Atypical Keratic Precipitates in Fuchs Uveitis

ABSTRACT

Purpose: Here, we report a case of otherwise typical Fuchs uveitis (FU) who presented with atypical keratic precipitates (KPs).

Case report: A 38 year-old man presented with decreased vision in the right eye. Best corrected visual acuity was 2/10 in the right eye and 10/10 in the left eye. He was known to have advanced glaucoma in the right eye. The presence of KPs, iris smoothness, posterior subcapsular cataract, vitreous cells, as well as imaging characteristics were in complete agreement with the classical picture of FU in this eye. However, KPs varied in size from small to large and had a triangular distribution over the inferior corneal endothelium. A tendency to confluence and pigments were also observed in some KPs. This is in sharp contrast with the description of typical diffuse, small, white, stellate KPs, which has been emphasized as a defining feature of FU in recent publications. To rule out other uveitis entities, a comprehensive laboratory workup was done, as well as a molecular assay on aqueous for common infectious uveitides with the similar clinical picture.

Conclusion: Ophthalmologists should be aware that FU can manifest with atypical KPs in a minority of patients to prevent erroneous diagnosis and unnecessary treatments.

Additional information

Funding

There is no financial interest to disclose.