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Cytomegalovirus as an etiologic factor in corneal endotheliitis.
Ophthalmology. 2008 Feb; 115(2):292-297.e3.O

Abstract

PURPOSE

To investigate clinical manifestations and response to antiviral therapy of 8 patients with cytomegalovirus (CMV)-induced corneal endotheliitis who were diagnosed and treated at 2 university hospitals in Japan.

DESIGN

Retrospective, consecutive, multicenter case series.

PARTICIPANTS

Eight eyes of 8 patients diagnosed with active CMV corneal endotheliitis at Kyoto Prefectural University of Medicine and Ehime University School of Medicine. The diagnosis was made based on the detection by polymerase chain reaction assay of CMV, but not herpes simplex virus (HSV) and varicella zoster virus (VZV) DNA, in the aqueous humor from the affected eye.

METHODS

Retrospective review of the clinical manifestations and responses to antiviral treatment.

MAIN OUTCOME MEASURES

Patient profiles, including duration of corneal endotheliitis, systemic disease, intraocular pressure, and clinical manifestation of anterior and posterior segments. The clinical response to systemic and topical antiviral treatment was evaluated by slit-lamp examination. Corneal endothelial density was examined by specular microscopy.

RESULTS

The average observation period after CMV detection was 10.4 months (range, 2-24 months). None of the patients had systemic immunodeficiency. Corneal manifestations included linear keratic precipitates associated with multiple coin-shaped lesions and local corneal stromal edema. Of the 8 patients, 4 had undergone penetrating corneal transplantation. Systemic ganciclovir therapy was used in 7 patients, and in 1 patient, valacyclovir was administered, with the corneal endotheliitis responding quickly to the early administration of galovir. At the final examination, 6 eyes had a clear cornea, but 2 eyes had bullous keratopathy.

CONCLUSIONS

Besides HSV and VZV, CMV must be considered as an etiologic agent in patients with corneal endotheliitis. Cytomegalovirus corneal endotheliitis may be a newly identified clinical entity of reactivated CMV in the anterior chamber of individuals free of accompanying systemic symptoms.

Authors+Show Affiliations

Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan. nkoizumi@ophth.kpu-m.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17669498

Citation

Koizumi, Noriko, et al. "Cytomegalovirus as an Etiologic Factor in Corneal Endotheliitis." Ophthalmology, vol. 115, no. 2, 2008, pp. 292-297.e3.
Koizumi N, Suzuki T, Uno T, et al. Cytomegalovirus as an etiologic factor in corneal endotheliitis. Ophthalmology. 2008;115(2):292-297.e3.
Koizumi, N., Suzuki, T., Uno, T., Chihara, H., Shiraishi, A., Hara, Y., Inatomi, T., Sotozono, C., Kawasaki, S., Yamasaki, K., Mochida, C., Ohashi, Y., & Kinoshita, S. (2008). Cytomegalovirus as an etiologic factor in corneal endotheliitis. Ophthalmology, 115(2), 292-e3.
Koizumi N, et al. Cytomegalovirus as an Etiologic Factor in Corneal Endotheliitis. Ophthalmology. 2008;115(2):292-297.e3. PubMed PMID: 17669498.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cytomegalovirus as an etiologic factor in corneal endotheliitis. AU - Koizumi,Noriko, AU - Suzuki,Takashi, AU - Uno,Toshihiko, AU - Chihara,Hidemi, AU - Shiraishi,Atsushi, AU - Hara,Yuko, AU - Inatomi,Tsutomu, AU - Sotozono,Chie, AU - Kawasaki,Satoshi, AU - Yamasaki,Kenta, AU - Mochida,Chikako, AU - Ohashi,Yuichi, AU - Kinoshita,Shigeru, Y1 - 2007/07/31/ PY - 2007/01/27/received PY - 2007/04/04/revised PY - 2007/04/06/accepted PY - 2007/8/3/pubmed PY - 2008/2/12/medline PY - 2007/8/3/entrez SP - 292 EP - 297.e3 JF - Ophthalmology JO - Ophthalmology VL - 115 IS - 2 N2 - PURPOSE: To investigate clinical manifestations and response to antiviral therapy of 8 patients with cytomegalovirus (CMV)-induced corneal endotheliitis who were diagnosed and treated at 2 university hospitals in Japan. DESIGN: Retrospective, consecutive, multicenter case series. PARTICIPANTS: Eight eyes of 8 patients diagnosed with active CMV corneal endotheliitis at Kyoto Prefectural University of Medicine and Ehime University School of Medicine. The diagnosis was made based on the detection by polymerase chain reaction assay of CMV, but not herpes simplex virus (HSV) and varicella zoster virus (VZV) DNA, in the aqueous humor from the affected eye. METHODS: Retrospective review of the clinical manifestations and responses to antiviral treatment. MAIN OUTCOME MEASURES: Patient profiles, including duration of corneal endotheliitis, systemic disease, intraocular pressure, and clinical manifestation of anterior and posterior segments. The clinical response to systemic and topical antiviral treatment was evaluated by slit-lamp examination. Corneal endothelial density was examined by specular microscopy. RESULTS: The average observation period after CMV detection was 10.4 months (range, 2-24 months). None of the patients had systemic immunodeficiency. Corneal manifestations included linear keratic precipitates associated with multiple coin-shaped lesions and local corneal stromal edema. Of the 8 patients, 4 had undergone penetrating corneal transplantation. Systemic ganciclovir therapy was used in 7 patients, and in 1 patient, valacyclovir was administered, with the corneal endotheliitis responding quickly to the early administration of galovir. At the final examination, 6 eyes had a clear cornea, but 2 eyes had bullous keratopathy. CONCLUSIONS: Besides HSV and VZV, CMV must be considered as an etiologic agent in patients with corneal endotheliitis. Cytomegalovirus corneal endotheliitis may be a newly identified clinical entity of reactivated CMV in the anterior chamber of individuals free of accompanying systemic symptoms. SN - 1549-4713 UR - https://www.unboundmedicine.com/medline/citation/17669498/Cytomegalovirus_as_an_etiologic_factor_in_corneal_endotheliitis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(07)00571-4 DB - PRIME DP - Unbound Medicine ER -