🔷Anterior Uveitis🔷
🔶Keratic Precipitates (KPs)🔶
🔶‘Mutton fat’ KPs🔶
🟢 Granulomatous KPs may be microgranulomatous, medium sized, or large.
🟢 Endothelial deposits of lymphocytes, macrophages, and epithelioid cells forming large granulomatous KPs with a greasy apperance are defined as ‘mutton fat’ KPs.
🟢 They are typically seen in granulomatous diseases such as sarcoid uveitis.
🟢 Large flat KPs of grayish or rusty color are typical of acute herpetic anterior uveitis, but may also be seen in other infectious entities.
🟢 Microgranulomatous or medium sized KPs may form in eyes with low-grade chronic anterior uveitis.
🟢 In cytomegalovirus-associated anterior uveitis, medium-sized granulomatous KPs may be surrounded by a translucent halo and sometimes accompanied by a spot of pigment.
🟢 According to the type and stage of inflammatory process, a mixture of fine and granulomatous KPs may be seen and KP morphology may change with treatment.
🟢 Endothelial dusting may disappear without any trace or with only sparse fine pigment deposits.
🟢 Large granulomatous KPs may become smaller, less greasy, and then become pigmented or completely disappear.
🟢 ‘Foot prints’ of granulomatous KPs may be seen in some cases following complete resolution of inflammation.
🟢 Fine stellate KPs and granulomatous KPs with stellate extensions are typical of Fuchs uveitis and are usually stable over the course of the disease.
🟢 Fine pigment precipitates on the corneal endothelium seen after resolution of anterior uveitis should be differentiated from pigment precipitates associated with pigment dispersion syndrome, pseudoexfoliation syndrome, or any other condition that may cause pigment discharge into the anterior chamber.
🟢 Pigment dispersion syndrome typically causes a perpendicular line of pigment deposition defined as a Krukenberg’s spindle.
🟢 There are also recently described entities of pigment dispersion that may masquerade anterior uveitis.
🟢 In both bilateral acute depigmentation of the iris (BADI) and bilateral acute transillumination of the iris (BAIT), the finding of corneal endothelial pigment precipitates is a useful clue to the differential diagnosis.
👤 Dr. Josep Torras Sanvicens, MD-FEBO.
🏨 Hospital Clinic of Barcelona
👁 YouTube.com/@VisualSystem
🏛 University of Barcelona
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