P 420
Diagnostic delay in Fuchs heterochromic iridocyclitis
A. Heiland, H. Wenkel
Introduction: Fuchs heterochromic iridocyclitis
is characterized by a strictly unilateral iridocyclitis with heterochromia and a high incidence of secondary open-angle glaucoma and cataracta formation. We wanted to evaluate primary clinical symptoms and potential diagnostic problems in Fuchs heterochromic iridocyclitis.Patients and Methods: In a retrospective fashion we re-evaluated 34 patients with the clinical diagnosis of Fuchs heterochromic iridocyclitis between 1995 and 1999. Special interest was focused on primary clinical symptoms and the interval between first symptom and diagnosis.
Results: There were 14 female and 20 male patients with an average age of 41 years (14 to 74 years). The median duration of clinical symptoms prior to diagnosis of Fuchs heterochromic iridocyclitis was 4.5 years (1 day to 44 years). Reported first clinical symptoms were decreased visual acuity (22/35), ocular inflammation (6/35), blurred vision (4/35), pain (1/35), and rise in intraocular pressure (1/35). 14 patients required treatment for glaucoma and 28 underwent cataract surgery.
Conclusion: Fuchs heterochromic iridocyclitis should be primarily considered in patients with unilateral iridocyclitis presenting with scattered small retrocorneal precipitates but without posterior synechiae. A long-lasting often unnecessary antiinflammatory treatment might be avoided.
Department of Ophthalmology, University Erlangen-Nürnberg, Schwabachanlage 6, D-91054 Erlangen