Session Title: Quick Fire Free Paper 4
Session Date/Time: Sunday 14/09/2014 | 08:00-10:00
Paper Time: 08:35
Venue: Boulevard B
First Author: : S.Mahmood UK
Co Author(s): : B. Arya M. Westcott C. Pavesio
Purpose: To describe our experience that disc hyperfluorescence can be used as a diagnostic tool for Fuchs’ heterochromic uveitis and also to identify the possible cause for disc hyperfluorescence.
Setting: Retrospective non comparative case series
Methods: Eight patients with presumed Fuchs’ heterochromic uveitis were included. All patients were assessed by a uveitis specialist. A complete ocular examination was performed including; Snellen visual acuity, slit-lamp biomicroscopy, applanation tonometry, dilated funduscopy, fundus fluorescein angiography where optic disc hyperfluorescence was anonymously graded from 1 to 3 and spectral-domain optical coherence tomography for optic nerve head.
Results: There were 4 males and 4 female patients, and the mean age at diagnosis was 41.7 years. The most common ocular symptom was floaters (5/9). The range of initial visual acuity was 6/5-6/12. The most frequent clinical sign was inflammatory cells in the anterior chamber (9/9). Iris nodules were noticed on the pupillary margin in 2 eyes (Koeppe) and on the iris stroma in further 2 (Busacca). Fundal examination was unremarkable in 6/9. Fundus fluorescein angiography showed disc hyperfluorescence in all but one patient. Mild mid-peripheral retinal vascular leakage was present in only one eye. Cystoid macular oedema was not noticed in any of the population sample. Optical coherence tomography did not show any evidence of vitreopapillary traction in all cases.
Conclusion: We thing that the high frequency of disc hyperfluorescence on fundus fluorescein angiography is an indication of inflammatory process rather than mechanical, as it is part of the inflammatory process that happened in Fuchs’ heterochromic uveitis.