Escribano López Patricia, González Guijarro Juan Jacobo
Hospital Universitario de La Princesa, C/Diego de Leon, 62, 28006, Madrid, Spain.
Facultad de Medicina, Universidad Autónoma de Madrid, C/Arzobispo Morcillo, 4, 28029, Madrid, Spain.
Graefes Arch Clin Exp Ophthalmol. 2025 Jan 7. doi: 10.1007/s00417-024-06714-4.
To compare iridian Swept-Source Anterior Segment OCT (SS-AS-OCT) and microbiological features in Aqueous Humor (AH) in patients with Fuchs Uveitis Syndrome (FUS) and Posner-Schlossman Syndrome (PSS).
Comparative, retrospective-prospective single center study examining 131 eyes from 66 patients, including 33 eyes with PSS, 37 eyes with FUS, and 61 healthy eyes. AH samples were collected from affected eyes in all patients. Cross-sectional 6 mm SS-AS-OCT B-scans were taken from iris quadrants and analyzed for Stromal Thickness (ST), Smooth Index (SI), and Optical Density (OD) with ImageJ®. Statistical analysis was performed using SPSS®.
Among 32 PSS patients, Cytomegalovirus (CMV) was detected in 21 (65.5%). Of 34 FUS patients, 22 (64.7%) tested positive for Rubella Virus (RV) and one for CMV (2,9%). FUS eyes showed decreased ST compared to PSS ones in the superior (328.2 ± 49.4 vs 352.2 ± 47.4; p = 0.010) and temporal (322.6 ± 54.4 vs 294.3 ± 47.9; p = 0.024) quadrants. FUS eyes had a higher mean SI (p = 0.021), notably in the temporal quadrant (p = 0.002). Both FUS and PSS eyes showed significant differences in all parameters compared to healthy eyes, except for ST and OD in the temporal quadrant in PSS, and OD in the nasal quadrant in FUS. Quantitative analysis of iris OCT images showed that RV-related and non-RV-related FUS eyes were similar, as were CMV-associated and non-CMV-associated PSS eyes.
CMV and RV were found to be the main etiologies of PSS and FUS respectively. Quantitative analysis of iris OCT images has proved to be an objective method to differentiate between these two syndromes.
What is known The etiopathogenesis of Fuchs Uveitis Syndrome (FUS) and Posner-Schlossman Syndrome (PSS) remains under discussion. Viral etiology is the most widely accepted theory: Rubella virus (RV) has been associated mostly with FUS and cytomegalovirus (CMV) with PSS. Although FUS and PSS are distinct conditions, their differential diagnosis can be challenging at times due to clinical similarities, particularly iris damage. What is new The quantitative analysis of iris images from Swept Source Anterior Segment OCT is an objective, reliable, and non-invasive method that allows differentiation between FUS and PSS. In this study, RV in FUS and CMV in PSS have been detected in almost 2/3 of patients. This is the first study to perform a comparative analysis of aqueous humor results between PSS and FUS along with the examination of iris images using SS-AS-OCT.
比较富克斯葡萄膜炎综合征（FUS）和波斯纳-施洛斯曼综合征（PSS）患者的虹膜扫频源眼前节光学相干断层扫描（SS-AS-OCT）和房水（AH）中的微生物学特征。
采用比较性、回顾性-前瞻性单中心研究，对66例患者的131只眼进行检查，其中包括33只患有PSS的眼睛、37只患有FUS的眼睛和61只健康眼睛。收集所有患者患眼的AH样本。从虹膜象限获取6毫米的横断面SS-AS-OCT B扫描图像，并使用ImageJ®分析基质厚度（ST）、平滑指数（SI）和光密度（OD）。使用SPSS®进行统计分析。
在32例PSS患者中，21例（65.5%）检测到巨细胞病毒（CMV）。在34例FUS患者中，22例（64.7%）风疹病毒（RV）检测呈阳性，1例（2.9%）CMV检测呈阳性。与PSS患者的眼睛相比，FUS患者的眼睛在上方象限（328.2±49.4 vs 352.2±47.4；p = 0.010）和颞侧象限（322.�54.4 vs 294.3±47.9；p = 0.024）的ST降低。FUS患者的眼睛平均SI较高（p = 0.021），尤其是在颞侧象限（p = 0.002）。与健康眼睛相比，FUS和PSS患者的眼睛在所有参数上均表现出显著差异，但PSS患者颞侧象限的ST和OD以及FUS患者鼻侧象限的OD除外。虹膜OCT图像的定量分析表明，与RV相关和不相关的FUS患者的眼睛相似，与CMV相关和不相关的PSS患者的眼睛也相似。
发现CMV和RV分别是PSS和FUS的主要病因。虹膜OCT图像的定量分析已被证明是区分这两种综合征的客观方法。
已知内容：富克斯葡萄膜炎综合征（FUS）和波斯纳-施洛斯曼综合征（PSS）的发病机制仍在讨论中。病毒病因是最被广泛接受的理论：风疹病毒（RV）主要与FUS相关，巨细胞病毒（CMV）与PSS相关。尽管FUS和PSS是不同的病症，但由于临床相似性，尤其是虹膜损伤，它们的鉴别诊断有时可能具有挑战性。新内容：扫频源眼前节OCT虹膜图像的定量分析是一种客观、可靠且无创的方法，可用于区分FUS和PSS。在本研究中，近2/3的FUS患者检测到RV，PSS患者检测到CMV。这是第一项对PSS和FUS的房水结果进行比较分析，并使用SS-AS-OCT检查虹膜图像的研究。
