retrospective study of patients with a clinical diagnosis of CMV anterior uveitis/endotheliitis demonstrated by a positive polymerase chain reaction and/or Goldmann-Witmer coefficient (GWc).We report a series of 15 patients presenting clinical characteristics of CMV anterior uveitis. Patients had a pretreatment follow-up of 13.00 ± 12.78 months and a posttreatment follow-up of 42.64 ± 31.23 months. The 14 non-Asian patients (93.3%) had clinical characteristics of Posner-Schlossman syndrome, and the only Asian patient (6.7%) had keratic precipitates like Fuchs heterochromic iridocyclitis. At presentation, uveitis was unilateral in all patients, visual acuity (VA) was 0.91 ± 0.25, and all patients had an increased intraocular pressure (IOP), with a mean IOP of 41.40 ± 10.35 mmHg. At the end of the follow-up, 5 patients (33.3%) had glaucoma, 2 needed glaucoma surgery (13.3%). The mean final VA was 0.93 ± 0.11; 13 patients (86.5%) reached a final VA of 0.7 to 1. Patients had a significantly lower number of recurrences/year posttreatment (0.76 ± 0.57) than in the pretreatment period (3.76 ± 2.44) (P = 0.001). The mean time to recurrence increased from 4.03 months before treatment to 12.58 months after treatment (P = 0.003).Our results suggest that patients treated with 0.15% topical ganciclovir have a decreased frequency of CMV anterior uveitis recurrences, most preserve a relatively good central vision over time. However, glaucoma is a frequent and severe complication.

Purpose To investigate the clinical and virologic-associated and predictive factors of intraocular pressure (IOP) evolution over time and its severity in Fuchs' heterochromic iridocyclitis (FHC). Methods Consecutive patients with both clinical FHC and intraocular synthesis of rubella virus (RV)-specific antibodies were included in this study. Specific ocular production of RV antibodies was confirmed using the quotient of serum/aqueous humor ratio of RV IgGs (Crv) and control antiviral IgGs (Cctl), using quantitative serology methods. Epidemiologic, clinical, biological, and virologic data at referral were collected and correlated with IOP values over time, occurrence, and severity of glaucoma. Results Sixty-eight eyes of 68 patients were included. Mean age at diagnosis was 40.7 ± 11.1 years. Mean follow-up was 4.3 ± 4.3 years. Mean baseline Crv and Cctl values were 12.34 ± 14.67 and 216.70 ± 98.4, respectively. Mean baseline IOP was 17.2 ± 7.2 mm Hg (range, 9-40) and 15.6 ± 5.6 (range, 3-30) 5 years after referral. The predictive factors for pejorative IOP evolution over time and glaucoma severity were male sex (P = 0.03) and decreased Crv (P = 0.04) and presence of iris nodules (P < 0.001) and decreased Cctl (P = 0.02), respectively. Diagnostic delay was associated with increased likelihood of undergoing glaucoma surgery (P = 0.02). Conclusions Time to diagnosis, male sex, presence of iris nodules at baseline, and decreased Crv and Cctl ratios were associated with increased likelihood of pejorative IOP evolution over time. Given the aggressiveness of glaucoma in FHC, these results provide interesting insight into what category of patients should need the closest screening.

To investigate the outcome of mitomycin C (MMC)-augmented trabeculectomy with subconjunctival bevacizumab in the management of Fuchs heterochromic iridocyclitis (FHI)-related glaucoma in 1-year follow-up period. This retrospective study included 50 eyes with FHI-related glaucoma those had underwent initial trabeculectomy with MMC (0.2 mg/ml—3 min). Thirty-one of them had single-dose bevacizumab injection (1.25 mg/0.05 ml) into the bleb area just at the end of the surgery, while 19 eyes did not have. The intraocular pressure (IOP) and the mean number of anti-glaucomatous medications were evaluated. The IOP value ≤ 21 mmHg was defined as complete or qualified surgical success in terms of using medical anti-glaucomatous treatment. Bleb height and vascularity were evaluated with Indiana bleb grading system. Paired sample t test, t test, Chi-square and Kolmogorov–Smirnov tests were used for statistical analysis. The preoperative IOP values of bevacizumab and without bevacizumab groups were 32.8 ± 4.5 mmHg and 32.8 ± 4.5 mmHg, respectively, and they decreased to 17.5 ± 4.6 mmHg and 17 ± 5.2 mmHg at the final visit (p

Fuchs' heterochromic iridocyclitis is an atypical form of chronic nongranulomatous anterior uveitis and is almost always unilateral. It presents with cataract, mild anterior chamber reaction, diffuse stellate keratic precipitates, absence of posterior synechiae, iris hypochromia and glaucoma. It is usually bilateral but may be asymmetrical. Unilateral megalocornea has been reported in a case of lamellar icthyosis. Slit lamp evaluation of right eye of a 70 year old revealed diffusely distributed fine, stellate white keratic precipitates, mild anterior chamber reaction and hypermature morgagnian cataract. Examination also revealed large cornea in right eye with normal pachymetry and keratometry values.

