Fuchs's heterochromic cyclitis. Electron-microscopic study of nine iris biopsies (author's transl)

Abstract

The irises of 9 cases of Fuchs's heterochromic cyclitis, obtained by iridectomy during cataract surgery, were examined pathohistologically and electron microscopically. There is a chronic type of iridocyclitis with infiltration of mainly plasma cells and with a marked degenerative and atrophic component. The main feature of the fine structure is the presence of isolated organelles, mainly mitochondria, with intact structure, a result of a process which seems to destroy first the endoplasmatic reticulum and leads to cytolysis. This phenomenon, however, is present too in cases of types chronic iridocyclitis, but to a lesser extent. Thus, the extent of the atrophic process seems to be the only pathognomonic criteria for Fuchs's heterochromic cyclitis. The electron microscope cannot reveal pathognomonic criteria for Fuchs's heterochromic cyclitis, and, furthermore, we could not demonstrate any findings which could establish or confirm the etiology. The theory of a dysfunction of the sympathetic innervation and the theory of a vascular pathogenesis could not be confirmed. The question is discussed whether Fuchs's heterochromic cyclitis is a autoimmune-disease which attacks the endoplasmatic reticulum first.