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Clinical features of anterior uveitis caused by three different herpes viruses.
Int Ophthalmol. 2019 Dec; 39(12):2785-2795.IO

Abstract

PURPOSE

To compare the clinical findings in patients with anterior uveitis (AU) caused by herpes simplex virus (HSV), varicella zoster virus (VZV), and cytomegalovirus (CMV).

METHODS

We retrospectively analyzed the clinical profiles of HSV-AU (14 patients), VZV sine herpete (ZSH-AU: 21 patients), and CMV-AU (17 patients) diagnosed by the detection of corresponding viral DNA in aqueous humor samples by polymerase chain reaction. Further, five patients with Posner-Schlossman (P-S) syndrome were selected as controls for CMV-AU.

RESULTS

Patients with CMV-AU were predominately male or older in age, and all cases were unilateral except for three patients with CMV-AU. Mutton-fat keratic precipitates (KPs) were found mostly in patients with HSV-AU and ZSH-AU. Severities of AU and viral load were the highest in ZSH-AU, followed by HSV-AU and CMV-AU. Iris atrophy was observed in HSV-AU (50%) and ZSH-AU (76%), with typical morphology of round type and sector type, respectively. In patients with CMV-AU, a ring-shaped KP was found in 53% patients, 76% of whom showed a decreased number of corneal endothelial cells. CMV was not detected in the aqueous humor of patients with typical P-S syndrome.

CONCLUSION

Clinical findings of HSV-AU and VZV-AU were similar; however, more inflammatory findings were observed in VZV-AU. Iris atrophy morphologically differed in HSV-AU and VZV-AU. Inflammatory findings in CMV-AU were mild, and clinical features of iritis differed from those of the two former groups. A difference in the etiology between CMV-AU and P-S syndrome was observed.

Authors+Show Affiliations

Department of Ophthalmology, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.Department of Ophthalmology, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan. usuyoshi@gmail.com.Department of Ophthalmology, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.Department of Ophthalmology, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.Department of Ophthalmology, Tokyo Medical University Hospital, 6-7-1 Nishishinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31134426

Citation

Sakai, Jun-Ichi, et al. "Clinical Features of Anterior Uveitis Caused By Three Different Herpes Viruses." International Ophthalmology, vol. 39, no. 12, 2019, pp. 2785-2795.
Sakai JI, Usui Y, Suzuki J, et al. Clinical features of anterior uveitis caused by three different herpes viruses. Int Ophthalmol. 2019;39(12):2785-2795.
Sakai, J. I., Usui, Y., Suzuki, J., Kezuka, T., & Goto, H. (2019). Clinical features of anterior uveitis caused by three different herpes viruses. International Ophthalmology, 39(12), 2785-2795. https://doi.org/10.1007/s10792-019-01125-5
Sakai JI, et al. Clinical Features of Anterior Uveitis Caused By Three Different Herpes Viruses. Int Ophthalmol. 2019;39(12):2785-2795. PubMed PMID: 31134426.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical features of anterior uveitis caused by three different herpes viruses. AU - Sakai,Jun-Ichi, AU - Usui,Yoshihiko, AU - Suzuki,Jun, AU - Kezuka,Takeshi, AU - Goto,Hiroshi, Y1 - 2019/05/27/ PY - 2018/10/10/received PY - 2019/05/22/accepted PY - 2019/5/28/pubmed PY - 2020/3/17/medline PY - 2019/5/29/entrez KW - Anterior uveitis KW - Corneal endotheliitis KW - Cytomegalovirus KW - Herpes simplex virus KW - Varicella zoster virus SP - 2785 EP - 2795 JF - International ophthalmology JO - Int Ophthalmol VL - 39 IS - 12 N2 - PURPOSE: To compare the clinical findings in patients with anterior uveitis (AU) caused by herpes simplex virus (HSV), varicella zoster virus (VZV), and cytomegalovirus (CMV). METHODS: We retrospectively analyzed the clinical profiles of HSV-AU (14 patients), VZV sine herpete (ZSH-AU: 21 patients), and CMV-AU (17 patients) diagnosed by the detection of corresponding viral DNA in aqueous humor samples by polymerase chain reaction. Further, five patients with Posner-Schlossman (P-S) syndrome were selected as controls for CMV-AU. RESULTS: Patients with CMV-AU were predominately male or older in age, and all cases were unilateral except for three patients with CMV-AU. Mutton-fat keratic precipitates (KPs) were found mostly in patients with HSV-AU and ZSH-AU. Severities of AU and viral load were the highest in ZSH-AU, followed by HSV-AU and CMV-AU. Iris atrophy was observed in HSV-AU (50%) and ZSH-AU (76%), with typical morphology of round type and sector type, respectively. In patients with CMV-AU, a ring-shaped KP was found in 53% patients, 76% of whom showed a decreased number of corneal endothelial cells. CMV was not detected in the aqueous humor of patients with typical P-S syndrome. CONCLUSION: Clinical findings of HSV-AU and VZV-AU were similar; however, more inflammatory findings were observed in VZV-AU. Iris atrophy morphologically differed in HSV-AU and VZV-AU. Inflammatory findings in CMV-AU were mild, and clinical features of iritis differed from those of the two former groups. A difference in the etiology between CMV-AU and P-S syndrome was observed. SN - 1573-2630 UR - https://www.unboundmedicine.com/medline/citation/31134426/Clinical_features_of_anterior_uveitis_caused_by_three_different_herpes_viruses_ L2 - https://doi.org/10.1007/s10792-019-01125-5 DB - PRIME DP - Unbound Medicine ER -