Purpose

To identify the likelihood of complications and outcomes in patients presenting with mutton-fat keratic precipitates (MFKP), compared with those presenting without MFKP

Methods

Retrospective analysis of a cohort of 4872 new patients presenting with uveitis over a 29-year period to a specialist clinic

Results

Patients with MFKP were older (41.4 vs 36.7yrs, p=0.0001), more likely to be Afro-Caribbean (p=0.001), more likely to have associated chest symptoms (p=0.00001) and bilateral uveitis (p=0.03), more likely to develop ocular hypertension or glaucoma (p=0.0008), to receive oral steroid treatment (p=0.00001), and to develop severe vision loss (12.1% of patients presented with MFKP but generated 32.1% of visual handicap registration), and more likely to reach a formal diagnosis (p=0.0001). The most common diagnoses in those with MFKP were sarcoidosis (26.7%), tuberculosis (12.3%), viral uveitis (9.1%), sympathetic uveitis (4.9%) and toxoplasmosis (3.4%). With the exception of chest symptoms, all of the above parameters remained significant, independent of a diagnosis of sarcoidosis

Conclusions

Mutton-fat KP are an intrinsic marker of uveitis severity, independent of diagnosis. They indicate a higher risk of complications and poorer outcomes and should indicate a proactive approach to treatment