Transient changes in specular appearance of the corneal endothelium and in corneal thickness during anterior uveitis.

Specular microscopic investigations on the corneal endothelium and optical measurements of the corneal thickness were carried out before and at intervals during treatment in 15 patients with acute anterior uveitis. The inflammatory induced changes in the specular appearance of the endothelium included a range of specular defects of which 4 types were distinguished: 1) large defects caused by large precipitates on the back of the cornea, 2) smaller defects also ascribed to precipitates, 3) gutta-like defects which were not associated with typical precipitates, and 4) defects smaller than one cell's width, the non-specular correlate of which was uncertain. The fractional area occupied by the specular defects in the acute phase was found to correlate significantly to the observed increase in corneal thickness. With a few exceptions, the endothelial changes disappeared completely in parallel with the other signs of acute inflammation. No cell loss was demonstrated in patients where a control count could be obtained. The maximum increase in corneal thickness ranged from 0.015 to 0.200 mm. During recovery the thickness showed a peculiar tendency to reach slightly subnormal values as a transient phenomenon. The clinical significance of these findings is discussed.