CILIARY BODY ENLARGEMENT AND CYST FORMATION IN UVEITIS

Background-Acute anterior uveitis has diverse causes and systemic asso ciations. Inflammation is predominantly localised to the iris and pars plicata. Little is known about the in vivo effects of uveitis on cili ary body anatomy. Methods-Bilateral, high frequency, high resolution, ultrasound biomicroscopy was performed on consecutive patients with un ilateral anterior uveitis to evaluate ciliary body anatomy. Imaging wa s repeated when possible during the clinical course. The cross section al area of the anterior ciliary body was measured using image processi ng and analysis software. Measurements from the uveitic eyes were comp ared with the fellow eyes and the effect of treatment was evaluated. R esults-Fourteen patients were enrolled. Ultrasound biomicroscopy demon strated a larger ciliary body cross sectional area in the uveitic eyes compared with the fellow, clinically uninvolved eyes (2.45 (SD 0.48) mm(2) versus 1.55 (SD 0.15) mm(2), (p = 0.0000; paired t test)). A cil iochoroidal effusion was present in one uveitic eye. Epithelial cysts were imaged bilaterally in four uveitic patients (29%) and unilaterall y in unaffected eyes of two uveitic patients. Ciliary body cross secti onal area decreased following steroid therapy (p 0.0001; paired t test ). New cysts were noted in three uveitic eyes during the follow up per iod and in none of the fellow, unaffected eyes. Conclusion-Ultrasound biomicroscopy offers a new approach to the evaluation of anterior uvei tis. The response to treatment can be evaluated objectively and therap eutic efficacy can be more easily assessed. It has the potential to he lp elucidate the pathophysiology and anatomical changes of this hetero geneous group of disorders.