Development of revised diagnostic criteria for Fuchs' uveitis syndrome in a Chinese population

P.Z. Yang*, W.Y. Zhang, Z.J. Chen, H. Zhang, G.N. Su, Q.F. Cao, Y. Zhu, Z.Y. Zhong, C.J. Zhou, Y. Wang, A. Kijlstra

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

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Abstract

Background/aims Fuchs' uveitis syndrome (FUS) is one of the frequently misdiagnosed uveitis entities, which is partly due to the absence of internationally recognised diagnostic criteria. This study was performed to develop and evaluate a set of revised diagnostic criteria for FUS. Methods The clinical data of Chinese patients with FUS and patients with non-FUS were collected and analysed from a tertiary referral centre between April 2008 and December 2020. A total of 593 patients with FUS and 625 patients with non-FUS from northern China were enrolled for the development of diagnostic criteria for FUS. Three hundred and seventy-seven patients with FUS and 503 patients with non-FUS from southern China were used to validate the criteria. Clinical symptoms and ocular signs were collected from all patients with FUS and patients with non-FUS. Multivariate two-step cluster analysis, logistic regression and decision tree algorithms in combination with the clinical judgement of uveitis experts were used to revise diagnostic criteria for FUS. Results Three essential findings including diffuse iris depigmentation, absence of posterior synechiae, mild inflammation in the anterior chamber at presentation and five associated findings including mostly unilateral involvement, cataract, vitreous opacities, absence of acute symptoms and characteristic iris nodules were used in the development of FUS diagnostic criteria. All essential findings were required for the diagnosis of FUS, and the diagnosis was further strengthened by the presence of associated findings. Conclusion Revised diagnostic criteria for FUS were developed and validated by analysing data from Chinese patients and showed a high sensitivity (96.55%) and specificity (97.42%).
Original languageEnglish
Pages (from-to)1678-1683
Number of pages6
JournalBritish Journal of Ophthalmology
Volume106
Issue number12
Early online date8 Jun 2021
DOIs
Publication statusPublished - Dec 2022

Keywords

  • diagnostic tests
  • investigation
  • iris
  • anterior chamber
  • imaging
  • HETEROCHROMIC IRIDOCYCLITIS
  • IRIS NODULES
  • SPECTRUM

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