Znakovi eksudacije u prednjoj komorici razvijaju se na slijedeći način: iz upaljenih šareničnih žila leukociti izlaze u sobnu vodicu, gdje se osvijetljeni procjepnim svjetlom vide kao svjetlucave lebdeće čestice, poput čestica dima u snopu svjetla kino-projektora (Tyndallov fenomen - pojava da osvijetljena koloidna čestica reflektira svjetlo kao sekundarni izvor svjetlosti).
Leukociti se hvataju na endotel rožnice, pa ovaj izgleda kao je prašnjav (prašinasti precipitati). Ako ih je mnogo, u daljnjem toku upale talože se na endotelu u obliku okomite crte koja seže okomito od dna prednje komorice do središta rožnice, a potom u obliku zrnastih precipitata koji oblikuju trokut s bazom prema dnu prednje komorice, a vrhom prema središtu rožnice, i to tako da su grublja zrnca bliže bazi, a sitnija bliže vrhu trokuta.
U najtežem slučaju leukociti se talože u dnu prednje komorice i vide se kao bijeli talog (hipopion). Intraokularni tlak je normalan ili malo povišen. Ovakav oblik iridociklitisa naziva se negranulomatoznim, a prema vrsti zamućenja sobne vodice razlikuje se serozni, fibrinozni, hemoragički ili purulentni iridociklitis. Negranulomatozni iridociklitis može imati akutan ili kroničan tok.
http://dro.hs.columbia.edu/kp.htmVrste:
1) Acute, fresh KPs tend to be white and round, while old KPs are usually irregular, faded and pigmented.
2) Mutton-fat KP: large, greasy-white KPs (approximately 1 mm in diameter), which represent clusters of macrophages and epithelioid cells. Typically occur in granulomatous uveitis.
3 ) Pigmented - stari od kronične upale
4) Red iliti crveni KP's (kod herpes simplex, herpes zoster)
Mutton-fat KPs occur in granulomatous inflammatory diseases, and they generally fill the Arlt triangle inferiorly. Arlt distribution is caused by convection currents within the anterior chamber and the cooler temperature in the inferior cornea. These larger granulomatous KPs will pigment and then shrink as inflammation abates or is controlled by steroid therapy. They often fail to disappear completely, and they may alter the endothelium where they rest, leaving a halo on the endothelium. Granulomatous deposits also may be seen in the anterior chamber angle by gonioscopy.
Nongranulomatous KPs are small to medium in size and white in color with Arlt distribution pattern. Old KPs accumulate pigment, and, as they begin to involute, shrink and disappear.
Either type of KP may be seen within the distribution of a central or peripheral herpetic disciform keratitis, which is often also accompanied by herpetic uveitis. Although the intraocular pressure is, as a rule, lowered in acute anterior uveitis, some patients may have elevated intraocular pressure because of inflammatory debris in the trabecular meshwork or herpetic trabeculitis. Precipitates identical in histopathologic content to KPs also may be seen deposited within the chamber angle, intraocular lenses, or seton implants.
Stellate KPs are unique, fibrillar, dendriform, microscopic lesions found throughout the endothelium. No predilection exists for the center, periphery, or Arlt inferior triangle. Stellate KPs typically are seen in Fuchs heterochromic iridocyclitis, but they commonly are noted in herpes simplex, herpes zoster, and CMV retinitis infections. Stellate KPs can be seen in toxoplasmosis, but granulomatous or nongranulomatous KPs also are seen.
Peripheral KPs may be seen following intraocular surgery, with peripheral corneal edema following intracapsular cataract surgery (Brown syndrome), with herpes simplex or zoster uveitis, following acute angle-closure glaucoma, or after blunt ocular trauma.
KPs must be differentiated from corneal endothelial guttatae and pigment deposits. Pigment may have a random, diffuse, central, or disciform distribution following previous inflammation. Krukenberg spindles are found in a central vertical pattern, which is not characteristic of inflammation. Guttatae are central or diffuse and do not fulfill the usual distribution patterns of inflammatory disease. Guttatae can be identified by specular microscopy and more elegantly by confocal microscopy.
http://books.google.hr/books?id=wuc0Ox0 ... de&f=false