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Clinical significance of owl eye morphologic features by in vivo laser confocal microscopy in patients with cytomegalovirus corneal endotheliitis.
Am J Ophthalmol. 2012 Mar; 153(3):445-53.AJ

Abstract

OBJECTIVE

To demonstrate the clinical significance of owl eye morphologic features observed by in vivo laser confocal microscopy in patients with cytomegalovirus (CMV) corneal endotheliitis.

DESIGN

Observational case series.

METHODS

participants: Six eyes of 6 patients (6 men; mean age, 73.3 years) with cytomegalovirus corneal endotheliitis diagnosed by clinical manifestations together with polymerase chain reaction from aqueous humor samples. intervention: All patients were examined by slit-lamp biomicroscopy and in vivo laser confocal microscopy. main outcome measures: Clinical manifestations were summarized by reviewing medical records. Selected confocal images of corneal layers were evaluated qualitatively for shape and degree of light reflection of abnormal cells and deposits.

RESULTS

All patients had long histories of anterior uveitis with intraocular pressure elevation, corneal edema with keratic precipitates, and decrease of endothelial cell densities. Coin-shaped lesions were observed by slit lamp only in 1 patient at the first visit and in 2 additional patients at subsequent follow-up. In all patients, confocal microscopy demonstrated reduced subepithelial nerves, subepithelial opacity, increased reflectivity of keratocytes, highly reflective dots, and needle-shaped bodies. Owl eye morphologic features were observed consistently in all patients at the initial visit, and highly reflective round bodies were detected in 5 patients; most notably, these confocal features were reversible after resolution of endotheliitis.

CONCLUSIONS

Owl eye morphologic features and highly reflective round bodies observed by confocal microscopy may be useful as an adjunct for the noninvasive diagnosis of cytomegalovirus corneal endotheliitis. Reversibility of these features after resolution of endotheliitis may be useful for monitoring the therapeutic effects without multiple anterior chamber tap.

Authors+Show Affiliations

Department of Ophthalmology, Kanazawa University Graduate School of Medical Science, Japan. kobaya@kenroku.kanazawa-u.ac.jpNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

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

Language

eng

PubMed ID

22030352

Citation

Kobayashi, Akira, et al. "Clinical Significance of Owl Eye Morphologic Features By in Vivo Laser Confocal Microscopy in Patients With Cytomegalovirus Corneal Endotheliitis." American Journal of Ophthalmology, vol. 153, no. 3, 2012, pp. 445-53.
Kobayashi A, Yokogawa H, Higashide T, et al. Clinical significance of owl eye morphologic features by in vivo laser confocal microscopy in patients with cytomegalovirus corneal endotheliitis. Am J Ophthalmol. 2012;153(3):445-53.
Kobayashi, A., Yokogawa, H., Higashide, T., Nitta, K., & Sugiyama, K. (2012). Clinical significance of owl eye morphologic features by in vivo laser confocal microscopy in patients with cytomegalovirus corneal endotheliitis. American Journal of Ophthalmology, 153(3), 445-53. https://doi.org/10.1016/j.ajo.2011.07.026
Kobayashi A, et al. Clinical Significance of Owl Eye Morphologic Features By in Vivo Laser Confocal Microscopy in Patients With Cytomegalovirus Corneal Endotheliitis. Am J Ophthalmol. 2012;153(3):445-53. PubMed PMID: 22030352.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical significance of owl eye morphologic features by in vivo laser confocal microscopy in patients with cytomegalovirus corneal endotheliitis. AU - Kobayashi,Akira, AU - Yokogawa,Hideaki, AU - Higashide,Tomomi, AU - Nitta,Koji, AU - Sugiyama,Kazuhisa, Y1 - 2011/10/25/ PY - 2011/06/04/received PY - 2011/07/23/revised PY - 2011/07/28/accepted PY - 2011/10/28/entrez PY - 2011/10/28/pubmed PY - 2012/4/21/medline SP - 445 EP - 53 JF - American journal of ophthalmology JO - Am. J. Ophthalmol. VL - 153 IS - 3 N2 - OBJECTIVE: To demonstrate the clinical significance of owl eye morphologic features observed by in vivo laser confocal microscopy in patients with cytomegalovirus (CMV) corneal endotheliitis. DESIGN: Observational case series. METHODS: participants: Six eyes of 6 patients (6 men; mean age, 73.3 years) with cytomegalovirus corneal endotheliitis diagnosed by clinical manifestations together with polymerase chain reaction from aqueous humor samples. intervention: All patients were examined by slit-lamp biomicroscopy and in vivo laser confocal microscopy. main outcome measures: Clinical manifestations were summarized by reviewing medical records. Selected confocal images of corneal layers were evaluated qualitatively for shape and degree of light reflection of abnormal cells and deposits. RESULTS: All patients had long histories of anterior uveitis with intraocular pressure elevation, corneal edema with keratic precipitates, and decrease of endothelial cell densities. Coin-shaped lesions were observed by slit lamp only in 1 patient at the first visit and in 2 additional patients at subsequent follow-up. In all patients, confocal microscopy demonstrated reduced subepithelial nerves, subepithelial opacity, increased reflectivity of keratocytes, highly reflective dots, and needle-shaped bodies. Owl eye morphologic features were observed consistently in all patients at the initial visit, and highly reflective round bodies were detected in 5 patients; most notably, these confocal features were reversible after resolution of endotheliitis. CONCLUSIONS: Owl eye morphologic features and highly reflective round bodies observed by confocal microscopy may be useful as an adjunct for the noninvasive diagnosis of cytomegalovirus corneal endotheliitis. Reversibility of these features after resolution of endotheliitis may be useful for monitoring the therapeutic effects without multiple anterior chamber tap. SN - 1879-1891 UR - https://www.unboundmedicine.com/medline/citation/22030352/Clinical_significance_of_owl_eye_morphologic_features_by_in_vivo_laser_confocal_microscopy_in_patients_with_cytomegalovirus_corneal_endotheliitis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002-9394(11)00609-X DB - PRIME DP - Unbound Medicine ER -