Mesure quantitative de l'inflammation dans l'uvéite antérieure aiguë (UAA) HLA-B27 à l'aide du laser flare-cell meter Kowa FC-1000

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Abstract
LFP represents a major gain of sensitivity over slit-lamp evaluation of aqueous flare, allowing to detect subclinical changes of flare both in low grade and high grade flare situations. It is now possible to exactly quantify anterior chamber inflammation and determine inflammatory patterns. The purpose of this study was to determine the mean initial and evolutionary flare in AAU and the mean duration of an AAU episode. Since 1990 routine LFP follow-up of inflammation in uveitis patients is performed by the same technician with a Kowa FC-1000 laser flare-cell meter. The standard treatment for AAU was to begin with hourly topical 1% prednisolone acetate drops during the day and ointment at night and mydriatic drops. In case of a flare rise or persistence of the initial high flare after 48 hours a periocular injection of betamethasone (4 mg) was added to the topical therapy. End of an episode was defined as a flare under 8 photons/ms. Mean initial flare was 160.7 +/- 22 ph/ms (n = 61). Mean duration of an AAU episode was 18.5 +/- 15 days and evolution of mean flare showed that 50% flare reduction occurred on day 2 of therapy and 90% reduction on day 8. With our treatment protocol 14% of non complicated AAU needed an additional periocular steroid injection. LFP represents a major improvement in the management of AAU patients by allowing precise adjustment of therapy and favors good patient compliance because of the numbered evidence of disease recovery.

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