Purpose: To analyse keratic precipitates in Fuchs' heterochromic cyclitis (FHC) by in-vivo confocal microscopy (IVCM).
Patients and methods: A retrospective chart review of 13 consecutive patients with FHC was conducted. Data collection included medical and ophthalmological history, age, age at diagnosis, gender, detailed slit-lamp examination and IVCM images. The IVCM characteristics of keratic precipitates and of the endothelium were analysed.
Results: Large hyperreflective deposits corresponding to keratic precipitates were observed on the endothelium of all FHC eyes and showed a great consistency among the different patients. These infiltrating keratic precipitates had a dendritic shape, with a small central core with numerous thin pseudopodia sometimes making connection between different keratic precipitates. The mean density of these keratic precipitates was 16.01/mm(2) (SD 6.54). The mean size of the largest dimension of these keratic precipitates was 127.31 microm (SD 41.49; range 66.16-201.4 microm). Hyporeflective round defects were observed at the level of the endothelium at contact or in the close vicinity of keratic precipitates or smaller hyperreflective deposits. All contralateral (non-affected eyes) had no keratic precipitates nor endothelial abnormalities.
Conclusions: By providing high resolution images of corneal endothelium and keratic precipitates, IVCM could help the diagnosis and understanding of complex forms of intraocular inflammation such as FHC.