Patients with uveitis can present with a spectrum of intraocular pressures (IOPs) ranging from low to high. Using a nationwide database in Taiwan, it was estimated that 8.5 % of patients had glaucoma when uveitis was diagnosed and another 6.7 % developed glaucoma in follow-up (Hwang DK, et al. in J Glaucoma, 2013, [1]. This vision threatening complication of uveitis can occur from a variety of mechanisms. The trabecular meshwork can be the primary site of inflammation as is often seen in herpetic eye disease (Amano et al. in Am J Ophthalmol 127:721–722, 1999, [2]). Secondary obstruction of the trabecular meshwork with inflammatory cells and fibrin represents another open-angle mechanism of elevated IOP exhibited by uveitis patients. There can be pupillary block mechanisms due to 360° of posterior synechiae. With time permanent peripheral anterior synechiae can produce angle closure glaucoma. There can also be uveal effusion syndrome (such as in scleritis) with forward rotation of the iris lens diaphragm. Finally, treatment of uveitis with steroids can induce a secondary open-angle glaucoma. It is important to keep in mind that the proper treatment of uveitis can reverse the outflow pathology if treated early with approaches directed at the root cause of inflammation. Also, in some instances, there may be predisposition to either open-angle glaucoma or angle closure glaucoma independent of the uveitis.

Fuchs heterochromic iridocyclitis (FHI) is type of low-grade chronic uveitis that makes up between 2 and 7 % of all cases of uveitis (Wakefield and Chang in Int Ophthalmol Clin 45(2):1–13, 2005). The majority of cases are unilateral and present with characteristic low-grade, asymptomatic iridocyclitis, iris heterochromia, and diffuse stellate keratic percipitates. While the etiology is unknown, there are several hypotheses linking the disorder to an infectious etiology, such as rubella or toxoplasmosis. Patients typically do not require treatment for their uveitis. The main source of vision loss is from cataracts and secondary glaucoma.

ObjectivesTo characterize the clinical features of Fuchs’ Heterochromic Iridocyclitis in a Saudi population.MethodsRetrospective analysis of the records of the consecutive patients presented to the uveitis clinic, Magrabi Eye and Ear Hospital, Jeddah, Saudi Arabia, between 2001and 2011.ResultsWe enrolled 21 eyes of 19 patients with the diagnosis of Fuch’s Heterochromic Iridocyclitis who completed a minimum of 6months follow up. The mean follow up was 25±13.35 (range 6–48) months. Males predominated (13/19, 68.3%). Majority (17/19, 89.5%) had unilateral presentation. The age at presentation was 36.2±11 (range 18–59) years. 31.6% (6/19) showed heterochromia. All patients (100%) showed fine stellate filamentary keratic precipitates and majority (57.9%) showed mild (

This case series assesses the utility of metagenomic deep sequencing in identifying rubella virus infection in patients with uveitis., Key Points Question What are the ocular findings of patients with the rubella viral genome detected with metagenomic deep sequencing? Findings In this case series study, 6 patients with detectable rubella virus RNA in the intraocular compartment exhibited typical and atypical characteristics of Fuchs heterochromic iridocyclitis. Confocal imaging of the cornea revealed endothelial cell alterations in the affected eyes. Meanings These findings suggest that patients with persistent intraocular rubella virus infection can present with heterogeneous clinical findings, including endothelial cell damage., Importance Metagenomic deep sequencing (MDS) demonstrates that persistent and active rubella virus (RV) infection is associated with Fuchs heterochromic iridocyclitis (FHI). Objective To assess the utility of MDS in identifying RV infection in patients with uveitis. Design, Setting, and Participants This case series assessed 6 patients diagnosed by MDS with RV-associated uveitis at a tertiary uveitis referral center in the United States. Exposures Prior RV infection. Main Outcomes and Measures Clinical examination findings, slitlamp photography, corneal confocal imaging, and infectious pathogen genome obtained from RNA sequencing. Results Six white men (age range, 36-61 years) were diagnosed with RV-associated uveitis by MDS. Three patients exhibited iris heterochromia associated with their uveitis in classic FHI fashion. The other 3 patients had less classic FHI features and exhibited anterior vitritis. Three patients had in vivo corneal confocal microscopy, with 2 demonstrating stellate keratic precipitates in addition to endothelial infiltration, spotlike holes, and enlarged intercellular boundaries. Of these 3 patients, 1 patient exhibited polymorphism and polymegathism of the endothelial cells. Conclusions and Relevance These findings suggest that persistent RV infection is associated with recurrent or chronic anterior or anterior-intermediate uveitis as well as corneal endothelial cell damage. Ophthalmologists should consider RV infection as a potential cause of hypertensive anterior and intermediate uveitis.

