Ocul Immunol Inflamm. 2020 May 28;1-3. doi: 10.1080/09273948.2020.1754433. Epub 2020 May 28.
Atypical Keratic Precipitates in Fuchs Uveitis.
Ocular immunology and inflammation
Mohammad Zarei, Nazanin Ebrahimiadib
Affiliations
Affiliations
- Ophthalmology Department, Retina Service, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
- Ophthalmology Department, Ocular Immunology and Uveitis Foundation, Waltham, Massachusetts, USA.
PMID: 32463307
DOI: 10.1080/09273948.2020.1754433
Abstract
PURPOSE: Here, we report a case of otherwise typical Fuchs uveitis (FU) who presented with atypical keratic precipitates (KPs).
CASE REPORT: A 38 year-old man presented with decreased vision in the right eye. Best corrected visual acuity was 2/10 in the right eye and 10/10 in the left eye. He was known to have advanced glaucoma in the right eye. The presence of KPs, iris smoothness, posterior subcapsular cataract, vitreous cells, as well as imaging characteristics were in complete agreement with the classical picture of FU in this eye. However, KPs varied in size from small to large and had a triangular distribution over the inferior corneal endothelium. A tendency to confluence and pigments were also observed in some KPs. This is in sharp contrast with the description of typical diffuse, small, white, stellate KPs, which has been emphasized as a defining feature of FU in recent publications. To rule out other uveitis entities, a comprehensive laboratory workup was done, as well as a molecular assay on aqueous for common infectious uveitides with the similar clinical picture.
CONCLUSION: Ophthalmologists should be aware that FU can manifest with atypical KPs in a minority of patients to prevent erroneous diagnosis and unnecessary treatments.
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