Adilovic Melita, Kalabic Majda, Cabric Arnes, Becirovic Darija
Polyclinic with daily hospital Doboj jug, Doboj Jug, BiH.
General hospital Tešanj.
Acta Inform Med. 2022 Jun;30(2):129-132. doi: 10.5455/aim.2022.30.129-132.
Fuchs heterochromic iridocyclitis is a chronic, unilateral iridocyclitis characterized by iris heterochromia. The gradual progression of the disease leads to the development of cataracts, glaucoma, and, occasionally, vitreous infiltration. The trigger for inflammation of the iris and ciliary body is still unknown. There are several as yet unconfirmed theories about the mechanism of occurrence, including Toxoplasma gondii infection, immune dysfunction, infiltration of sensitized lymphocytes, and chronic herpes virus infection.
The aim of this article is to present a case of Fuchs heterochromic iridocyclitis with complications in form of glaucoma and dense cataract in a female patient during a standard ophthalmologic exam in our clinic. The next aim is to show a proper algorithm of treatment in form of carbonic anhydrase inhibitors antiglaucoma medication, cataract surgery with implantation of the intraocular lens, yag laser capsulothomy.
A 55-year-old patient reports to our clinic for an examination. She was informed 7 years ago by her ophthalmologist that her lack of vision in the right eye is irreparable. Ophthalmological examination as well as a positive TORCH test (elevation of IgG for toxoplasma gondii) lead to a diagnosis of Fuchs heterochromic iridocyclitis with complications of glaucoma and dense cataract. Antiglaucoma drops are prescribed, PHACO surgery is performed on the right eye with implantation of the intraocular lens, and yag laser capsulotomy in the follow ups. There was a significant improvement of the visual acuity from light sensation with uncertain projection of the same on the right eye, to 0,5-0,6 Snellen scale. We also educated the patient of her disease as well as the importance of her treatment and follow up consultations.
Due to the insidious nature of this condition, along with a mild chronic course, most patients with FHI are not aware of the subtle changes that occur in their eyes. One of the most serious complications of FHI is secondary glaucoma, which can cause permanent vision loss in patients. The main cause of poor vision in patients with FHI is caused by cataract formation, with a prevalence of 23% to 90.7%. We placed special emphasis on educating the patient about her condition and the long-term and importance of regular check-ups to prevent possible recurrent or new complications.
富克斯异色性虹膜睫状体炎是一种慢性、单侧性虹膜睫状体炎，其特征为虹膜异色。疾病的逐渐进展会导致白内障、青光眼的发生，偶尔还会出现玻璃体浸润。虹膜和睫状体炎症的触发因素仍不明确。关于其发病机制有几种尚未得到证实的理论，包括弓形虫感染、免疫功能障碍、致敏淋巴细胞浸润以及慢性疱疹病毒感染。
本文旨在介绍在我们诊所的一次标准眼科检查中，一名女性患者出现富克斯异色性虹膜睫状体炎并伴有青光眼和致密性白内障并发症的病例。另一个目的是以碳酸酐酶抑制剂抗青光眼药物、人工晶状体植入白内障手术、钇铝石榴石激光晶状体囊切开术的形式展示适当的治疗方案。
一名55岁患者前来我们诊所进行检查。7年前她的眼科医生告知她右眼视力无法恢复。眼科检查以及TORCH试验阳性（弓形虫IgG升高）导致诊断为富克斯异色性虹膜睫状体炎并伴有青光眼和致密性白内障并发症。开具了抗青光眼滴眼液，右眼进行了超声乳化白内障吸除术并植入人工晶状体，后续进行了钇铝石榴石激光晶状体囊切开术。右眼视力从仅有光感且投影不确定显著提高到Snellen视力表0.5 - 0.6。我们还向患者介绍了她的病情以及治疗和后续会诊的重要性。
由于这种疾病隐匿的性质以及轻度慢性病程，大多数富克斯异色性虹膜睫状体炎患者并未意识到其眼睛中发生的细微变化。富克斯异色性虹膜睫状体炎最严重的并发症之一是继发性青光眼，这可能导致患者永久性视力丧失。富克斯异色性虹膜睫状体炎患者视力不佳的主要原因是白内障形成，其患病率为23%至90.7%。我们特别强调向患者介绍她的病情以及定期检查对于预防可能的复发或新并发症具有的长期重要性。