WOS: 000321935200006, PubMed ID: 23692885, PURPOSE: To assess the results of phacoemulsification and posterior chamber intraocular lens (PC IOL) implantation in patients with cataract secondary to anterior uveitis. SETTING: Department of Ophthalmology, Ministry of Health, Ankara Training and Research Hospital, Ankara, Turkey. DESIGN: Case series. METHOD: Consecutive patients with anterior uveitis and cataract were prospectively studied for outcomes after phacoemulsification and PC IOL implantation. RESULTS: Fifty-five eyes (48 patients; mean age 44.9 years +/- 15.6 [SD]) were included. Patients were followed for 6 months. The etiology of uveitis was presumed idiopathic anterior uveitis (n = 22), herpes simplex virus associated anterior uveitis (n = 10), Fuchs heterochromic iridocyclitis (n = 10), and anterior uveitis associated with collagen vascular disease (n = 13). Preoperative complications secondary to uveitis included posterior synechiae (12 eyes), glaucoma (26 eyes), and sequelae of cystoid macular edema (CME) (21 eyes). At the final visit, the corrected distance visual acuity (CDVA) was 20/40 or better in 52 eyes (94.5%) and 20/20 in 33 eyes (60.0%). The CDVA was worse than 20/40 in 3 eyes because of preoperative anterior and posterior segment abnormalities. Postoperative complications were CME, recurrent uveitis, and posterior capsule opacity in 7 eyes (12.7%) each; fibrinous anterior chamber reaction in 6 eyes (10.9%); raised intraocular pressure in 4 eyes; peripheral anterior synechiae in 1 eye (1.8%); and hypotony in 1 eye (1.8%). CONCLUSION: Patients with a history of anterior uveitis and cataract having phacoemulsification with PC IOL implantation had excellent visual results with a relatively low complication rate.

To describe the incidence and risk factors for ocular hypertension and/or glaucoma in patients with Fuchs heterochromic iridocyclitis (FHC).Retrospective analysis of 88 patients with FHC. Kaplan-Meier curves estimated the time to develop cataract and ocular hypertension/glaucoma. Possible prognostic factors were investigated in univariate Kaplan-Meier analyses using the Mantel-Cox logrank test.At presentation with FHC, 52% of patients had a cataract and 26% of patients had ocular hypertension/glaucoma. The estimated percentage of patients with a cataract or ocular hypertension/glaucoma by 4 years after presentation was 71% (CI: 58-81%) and 39% (CI: 28-51%), respectively. Patients aged ≥50 years had significantly greater risk of developing glaucoma (p = 0.0065). After adjusting for age-group, having a cataract at presentation was associated with increased risk of glaucoma (p = 0.032).Risk factors for development of ocular hypertension/glaucoma were increasing patient age and having a cataract at presentation with FHC.

