Pseudoguttata in uveitis: a new diagnostic criterion?
Doran Spencer MD, PhD
Shiley Eye Institute, Department of Ophthalmology, University of California, San Diego
Purpose: To present corneal endothelial pseudoguttata as a novel physical finding that is present universally in uveitis involving anterior chamber inflammation. Furthermore, to demonstrate the quantitative relationship between pseudoguttata, anterior chamber cell and flare.
Methods: Patients with uveitis involving anterior chamber inflammation underwent a complete ophthalmologic examination. Slit lamp photos were obtained during the active and convalescent stages of both eyes, as well as specular microscopy, quantitative assessment of anterior chamber cell via OCT, and flaremeter measurements.
Results: Twelve uveitis patients were assessed via slit lamp exam, specular microscopy and flaremeter measurements, and ten separate uveitis patients had anterior chamber cell measurements via OCT instead of flaremeter measurements. Pseudoguttata as measured by specular microscopy were visible at all pathologic levels of flaremeter measurements and anterior chamber cell. Pseudoguttata were noted to be present at the highest levels at increased flaremeter measurements although they were maximally present at 2+ anterior chamber cell findings. Pseudoguttata were noted to resolve after treatment.
Conclusions: Pseudoguttata represent a reliable, readily discernible and overlooked physical finding that are reproducibly present in the setting of uveitis involving active anterior chamber inflammation of greater than 50 different etiologies. This finding shoud be considered as a novel SUN criterion.