Ultra-widefield fundus fluorescein angiography findings in patients with Fuchs' uveitis syndrome

Document Type : Original Article


Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran


Background: The aim of this study was to evaluate ultra-widefield (UWF) fundus fluorescein angiography (FFA) findings in patients with Fuchs' uveitis syndrome (FUS). Materials and Methods: This cross-sectional study was conducted in patients with FUS. All the patients underwent a complete ophthalmologic examination, and FFA was carried out with Optos UWF retinal imaging. Standard FFA and image acquisition consisted of early phase (15–45 s) images, and late-phase (5–10 min) images were also obtained for both eyes. Results: Forty eyes from twenty unilateral FUS patients, including 11 females (55%), who had a mean age of 38.50 ± 6.97 years, were enrolled. Eighty-five percent of the FUS eyes had optic disc hyperfluorescence (ODH) in the FFA. A significant relationship was observed between ODH and iris heterochromia (P = 0.004). ODH was seen in all the patients with iris heterochromia (n = 16). Peripheral vascular leakage (PVL), capillary nonperfusion, chorioretinal scar, and vascular sheathing were observed in 3, 3, 2, and 8 of the patients' eyes, respectively. Conclusion: UWF FFA imaging seemed to be mandatory for evaluating the prognosis of the FUS patients, and another investigation may require to be conducted to evaluate the effect of antivascular endothelial growth factor agents for the management of PVL in these patients.


Kardes E, Sezgin Akçay BI, Unlu C, Ergin A. Choroidal thickness in eyes with Fuchs uveitis syndrome. Ocul Immunol Inflamm 2017;25:259-66.  Back to cited text no. 1
Aziz S, Arya B, Westcott M, Pavesio C. An investigation of the disc hyperfluorescence in Fuchs uveitis syndrome using optical coherence tomography imaging. Ocul Immunol Inflamm 2015;23:152-6.  Back to cited text no. 2
Bouchenaki N, Herbort CP. Fluorescein angiographic findings and clinical features in Fuchs' uveitis. Int Ophthalmol 2010;30:511-9.  Back to cited text no. 3
Yang P, Fang W, Jin H, Li B, Chen X, Kijlstra A. Clinical features of Chinese patients with Fuchs' syndrome. Ophthalmology 2006;113:473-80.  Back to cited text no. 4
Callaway NF, Mruthyunjaya P. Widefield imaging of retinal and choroidal tumors. Int J Retina Vitreous 2019;5:49.  Back to cited text no. 5
Choudhry N, Golding J, Manry MW, Rao RC. Ultra-widefield steering-based spectral-domain optical coherence tomography imaging of the retinal periphery. Ophthalmology 2016;123:1368-74.  Back to cited text no. 6
Kato Y, Inoue M, Hirakata A. Quantitative comparisons of ultra-widefield images of model eye obtained with Optos((R)) 200T×and Optos((R)) California. BMC Ophthalmol 2019;19:115.  Back to cited text no. 7
Choudhry N, Duker JS, Freund KB, Kiss S, Querques G, Rosen R, et al. Classification and Guidelines for Widefield Imaging: Recommendations from the International Widefield Imaging Study Group. Ophthalmol Retina 2019;3:843-9.  Back to cited text no. 8
Hirano T, Imai A, Kasamatsu H, Kakihara S, Toriyama Y, Murata T. Assessment of diabetic retinopathy using two ultra-wide-field fundus imaging systems, the Clarus® and Optos™ systems. BMC Ophthalmol 2018;18:332.  Back to cited text no. 9
Xu A, Chen C. Clinical application of ultra-widefield fundus autofluorescence. Int Ophthalmol 2022;41:727-41.  Back to cited text no. 10
Kimura SJ, Hogan MJ, Thygeson P. Fuchs' syndrome of heterochromic cyclitis. AMA Arch Ophthalmol 1955;54:179-86.  Back to cited text no. 11
Patel SN, Shi A, Wibbelsman TD, Klufas MA. Ultra-widefield retinal imaging: an update on recent advances. Ther Adv Ophthalmol 2020;12:2515841419899495.  Back to cited text no. 12
Tugal-Tutkun I, Güney-Tefekli E, Kamaci-Duman F, Corum I. A cross-sectional and longitudinal study of Fuchs uveitis syndrome in Turkish patients. Am J Ophthalmol 2009;148:510-50.  Back to cited text no. 13
Norrsell K, Holmér AK, Jacobson H. Aqueous flare in patients with monocular iris atrophy and uveitis. A laser flare and iris angiography study. Acta Ophthalmol Scand 1998;76:405-12.  Back to cited text no. 14
Zarei M, KhaliliPour E, Ebrahimiadib N, Riazi-Esfahani H. Quantitative analysis of the iris surface smoothness by anterior segment optical coherence tomography in Fuchs uveitis. Ocul Immunol Inflamm. 2020; 1-6. DOI: 10.1080/09273948.2020.1823424.  Back to cited text no. 15
Zarei M, Ebrahimiadib N, Riazi-Esfahani H. Using anterior segment optical coherence tomography to compare the smoothness of anterior iris surface between two eyes in unilateral Fuchs' uveitis syndrome. Graefes Arch Clin Exp Ophthalmol 2019;257:2799-800.  Back to cited text no. 16
Aksoy FE, Altan C, Basarir B, Garip D, Pasaoglu I, Perente I, et al. Analysis of retinal microvasculature in Fuchs' uveitis syndrome. Retinal microvasculature in Fuchs' uveitis. J Fr Ophtalmol 2020;43:324-9.  Back to cited text no. 17
Zarei M, Abdollahi A, Darabeigi S, Ebrahimiadib N, Roohipoor R, Ghassemi H, et al. An investigation on optic nerve head involvement in Fuchs uveitis syndrome using optical coherence tomography and fluorescein angiography. Graefes Arch Clin Exp Ophthalmol 2018;256:2421-7.  Back to cited text no. 18
Mohamed Q, Zamir E. Update on Fuchs' uveitis syndrome. Curr Opin Ophthalmol 2005;16:356-63.  Back to cited text no. 19
Bonfioli AA, Curi AL, Orefice F. Fuchs' heterochromic cyclitis. Semin Ophthalmol 2005;20:143-6.  Back to cited text no. 20
Moshirfar M, Villarreal A, Ronquillo Y. Fuchs uveitis syndrome. In: StatPearls. Treasure Island (FL): StatPearls Publishing Copyright© 2020, StatPearls Publishing LLC; 2020.  Back to cited text no. 21