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Clinical science
Clinical features of patients with diabetic anterior uveitis
  1. Takayo Watanabe1,
  2. Hiroshi Keino1,
  3. Kyoko Nakayama1,
  4. Wakako Taki1,
  5. Nariaki Echizen1,2,
  6. Annabelle A Okada1
  1. 1 Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, Japan
  2. 2 Department of Ophthalmology, St Luke’s International Hospital, Tokyo, Japan
  1. Correspondence to Dr Annabelle A Okada, Department of Ophthalmology, Kyorin University School of Medicine, Tokyo 181-8611, Japan; aokada{at}eye-center.org

Abstract

Aim To describe clinical features and outcomes of new-onset anterior uveitis associated with poorly controlled or undiagnosed diabetes mellitus.

Methods Retrospective analysis of 25 eyes of 18 patients (14 men, 4 women; mean age 44 years) who presented between December 2001 and October 2016 to the Kyorin Eye Center.

Results Ocular findings at presentation included posterior synechiae (15 eyes, 60%), anterior chamber fibrin (13 eyes, 52%), keratic precipitates (10 eyes, 40%), Descemet membrane folds (7 eyes, 28%) and hypopyon (3 eyes, 12%). Seven cases were bilateral. Intraocular pressure >21 mm Hg (7 eyes, 28%) and diabetic retinopathy (7 eyes, 28%, all non-proliferative) were also noted. The mean random blood glucose was 332 mg/dL (range 135–604 mg/dL) and the mean haemoglobin A1c was 12.6% (range 9.7%–16.7%). Seven patients (39%) were unaware of their hyperglycaemic state, and the remainder had either poor glucose control or had discontinued their diabetes treatment. Systemic examination and ancillary testing ruled out other possible causes of the uveitis. The ocular inflammation was managed in all cases using local corticosteroid therapy (drops and subconjunctival injections) in addition to internal medicine intervention for the diabetes. The best-corrected visual acuity (BCVA) was improved or maintained in all eyes at 3 months. The BCVA was ≤0.5 in two eyes due to both cataract and diabetic macular oedema.

Conclusions We characterised new-onset anterior uveitis in 18 patients in association with poorly controlled or undiagnosed diabetes mellitus. The uveitis was managed in all cases with local corticosteroid therapy in addition to proper diabetes systemic treatment.

  • anterior chamber
  • inflammation

https://doi.org/10.1136/bjophthalmol-2017-311453

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    Footnotes

    • Contributors WT designed the study and wrote the initial draft of the manuscript. HK and AAO contributed to analysis and interpretation of data, and assisted in the preparation of the manuscript. All other authors have contributed to data collection and interpretation, and critically reviewed the manuscript. All authors read and approved the final manuscript.

    • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

    • Ethics approval The study was approved by the Kyorin University Hospital Research Ethics Committee.

    • Provenance and peer review Not commissioned; externally peer reviewed.

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