Purpose: To analyse keratic precipitates (KPs) 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 ophthalmologic history, age, age at diagnosis, gender, detailed slit-lamp examination and IVCM images. The IVCM characteristics of KPs and of the endothelium were analysed.
Results: Large hyper-reflective deposits corresponding to KPs were observed on the endothelium of all FHC eyes and showed a great consistency among the different patients. These infiltrating KPs had a dendritic shape, with a small central core with numerous thin pseudopodia making sometimes connection between different KPs. The mean density of these KPs was 16.01 ± 6.54 KPs/mm2. The mean size of the largest dimension of these KPs was 127.31 ± 41.49 µm (range: 66.16 to 201.4 µm). Hypo-reflective round defects were observed at the level of the endothelium at the contact or in the close vicinity of KPs or smaller hyper-reflective deposits. All contralateral (non-affected eyes) had no KPs, nor endothelial abnormalities.
Conclusions: By providing high resolution images of corneal endothelium and KPs, IVCM could help the diagnosis and the understanding of complex forms of intraocular inflammation such as FHC.