Clinical features and treatment results of Fuchs uveitis syndrome

PURPOSE: The study aims to evaluate the clinical features and treatment results of patients with Fuchs uveitis syndrome (FUS).
METHODS: A retrospective chart review was carried out for all the FUS patients who were treated and followed up at the Uvea Unit of our clinic between 2008 and 2019. Demographic data of all patients and best corrected visual acuity (BCVA), intraocular pressure (IOP) values, anterior and posterior segment examination findings at the time of diagnosis, and the complications along with medical and surgical treatments were analyzed.
RESULTS: The mean age of 56 patients included in the study was 40.19±9.69 (20–66) years and the mean follow-up period was 25.91±33.86 (1–154) months. The mean BCVA was 0.43±0.73 (0–3.1) LogMAR, and the mean IOP value was 17.75±9.64 (8–52) mmHg. At the time of admission, 19.6% patients were under systemic immunosuppressive treatment with corticosteroid and/or immunomodulator agents. The most common presenting symptoms were visual disturbance and blurriness (39.2%). Moreover, the most common complications were cataracts (53.5%) and IOP elevation (26.7%). Phacoemulsification was performed in 50% of eyes with cataracts, and BCVA showed a statistically significant increase postoperatively (p<0.0001). While pressure could be controlled with medical treatment in 73.3% of eyes with high IOP, 26.7% of eyes required glaucoma surgery. BCVA was found <2.10 logMAR in 20% eyes with glaucoma at the last visit.
CONCLUSION: In eyes with FUS, the most common presenting symptom was visual loss and blurriness and the most common complications were cataract and IOP elevation. While the surgical treatment of cataracts can be successfully performed, blindness may develop in eyes with glaucoma despite treatment. Therefore, early diagnosis is essential to prevent unnecessary steroid use in these cases.