PURPOSE To compare the safety and efficacy of phacoemulsification and manual small incision cataract surgery (SICS) to treat cataract in patients with Fuchs heterochromic iridocyclitis (FHI). DESIGN A randomized, double-masked, prospective, multicenter study. METHODS Consecutive patients with cataract after FHI were randomly assigned to have phacoemulsification or manual SICS by 1 of 2 surgeons experienced in both techniques. Complications (intraoperatively and postoperatively), operative time, visual acuities, endothelial cell counts, and surgically induced astigmatism were compared. RESULTS At 6 months, 65 (92.8%) patients in the phacoemulsification group and 70 (92.1%) in the manual SICS group had a corrected distance visual acuity of 20/63 or better (P = 0.974). Surgical time was significantly shorter in the SICS group (11.2 ± 2.4 minutes) than in the phacoemulsification group (14.2 ± 3.1 minutes) (P < 0.001). The mean surgically induced astigmatism was 0.8 ± 0.2 diopters (D) in the phacoemulsification group and 1.16 ± 0.2 D in the SICS group (P < 0.001). Endothelial cell counts at 1 week and at 6 months did not differ significantly in the phacoemulsification and SICS groups (t test; P = 0.133 and P = 0.032, respectively). Intraoperatively, 2 (3%) eyes randomized to receive phacoemulsification and 4 (5.3%) eyes randomized to receive SICS had posterior capsular rent (P = 0.465). CONCLUSIONS Both techniques achieved good visual outcomes with low rates of complications. Manual SICS may be a viable alternative for cataract management in patients with FHI in settings with limited access to phacoemulsification.

Purpose. To study epidemiology, clinical findings and visual prognosis of patients with Fuchs’ Heterochromic Iridocyclitis (FHI).Methods. A retrospective analysis was performed on 158 patients with FHI. Thirty-five patients were observed only once; the remaining 123 had a mean follow-up of 30.7 months (50 of them had a mean follow-up of 63.5 months) and in those we assessed complications, medical and surgical treatment, and long-term visual prognosis.Results. Average age at uveitis diagnosis was 27.2 years and 18.3% of patients were children. Blurred vision (54.5%) and floaters (40.5%) were the most frequent presenting symptoms. Small to medium-sized keratic precipitates (95.6%), iris atrophy (86.8%), and vitreous opacities (91.2%) were the most common signs; the prevalence of cataract and IOP increase was 63.5% and 20.1%, respectively, and their incidence was 0.1 and 0.06 eye/year. Significant risk factor for visual loss was IOP increase at presentation (p=0.02). At final examination 98% of the eye had a visual acuity ≥ 0.6, and topical (p<0.001) and systemic (p<0.001) corticosteroids therapy were used less frequently than before referral.Conclusions. FHI has a good visual prognosis, despite the significant incidence of cataract and glaucoma. A correct and prompt diagnosis might avoid unnecessary therapies and provide excellent visual outcomes.

Purpose: The aim of this study is analyze the Etiology of the Uveitis diagnosed in the first three years of a Uveitis unit in a small hospital and share the experience and organization of a collaborative Rheumatology-Ophthalmology Uveitis Unit. Methods: This study includes 136 patients with Uveitis. Results: The most common form of Uveitis was anterior Uveitis (67.2%) and the most common diagnoses were Ankylosing spondylitis (17.8%), Herpes (14.3%), HLA-B27+ (9.5%), Fuchs Heterochromic Iridocyclitis (3.5%). Posterior Uveitis were 16.8% and the most common diagnoses were toxoplasmosis (42.9%), Serpiginous choroidopathy (23.8%), Tuberculosis (4.8%) and Vogt Koyanagi Harada disease (4.8%). Panuveitis was diagnosed in 8.8% of the cases and the most frequent causes were Behcet's disease (18.8%), Endophthalmitis (9%), and Toxoplasmosis (9%). Intermediate Uveitis with 7.2% of the diagnoses, the most frequent were Sarcoidosis (11%), syphilis (11%), and multiple sclerosis (11%). Conclusion: This secondary center based study shows the difference in type of Uveitis and etiology in a secondary hospital from a tertiary one.

To describe the epidemiology of chronic anterior uveitis (CAU) at a tertiary center over 35 years.Data regarding etiology of CAU was collected from medical records of patients evaluated between 1973-2007. Relative frequencies of each diagnosis of CAU were calculated. Linear regression analyses were performed on the common types of CAU.5970 patients were evaluated between 1973-2007; 31% carried a diagnosis of CAU. Idiopathic disease was diagnosed in 54% of patients (39 to 72% annually), ocular sarcoidosis in 14% of patients (2 to 20% annually), Fuchs heterochromic iridocyclitis (FHI) in 12% of patients (4 to 22% annually), and juvenile idiopathic arthritis (JIA) in 6% of patients (2 to 13% annually). The frequency of diagnosis of idiopathic CAU decreased over time, with no significant change for sarcoidosis, FHI or JIA. An increase in frequency of diagnosis was observed for HLA-B27-related disease and uveitis related to multiple sclerosis and inflammatory bowel disease.The relative frequency of idiopathic disease has decreased over the past 35 years at our center. This may be related to an increase in the diagnosis of CAU associated with HLA-B27 positivity, inflammatory bowel disease (including family history) and multiple sclerosis. Despite the advances over the last 35 years, idiopathic disease still comprises at least 39% of our patients with CAU each year.

