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Comparison of rubella virus- and herpes virus-associated anterior uveitis: clinical manifestations and visual prognosis.
Ophthalmology. 2011 Oct; 118(10):1905-10.O

Abstract

PURPOSE

To compare the clinical characteristics and visual prognosis of patients with anterior uveitis (AU) and intraocular fluid analysis positive for rubella virus (RV), herpes simplex virus (HSV), or varicella zoster virus (VZV).

DESIGN

Retrospective, observational study.

PARTICIPANTS

The study included 106 patients with AU and positive polymerase chain reaction (PCR) results, Goldmann-Witmer coefficients (GWCs), or both, for RV (n = 57), HSV (n = 39), or VZV (n = 10).

METHODS

Clinical records of the included patients were analyzed retrospectively; demographic constitution, ophthalmologic characteristics, and visual prognosis were compared.

MAIN OUTCOME MEASURES

Age, gender, and diverse clinical and laboratory characteristics, including course and laterality of AU; prevalence of positive results for PCR, GWC, or both; conjunctival redness; corneal edema; history of keratitis; presence of keratic precipitates; synechiae; heterochromia; and grade of inflammation. In addition, complications and visual acuity at 1 and 3 years of follow-up were recorded.

RESULTS

All 3 types of viral AU were characterized by unilateral involvement (80%-97%). Rubella virus AU was characterized by younger age at onset and chronic course and typically was associated with cataract at presentation. Heterochromia was present in 23% of RV AU patients. Anterior uveitis associated with HSV or VZV occurred characteristically in older patients and frequently followed an acute course. Clinical features associated with herpetic AU included conjunctival redness, corneal edema, history of keratitis, and development of posterior synechiae. Herpes simplex virus AU often had severe anterior chamber inflammation, whereas the presence of vitritis was more common in RV AU and VZV AU. The prevalence of documented intraocular pressure (IOP) of more than 30 mmHg (25%-50%; P = 0.06) and development of glaucoma (18%-30%; P = 0.686) were similar in all 3 groups. Focal chorioretinal scars were seen in 22% of RV AU eyes, in 0% of HSV AU eyes, and in 11% of VZV AU eyes (P = 0.003). Visual prognosis was favorable for all 3 groups.

CONCLUSIONS

These observations identify clinical differences between RV AU, HSV AU, and VZV AU and may be of particular value to ophthalmologists who are unable to carry out intraocular fluid analysis to discriminate between these types of viral AU.

FINANCIAL DISCLOSURE(S)

The author(s) have no proprietary or commercial interest in any materials discussed in this article.

Authors+Show Affiliations

Department of Ophthalmology, University Medical Center Utrecht, Utrecht, The Netherlands. barwensing@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21764137

Citation

Wensing, Barbara, et al. "Comparison of Rubella Virus- and Herpes Virus-associated Anterior Uveitis: Clinical Manifestations and Visual Prognosis." Ophthalmology, vol. 118, no. 10, 2011, pp. 1905-10.
Wensing B, Relvas LM, Caspers LE, et al. Comparison of rubella virus- and herpes virus-associated anterior uveitis: clinical manifestations and visual prognosis. Ophthalmology. 2011;118(10):1905-10.
Wensing, B., Relvas, L. M., Caspers, L. E., Valentincic, N. V., Stunf, S., de Groot-Mijnes, J. D., & Rothova, A. (2011). Comparison of rubella virus- and herpes virus-associated anterior uveitis: clinical manifestations and visual prognosis. Ophthalmology, 118(10), 1905-10. https://doi.org/10.1016/j.ophtha.2011.03.033
Wensing B, et al. Comparison of Rubella Virus- and Herpes Virus-associated Anterior Uveitis: Clinical Manifestations and Visual Prognosis. Ophthalmology. 2011;118(10):1905-10. PubMed PMID: 21764137.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of rubella virus- and herpes virus-associated anterior uveitis: clinical manifestations and visual prognosis. AU - Wensing,Barbara, AU - Relvas,Lia M, AU - Caspers,Laure E, AU - Valentincic,Natasa Vidovic, AU - Stunf,Spela, AU - de Groot-Mijnes,Jolanda D F, AU - Rothova,Aniki, Y1 - 2011/07/20/ PY - 2011/01/27/received PY - 2011/03/23/revised PY - 2011/03/24/accepted PY - 2011/7/19/entrez PY - 2011/7/19/pubmed PY - 2011/12/13/medline SP - 1905 EP - 10 JF - Ophthalmology JO - Ophthalmology VL - 118 IS - 10 N2 - PURPOSE: To compare the clinical characteristics and visual prognosis of patients with anterior uveitis (AU) and intraocular fluid analysis positive for rubella virus (RV), herpes simplex virus (HSV), or varicella zoster virus (VZV). DESIGN: Retrospective, observational study. PARTICIPANTS: The study included 106 patients with AU and positive polymerase chain reaction (PCR) results, Goldmann-Witmer coefficients (GWCs), or both, for RV (n = 57), HSV (n = 39), or VZV (n = 10). METHODS: Clinical records of the included patients were analyzed retrospectively; demographic constitution, ophthalmologic characteristics, and visual prognosis were compared. MAIN OUTCOME MEASURES: Age, gender, and diverse clinical and laboratory characteristics, including course and laterality of AU; prevalence of positive results for PCR, GWC, or both; conjunctival redness; corneal edema; history of keratitis; presence of keratic precipitates; synechiae; heterochromia; and grade of inflammation. In addition, complications and visual acuity at 1 and 3 years of follow-up were recorded. RESULTS: All 3 types of viral AU were characterized by unilateral involvement (80%-97%). Rubella virus AU was characterized by younger age at onset and chronic course and typically was associated with cataract at presentation. Heterochromia was present in 23% of RV AU patients. Anterior uveitis associated with HSV or VZV occurred characteristically in older patients and frequently followed an acute course. Clinical features associated with herpetic AU included conjunctival redness, corneal edema, history of keratitis, and development of posterior synechiae. Herpes simplex virus AU often had severe anterior chamber inflammation, whereas the presence of vitritis was more common in RV AU and VZV AU. The prevalence of documented intraocular pressure (IOP) of more than 30 mmHg (25%-50%; P = 0.06) and development of glaucoma (18%-30%; P = 0.686) were similar in all 3 groups. Focal chorioretinal scars were seen in 22% of RV AU eyes, in 0% of HSV AU eyes, and in 11% of VZV AU eyes (P = 0.003). Visual prognosis was favorable for all 3 groups. CONCLUSIONS: These observations identify clinical differences between RV AU, HSV AU, and VZV AU and may be of particular value to ophthalmologists who are unable to carry out intraocular fluid analysis to discriminate between these types of viral AU. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article. SN - 1549-4713 UR - https://www.unboundmedicine.com/medline/citation/21764137/Comparison_of_rubella_virus__and_herpes_virus_associated_anterior_uveitis:_clinical_manifestations_and_visual_prognosis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0161-6420(11)00325-3 DB - PRIME DP - Unbound Medicine ER -