Clinical features of Chinese patients with Fuchs' syndrome.

PURPOSE

To characterize the clinical features of Chinese patients with Fuchs' syndrome.

DESIGN

Retrospective noncomparative case series.

PARTICIPANTS

One hundred eighteen eyes of 104 consecutive patients with Fuchs' syndrome initially examined between January 1999 and March 2005.

METHODS

The history and clinical findings of all consecutive Fuchs' patients attending the Zhongshan Ophthalmic Center were reviewed. Auxiliary examinations, including laser flare-cell photometry, ultrasound biomicroscopy (UBM), fundus fluorescein angiography (FFA), and serologic tests for Toxoplasma gondii, were performed in certain cases.

MAIN OUTCOME MEASURES

Patients' demographics, clinical presentation, and auxiliary examination findings.

RESULTS

One hundred four patients (49 male, 55 female) were included in this study. Unilateral involvement was noted in 90 patients (86.5%). The most common symptom was blurred or decreased vision (86%). Stellate and medium-sized keratic precipitates (KPs) were noted in 108 eyes (91.5%). A mild anterior chamber (AC) reaction was observed in all the affected eyes. Heterochromia was observed in only 15 affected eyes, although there were varying degrees of iris depigmentation in all patients. Iris nodules, mostly Koeppe, were present in 28.0% of the affected eyes. Complicated cataract, vitreous opacity, and secondary glaucoma were observed in 84 of 118 eyes (70.7%), 31 eyes of 42 eyes (73.8%), and 24 of 118 eyes (23.1%), respectively. The mean laser flare photometry value (6.4+/-2.3 photon counts per millisecond) and the cell number in the AC (1.5+/-1.2 cells per 0.5 mm3) in 25 patients were both significantly higher than those in 25 healthy controls (5.3+/-2.3 photon counts per millisecond and 0.8+/-0.6 cells per 0.5 mm3) (P<0.05). Ultrasound biomicroscopy revealed exudates adjacent to the ciliary body in 18 of 24 patients (75%). Serological tests failed to confirm an association of Fuchs' syndrome with toxoplasmosis. Retinal capillary leakage in the midperipheral fundus and disc staining at the late stage were observed in most of the eyes examined by FFA.

CONCLUSION

Fuchs' syndrome in Chinese patients is characterized by a mild uveitis with characteristic KPs, varying degrees of iris depigmentation, and, occasionally, heterochromia. Exudates adjacent to the ciliary body and subclinical retinal and optic nerve involvement were common in the patients who were studied by UBM and FFA.