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Quantitative evaluation of trabecular meshwork pigmentation in unilateral Fuchs uveitis syndrome
Kubra Ozdemir Yalcinsoy1, Mehmet Murat Uzel2
1Department of Ophthalmology, University of Health Sciences, Ulucanlar Eye Education and Research Hospital, Ankara, Turkey. kubraozdemir250@gmail.com.
Purpose:
To quantitatively analyze trabecular meshwork (TM) pigmentation in patients with unilateral Fuchs Uveitis Syndrome (FUS) and to compare the findings with those of the healthy fellow eyes.
Methods:
This cross-sectional study included patients with unilateral FUS. Demographic and ophthalmological data were recorded. Gonioscopic photographs of the anterior chamber angle of both eyes were taken under standardized conditions from the superior and inferior TM regions, using the same slit-lamp biomicroscope equipped with a mounted digital camera. TM pigmentation was quantitatively analyzed in the superior, inferior, and total (superior + inferior) regions using ImageJ software.
Results:
Of the 30 patients with unilateral FUS, 5 were excluded due to poor image quality. The remaining 25 patients were analyzed, with FUS eyes classified as the FUS group and fellow eyes as controls. The mean age was 49.0 ± 12.3 years (range: 24-64); 60% were female. Common findings in FUS eyes included vitritis (100%), posterior subcapsular cataract (96%), stellate keratic precipitates (80%), and diffuse iris atrophy (80%). Heterochromia was observed in 40% of patients. Mean intraocular pressure (IOP) did not differ significantly between groups (p = 0.182). TM pigmentation was higher in the FUS group across all regions, reaching statistical significance in the superior and total measurements (p = 0.006 and p = 0.040, respectively). TM pigmentation was lower in all regions in eyes with heterochromia compared to those without, with total values significantly reduced (p = 0.036). No significant correlation was found between IOP and TM pigmentation in the FUS group (p > 0.05).
Conclusion:
This study demonstrated increased TM pigmentation in eyes affected by FUS, which may be due to ongoing pigment release. Conversely, eyes with heterochromia showed reduced pigmentation, likely reflecting chronic pigment loss.This quantitative method may aid in better understanding pigment distribution and iris changes in FUS, providing clinicians with a more objective assessment tool.
