Abstract
AIMS/BACKGROUND--The aetiology of Fuchs' heterochromic uveitis (FHU) is unknown although it can occur in combination with a number of different ocular conditions. Five patients with FHU who show an association with sarcoidosis were studied. METHODS--Four patients with clinical signs compatible with FHU who had elevated serum angiotensin converting enzyme levels (sACE), and a fifth case with a normal sACE and a positive Kveim test were described. RESULTS--All five cases had iris nodules, two later developed mutton fat keratic precipitates, and one had peripheral retinal periphlebitis. Of the four cases with elevated sACE, one had respiratory function test abnormalities and an abnormal chest x ray compatible with pulmonary sarcoidosis. Another had a chorioretinal scar and developed intermediate uveitis 2 years after presentation. CONCLUSIONS--In all of these cases a diagnosis of FHU may represent a specific secondary ocular response to sarcoidosis rather than a primary idiopathic uveitis syndrome. Although FHU remains a clinical diagnosis, routine uveitis investigations should still be performed in this group of patients.
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Selected References
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- Baarsma G. S., La Hey E., Glasius E., de Vries J., Kijlstra A. The predictive value of serum angiotensin converting enzyme and lysozyme levels in the diagnosis of ocular sarcoidosis. Am J Ophthalmol. 1987 Sep 15;104(3):211–217. doi: 10.1016/0002-9394(87)90406-5. [DOI] [PubMed] [Google Scholar]
- Jones N. P. Fuchs' heterochromic uveitis: an update. Surv Ophthalmol. 1993 Jan-Feb;37(4):253–272. doi: 10.1016/0039-6257(93)90009-v. [DOI] [PubMed] [Google Scholar]
- La Hey E., Baarsma G. S. Fuchs' heterochromic cyclitis and retinal vascular abnormalities in progressive hemifacial atrophy. Eye (Lond) 1993;7(Pt 3):426–428. doi: 10.1038/eye.1993.84. [DOI] [PubMed] [Google Scholar]
- La Hey E., de Jong P. T., Kijlstra A. Fuchs' heterochromic cyclitis: review of the literature on the pathogenetic mechanisms. Br J Ophthalmol. 1994 Apr;78(4):307–312. doi: 10.1136/bjo.78.4.307. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Murray P. I. Fuchs' heterochromic cyclitis: an immunological disease or an immunological response? Int Ophthalmol. 1994;18(5):313–314. doi: 10.1007/BF00917836. [DOI] [PubMed] [Google Scholar]
- Murray P. I., Hoekzema R., van Haren M. A., de Hon F. D., Kijlstra A. Aqueous humor interleukin-6 levels in uveitis. Invest Ophthalmol Vis Sci. 1990 May;31(5):917–920. [PubMed] [Google Scholar]
- Regenbogen L. S., Naveh-Floman N. Glaucoma in Fuchs' heterochromic cyclitis associated with congenital Horner's syndrome. Br J Ophthalmol. 1987 Nov;71(11):844–849. doi: 10.1136/bjo.71.11.844. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Rothova A., La Hey E., Baarsma G. S., Breebaart A. C. Iris nodules in Fuchs' heterochromic uveitis. Am J Ophthalmol. 1994 Sep 15;118(3):338–342. doi: 10.1016/s0002-9394(14)72958-7. [DOI] [PubMed] [Google Scholar]
- Saraux H., Laroche L., Le Hoang P. Secondary Fuchs's heterochromic cyclitis: a new approach to an old disease. Ophthalmologica. 1985;190(4):193–198. doi: 10.1159/000309517. [DOI] [PubMed] [Google Scholar]
- Toledo de Abreu M., Belfort R., Jr, Hirata P. S. Fuchs' heterochromic cyclitis and ocular toxoplasmosis. Am J Ophthalmol. 1982 Jun;93(6):739–744. doi: 10.1016/0002-9394(82)90470-6. [DOI] [PubMed] [Google Scholar]
- Vuorre I., Saari M., Tiilikainen A., Rasanen O. Fuchs' heterochromic cyclitis associated with retinitis pigmentosa: a family study. Can J Ophthalmol. 1979 Jan;14(1):10–16. [PubMed] [Google Scholar]
- Weinreb R. N., Kimura S. J. Uveitis associated with sarcoidosis and angiotensin converting enzyme. Am J Ophthalmol. 1980 Feb;89(2):180–185. doi: 10.1016/0002-9394(80)90109-9. [DOI] [PubMed] [Google Scholar]