Researchers are offering a new set of diagnostic criteria for Fuchs uveitis, and a study published in the British Journal of Ophthalmology, shows the effect the protocal can have. . While it was developed for Chinese patients, investigators believe that the criteria may be applied in other ethnic populations.
According to researchers, Fuchs uveitis syndrome is frequently misdiagnosed. This is partly due to the lack of internationally recognized diagnostic criteria.
One of the key signs of Fuchs uveitis in White patients is heterochromia, according to the researchers. However, this sign is not typically observed in patients with Fuchs from Asian or Black populations, since these ethnicities typically have a dense melanin concentration in their irises. Although the prognosis for patients with Fuchs uveitis is generally good, an incorrect diagnosis may lead to unnecessary therapy and accelerate the onset of cataracts and secondary glaucoma.
To develop and evaluate a set of revised diagnostic criteria for Fuchs uveitis, investigators analyzed clinical data of Chinese patients with Fuchs’ uveitis and patients without the disease. A total of 593 patients from northern China with Fuchs’ uveitis and 625 patients without it were included in the study to develop diagnostic criteria. Then, 377 patients from southern China with Fuchs uveitis and 503 patients without the disease were used to validate the criteria. Clinical symptoms and ocular signs were collected from all patients.
Researchers noted 3 essential key criteria for diagnosing patients with Fuchs uveitis: diffuse iris depigmentation, absence of posterior synechiae, and mild inflammation in the anterior chamber. Five additional associated criteria were also observed: mostly unilateral involvement, cataract, vitreous opacities, absence of acute symptoms, and characteristic iris nodules. All essential findings were required for Fuchs’ uveitis diagnosis, and the presence of associated findings further strengthened the diagnosis.
Limitations of the study included that the findings may not be generalized to other heavily iris-pigmented populations and the lack of strong consensus among uveitis specialists regarding diagnosis.
Yang P, Zhang W, Chen Z, et al. Development of revised diagnostic criteria for Fuchs’ uveitis syndrome in a Chinese population. Br J Ophthalmol. Published online June 9, 2021. doi:10.1136/bjophthalmol-2021-319343