Labbé A, Dupas B, Offret H, Baudouin C, Labetoulle M
Department of Ophthalmology, Quinze-Vingts National Ophthalmology Hospital, Paris, France.
Br J Ophthalmol. 2009 May;93(5):673-7. doi: 10.1136/bjo.2008.146100. Epub 2008 Dec 17.
To analyse keratic precipitates in Fuchs' heterochromic cyclitis (FHC) by in-vivo confocal microscopy (IVCM).
A retrospective chart review of 13 consecutive patients with FHC was conducted. Data collection included medical and ophthalmological history, age, age at diagnosis, gender, detailed slit-lamp examination and IVCM images. The IVCM characteristics of keratic precipitates and of the endothelium were analysed.
Large hyperreflective deposits corresponding to keratic precipitates were observed on the endothelium of all FHC eyes and showed a great consistency among the different patients. These infiltrating keratic precipitates had a dendritic shape, with a small central core with numerous thin pseudopodia sometimes making connection between different keratic precipitates. The mean density of these keratic precipitates was 16.01/mm(2) (SD 6.54). The mean size of the largest dimension of these keratic precipitates was 127.31 microm (SD 41.49; range 66.16-201.4 microm). Hyporeflective round defects were observed at the level of the endothelium at contact or in the close vicinity of keratic precipitates or smaller hyperreflective deposits. All contralateral (non-affected eyes) had no keratic precipitates nor endothelial abnormalities.
By providing high resolution images of corneal endothelium and keratic precipitates, IVCM could help the diagnosis and understanding of complex forms of intraocular inflammation such as FHC.
通过活体共聚焦显微镜（IVCM）分析Fuchs异色性睫状体炎（FHC）中的角膜后沉着物。
对13例连续的FHC患者进行回顾性病历审查。数据收集包括病史和眼科病史、年龄、诊断时年龄、性别、详细的裂隙灯检查和IVCM图像。分析角膜后沉着物和内皮的IVCM特征。
在所有FHC患眼中，在内皮上观察到与角膜后沉着物相对应的大的高反射沉积物，并且在不同患者之间显示出高度一致性。这些浸润性角膜后沉着物呈树枝状，有一个小的中央核心，有许多细伪足，有时在不同的角膜后沉着物之间建立连接。这些角膜后沉着物的平均密度为16.01/mm²（标准差6.54）。这些角膜后沉着物最大尺寸的平均大小为127.31微米（标准差41.49；范围66.16 - 201.4微米）。在内皮接触角膜后沉着物处或其附近或较小的高反射沉积物处观察到低反射圆形缺损。所有对侧（未受影响的眼睛）均无角膜后沉着物及内皮异常。
通过提供角膜内皮和角膜后沉着物的高分辨率图像，IVCM有助于诊断和理解诸如FHC等复杂形式的眼内炎症。
