Classification Criteria for Fuchs Uveitis Syndrome

Abstract

Purpose: To determine classification criteria for Fuchs' uveitis syndrome.

Design: Machine learning of cases with Fuchs' uveitis syndrome and 8 other anterior uveitides.

Methods: Cases of anterior uveitides were collected in an informatics-designed preliminary database, and a final database was constructed of cases achieving supermajority agreement on the diagnosis, using formal consensus techniques. Cases were split into a training set and a validation set. Machine learning using multinomial logistic regression was used on the training set to determine a parsimonious set of criteria that minimized the misclassification rate among the anterior uveitides. The resulting criteria were evaluated on the validation set.

Results: One thousand eighty-three cases of anterior uveitides, including 146 cases of Fuchs' uveitis syndrome, were evaluated by machine learning. The overall accuracy for anterior uveitides was 97.5% in the training set and 96.7% in the validation set (95% confidence interval 92.4, 98.6). Key criteria for Fuchs' uveitis syndrome included unilateral anterior uveitis with or without vitritis and either: 1) heterochromia or 2) unilateral diffuse iris atrophy and stellate keratic precipitates. The misclassification rates for Fuchs' uveitis syndrome were 4.7% in the training set and 5.5% in the validation set, respectively.

Conclusions: The criteria for Fuchs' uveitis syndrome had a low misclassification rate and appeared to perform well enough for use in clinical and translational research.

Figure 1.

Iris heterochromia in a patient with Fuchs uveitis syndrome.

Figure 2.

Stellate keratic precipitates in a patient with Fuchs uveitis syndrome.