In vivo analysis and comparison of anterior segment structures of both eyes in unilateral Fuchs' uveitis syndrome

Abstract

Purpose: To compare corneal endothelial cell density (ECD), iris stromal thickness (IST), iris pigment epithelium optical density (IPE OD), and Schlemm's canal (SC) measurements in patients having unilateral Fuchs' uveitis syndrome (FUS).

Methods: This is a randomized, prospective study. Currently, diagnosed unilateral FUS and phakic cases were defined to be the inclusion criteria to the study. The specular microscope was used to measure ECD. Anterior segment images were acquired by using SD-OCT. The images were extracted and uploaded to the ImageJ program for further analysis. Two blinded investigators analyzed the IST, IPE OD, and SC area in both healthy (N) and affected eyes (FUS) and the comparative analysis was made by using SPSS program.

Results: Of twenty-one participants, 13 were female (62%). The mean age of the participants was 30 ± 9 (18-47) years. ECD was 2228 ± 365 and 2513 ± 209 cells/mm² in the FUS and N, respectively (p < 0,001). In FUS, the mean nasal and temporal (n-t) IST was measured as 380 ± 44 and 347 ± 41 μm, compared to 393 ± 61 and 355 ± 62 μm in N, respectively (p = 0.3 and p = 0.4 respectively). The mean n-t IPE OD was measured as 1110 ± 499 and 937 ± 370 in FUS, compared to 1147 ± 528 and 1267 ± 428 in N, respectively (p = 0.008 temporal). The mean n-t SC area was measured as 5479 ± 1951 and 5624 ± 2722 μm² in FUS, compared to 5736 ± 2574 and 5633 ± 1835 μm² in N, respectively (p = 0.9 and p = 0.7 respectively).

Conclusion: Decreased ECD in FUS may lead to serious complications after cataract surgery. Temporal IPE depigmentation occurs prior to the nasal side in FUS.

Keywords: Anterior segment spectral domain optical coherence tomography; Corneal endothelium cell density; Fuchs’ uveitis syndrome; Iris pigment epithelium; Iris stromal thickness; Schlemms’ canal.