Background: The aim of this study was to compare the safety and efficacy of primary trabeculectomy with mitomycin C and Ahmed glaucoma valve (AGV) implantation in patients with Fuchs heterochromic iridocyclitis (FHIC)-related glaucoma, a rare complication of an uncommon form of uveitis. Methods: In this retrospective comparative case series, 26 FHIC-associated glaucoma patients received trabeculectomy (n=12) or an AGV (n=14). Primary outcome measures were surgical success, defined as intraocular pressure (IOP) ≤21 mmHg, decreasing ≥20% from baseline, and no secondary glaucoma surgery. Secondary outcome measures were the number of glaucoma medications, complications, best corrected visual acuity (BCVA), and IOP. Results: The follow-up was 34.0±17.7 months in patients that received trabeculectomy and 33.4±18.6 months in AGV (P= 0.837). The cumulative probability of success rate was 41.7% for trabeculectomy and 85.7% for AGV, with no significant difference in complications (P>0.05). The IOP in patients that received trabeculectomy dropped from 23.4±3.3 mmHg to 21.6±5.2 mmHg at the final visit (P= 0.041). In patients that received AGV, the IOP decreased from 24±7.8 to 17.1±2.6 mmHg (P= 0.003). The number of glaucoma medications at baseline were 3.3±0.5 in those that received trabeculectomy and 3±0.6 in those that received AGV (P=0.233), and decreased to 2.4±1.0 (P=0.008) and 1.7±0.6 (P=0.002), respectively. BCVA was equal in both groups and did not change (P>0.05). Conclusion: Primary AGV had a higher success rate than trabeculectomy, with patients also needing fewer medications for the management of FHIC-associated glaucoma.

PURPOSE To specify confocal scan features of keratic precipitates (KPs) in uveitic eyes of various etiologies. METHODS Confocal scan was performed on 129 eyes of 93 patients with different types of uveitis to characterize the morphologic features of KPs. The study included Fuchs heterochromic iridocyclitis (FHIC) in 50 eyes, idiopathic granulomatous uveitis in 27, herpetic anterior uveitis in 10, pars planitis associated with endotheliitis in 9, Vogt-Koyanagi-Harada syndrome in 8, multiple sclerosis-related uveitis in 7, sarcoidosis in 3, acute anterior uveitis not associated with HLA B27 in 3, acute retinal necrosis in 2, psoriatic uveitis in 2, chronic endophthalmitis in 2, sclerouveitis in 2, HLA B27-associated anterior uveitis in 2, sympathetic ophthalmia in 1, and toxoplasmosis in 1. The differences in types of KPs between various uveitic groups were analyzed. RESULTS Mean age of the patients was 32.5 +/- 11.2 (range, 14-67) years, and 58 (62.36%) were female. Bilateral involvement was observed in 36 cases (38.7%). Stippled and globular KPs were predominantly observed in almost all types of uveitis. With comparing the infectious versus noninfectious uveitis, dendritiform KPs were almost more common in infectious uveitis (P = 0.053) and smooth-rounded KPs were significantly more common in noninfectious uveitis (P = 0.000). Dendritiform KPs were observed more commonly in nongranulomatous uveitis than in the granulomatous ones (P = 0.005). Smooth-rounded KPs were more common in chronic uveitis than in the acute forms (P = 0.000). Predominant morphologies of KPs in FHIC were dendritiform (80.0%) and infiltrating (78.0%). The most commonly observed morphologies of KPs in intermediate uveitis were dendritiform (56.3%) and smooth rounded (56.3%). Cruciform KPs were more frequently seen in cases with FHIC (60.0%). In bilateral cases, the morphologic features were similar. CONCLUSIONS Morphologic features of KPs in various types of uveitis are diverse. Stippled and globular KPs may be observed in almost all types of uveitis. Certain types of KPs are more frequently associated with specific forms of uveitis, that is, smooth-rounded KPs may be an indicative of a granulomatous uveitis and infiltrating and dendritiform in infectious uveitis. Confocal scan may play a potential important role in identification of underlying mechanisms in complex forms of uveitis.