CLINICAL AND HISTOPATHOLOGICAL FEATURES I N FUCHS HETEROCHROMIC CYCLITIS

Background Despite the fact that in 1906 Fuchs described the first cas e of Fuchs' heterochromic cyclitis histopathologic reports of this die sease are still rare. Patient and methods A clinicopathologic correlat ion of findings in Fuchs' heterochromic cyclitis is presented. In a pa tient with a history of Fuchs' heterochromic cyclitis for 15 rears a s econdary open-angle glaucoma developed. Several operations were perfor med including intracapsular cataract extraction, goniotrephanation (El liot) and repeated cyclocryotherapy. The eye finally had to be enuclea ted because of a painful absolute glaucoma. Results Clinical hallmarks of Fuchs' heterochromic cyclitis in this patient include cataract for mation and secondary open-angle glaucoma. Histology revealed accumulat ions of mononuclear cells on the surface of the iris and the corneal e ndothelium, as well as sparse inflammatory cells within the anterior c hamber. The trabecular meshwork showed an infiltration of mononuclear inflammatory cells, chiefly lymphocytes and plasma cells. Discussion A ccumulations of mononuclear cells on the surface of the iris, which hi stopathologically have not been described before, could represent the clinicopathologic correlate of Koeppe and Busacca nodules. Histologica lly, the cell deposits on the iris were similar to those in the anteri or chamber and to larger corneal precipitates. It is supposed that the cells, which originally emigrated from the iris vessels, may form pri mary cell deposits on the iris surface or endothelium. Such iris preci pitates may also be secondarily attracted by the endothelium in whole. An autoimmune-reaction against the corneal endothelium may be the und erlying reason.