Küchle M, Nguyen N X
Augenklinik mit Poliklinik, Universität Erlangen-Nürnberg.
Klin Monbl Augenheilkd. 2000 Sep;217(3):159-62. doi: 10.1055/s-2000-10339.
Fuchs' heterochromic uveitis is characterized by low-grade intraocular inflammation and a relatively benign clinical course. It was the aim of this study to quantitatively determine alterations of the blood-aqueous barrier in this disease by measuring the aqueous flare.
31 affected eyes of 31 patients with the characteristic clinical picture of Fuchs' heterochromic uveitis, 31 apparently unaffected contralateral eyes, and 120 age and sex-matched normal control eyes were included in this retrospective study. Five of the eyes with Fuchs' heterochromic uveitis showed signs of secondary open-angle glaucoma. Determination of aqueous flare was performed in all eyes using the laser flare-cell meter FC-1000 (Kowa, Japan) after pupillary dilation.
Aqueous flare values were moderately but significantly increased in eyes with Fuchs' heterochromic uveitis (mean 12.1 +/- 3.6 photon counts/ms) in comparison to normal control eyes (4.1 +/- 1.3 photon counts/ms, p < 0.001). Flare values of apparently unaffected contralateral eyes (mean 3.9 +/- 1.1 photon counts/ms) did not differ from normal control eyes (p = 0.5). In the group of eyes with Fuchs' heterochromic uveitis, aqueous flare was comparable in eyes with and without secondary open angle glaucoma (11.9 +/- 2.5 versus 12.1 +/- 3.8 photon counts/ms, p = 0.9).
The alteration of the blood-aqueous barrier in patients with Fuchs' heterochromic uveitis is unilateral and relatively mild, corresponding to the well-known clinical picture of the disease. Secondary open-angle glaucoma appears not to be associated with additional increase of aqueous flare. The unilaterality and the relatively homogeneous distribution of the degree of increased aqueous flare values support the clinical impression that Fuchs' heterochromic uveitis is a distinct clinical entity that should be differentiated from other variants of chronic anterior uveitis.
富克斯异色性葡萄膜炎的特征为低度眼内炎症和相对良性的临床病程。本研究的目的是通过测量房水闪光来定量确定该疾病中血-房水屏障的改变。
本回顾性研究纳入了31例具有富克斯异色性葡萄膜炎特征性临床表现的患者的31只患眼、31只明显未受影响的对侧眼以及120只年龄和性别匹配的正常对照眼。5只患有富克斯异色性葡萄膜炎的眼睛出现了继发性开角型青光眼的体征。在所有眼睛散瞳后，使用激光闪光细胞仪FC - 1000（日本兴和）测定房水闪光。
与正常对照眼（4.1±1.3光子计数/毫秒）相比，富克斯异色性葡萄膜炎患眼的房水闪光值中度但显著升高（平均12.1±3.6光子计数/毫秒，p < 0.001）。明显未受影响的对侧眼的闪光值（平均3.9±1.1光子计数/毫秒）与正常对照眼无差异（p = 0.5）。在富克斯异色性葡萄膜炎患眼组中，有继发性开角型青光眼和无继发性开角型青光眼的患眼的房水闪光相当（11.9±2.5对12.1±3.8光子计数/毫秒，p = 0.9）。
富克斯异色性葡萄膜炎患者的血-房水屏障改变是单侧且相对轻微的，与该疾病众所周知的临床表现相符。继发性开角型青光眼似乎与房水闪光的额外增加无关。房水闪光值升高程度的单侧性和相对均匀分布支持了临床印象，即富克斯异色性葡萄膜炎是一种独特的临床实体，应与慢性前葡萄膜炎的其他变体相鉴别。
