Abstract：
To draw attention to the higher proportion of Fuchs heterochromic iridocyclitis (FHI) cases in patients with multiple sclerosis (MS).
Retrospective study of data collected at the Center for the Diagnosis and Treatment of Uveitis.
An analysis of the medical records of 3016 patients with uveitis (in the years 2003-2020) was performed with a focus on MS. MS-associated uveitis was diagnosed in 90 patients (3%): anterior uveitis (n = 7), intermediate uveitis (n = 23), retinal vasculitis (n = 24), and panuveitis (n = 36). A clinical examination revealed signs of FHI in the anterior segment in 11 out of 90 cases (12%). Atypical manifestations of FHI included a higher incidence of bilateral involvement (45%), retinal vasculitis (27%), and vitreous snowballs (18%). The diagnosis of FHI preceded the diagnosis of MS in 4 cases. The median latency was 10.5 (range 8-15) years. In 4 patients, the diagnosis of demyelinating disease was established within one year of the diagnosis of FHI. We recommended a neurological examination for optic neuritis (n = 1), paresthesia (n = 3), relapse of motor deficit (n = 1), and screening of etiology in cases with involvement of the posterior segment (n = 3). In the other 3 cases, the diagnosis of MS preceded the diagnosis of FHI, with a median latency of 13 (range 8-19) years.
We detected clinical symptoms of FHI in 12% of uveitis cases associated with MS, more often in bilateral manifestations of intraocular inflammation. Based on our experience, we recommend an investigation of the medical history of patients with FHI for manifestations of sensitive, sensory and motor deficits, especially in bilateral cases.
Retrospective study of data collected at the Center for the Diagnosis and Treatment of Uveitis.
An analysis of the medical records of 3016 patients with uveitis (in the years 2003-2020) was performed with a focus on MS. MS-associated uveitis was diagnosed in 90 patients (3%): anterior uveitis (n = 7), intermediate uveitis (n = 23), retinal vasculitis (n = 24), and panuveitis (n = 36). A clinical examination revealed signs of FHI in the anterior segment in 11 out of 90 cases (12%). Atypical manifestations of FHI included a higher incidence of bilateral involvement (45%), retinal vasculitis (27%), and vitreous snowballs (18%). The diagnosis of FHI preceded the diagnosis of MS in 4 cases. The median latency was 10.5 (range 8-15) years. In 4 patients, the diagnosis of demyelinating disease was established within one year of the diagnosis of FHI. We recommended a neurological examination for optic neuritis (n = 1), paresthesia (n = 3), relapse of motor deficit (n = 1), and screening of etiology in cases with involvement of the posterior segment (n = 3). In the other 3 cases, the diagnosis of MS preceded the diagnosis of FHI, with a median latency of 13 (range 8-19) years.
We detected clinical symptoms of FHI in 12% of uveitis cases associated with MS, more often in bilateral manifestations of intraocular inflammation. Based on our experience, we recommend an investigation of the medical history of patients with FHI for manifestations of sensitive, sensory and motor deficits, especially in bilateral cases.
摘要：
目的：提请注意多发性硬化（MS）患者中Fuchs异色虹膜睫状体炎（FHI）的比例较高。
方法：回顾性研究葡萄膜炎诊断和治疗中心收集的数据。
结果：对3016例葡萄膜炎患者（2003-2020年）的病历进行了分析，重点是MS。在90例患者（3％）中诊断出MS相关葡萄膜炎：前葡萄膜炎（n=7），中度葡萄膜炎（n=23），视网膜血管炎（n=24），和全葡萄膜炎（n=36）。临床检查显示，90例中有11例（12％）在眼前段出现FHI迹象。FHI的非典型表现包括较高的双侧受累发生率（45％），视网膜血管炎（27%），和玻璃体雪球(18%)。4例FHI的诊断先于MS的诊断。中位潜伏期为10.5年（范围8-15年）。在4名患者中，脱髓鞘疾病的诊断是在FHI诊断后一年内确定的.我们建议视神经检查神经炎（n=1），感觉异常（n=3），运动缺陷复发（n=1），并筛查后段受累病例的病因（n=3）。在其他三个案例中，MS的诊断先于FHI的诊断,中位潜伏期为13年（范围8-19年）。
结论：我们在与MS相关的12％葡萄膜炎病例中检测到FHI的临床症状，多见于双侧眼内炎症的表现。根据我们的经验,我们建议对FHI患者的病史进行调查，感觉和运动缺陷，特别是在双边情况下。
方法：回顾性研究葡萄膜炎诊断和治疗中心收集的数据。
结果：对3016例葡萄膜炎患者（2003-2020年）的病历进行了分析，重点是MS。在90例患者（3％）中诊断出MS相关葡萄膜炎：前葡萄膜炎（n=7），中度葡萄膜炎（n=23），视网膜血管炎（n=24），和全葡萄膜炎（n=36）。临床检查显示，90例中有11例（12％）在眼前段出现FHI迹象。FHI的非典型表现包括较高的双侧受累发生率（45％），视网膜血管炎（27%），和玻璃体雪球(18%)。4例FHI的诊断先于MS的诊断。中位潜伏期为10.5年（范围8-15年）。在4名患者中，脱髓鞘疾病的诊断是在FHI诊断后一年内确定的.我们建议视神经检查神经炎（n=1），感觉异常（n=3），运动缺陷复发（n=1），并筛查后段受累病例的病因（n=3）。在其他三个案例中，MS的诊断先于FHI的诊断,中位潜伏期为13年（范围8-19年）。
结论：我们在与MS相关的12％葡萄膜炎病例中检测到FHI的临床症状，多见于双侧眼内炎症的表现。根据我们的经验,我们建议对FHI患者的病史进行调查，感觉和运动缺陷，特别是在双边情况下。
