Tags

Type your tag names separated by a space and hit enter

[Diagnosis of herpetic uveitis and keratouveitis].
Klin Monbl Augenheilkd. 1998 May; 212(5):359-62.KM

Abstract

BACKGROUND

In epithelial viral keratitis as in viral retinitis, the diagnosis is made on the basis of typical clinical findings. A laboratory confirmation is achieved in over 80% using routine laboratory methods. In contrast, it is almost impossible to confirm the diagnosis of stromal herpetic keratitis in vivo using the currently available laboratory methods. Nothing is known about the situation in cases of viral anterior uveitis.

METHODS

Of 52 patients with granulomatous anterior uveitis, 31 were diagnosed on the basis of clinical findings as active herpetic uveitis (group 1), 14 as active granulomatous uveitis of unknown origin (group 2), and 7 had inactive disease after quietening down of herpetic uveitis (group 3). From all patients, aqueous humor was collected at the time of diagnosis and processed for viral culture, Herpes antigen ELISA, and amplification of viral DNA of HSV-1 and VZV.

RESULTS

Viral growth in culture was found in only one case in group 3. In this group, viral antigen or viral DNA were detected in no case. Herpes antigen was found in 5/31 cases (16%) in group 1 and in 1/11 cases (9%) in group 2, and viral DNA was found in 8/31 cases from group 1 (5x HSV-1 and 3x VZV) and in 5/14 cases (31%) from group 2. After combination of antigen detection and DNA amplification, the presence of virus was confirmed in 14/45 cases (29%).

CONCLUSION

Virus culture has not proven useful in the diagnosis of viral anterior segment disease. Despite their high overall sensitivity, neither antigen ELISA nor the amplification of viral DNA proved sensitive enough to establish a viral etiology. Nevertheless, a laboratory confirmation should be attempted in granulomatous uveitis of unknown origin after preclusion of an underlying systemic disease because of the consequences of a diagnosis of viral anterior segment disease for treatment and prognosis.

Authors+Show Affiliations

Universitäts-Augenklinik, Inselspital, Bern.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

English Abstract
Journal Article

Language

ger

PubMed ID

9677579

Citation

Schacher, S, et al. "[Diagnosis of Herpetic Uveitis and Keratouveitis]." Klinische Monatsblatter Fur Augenheilkunde, vol. 212, no. 5, 1998, pp. 359-62.
Schacher S, Garweg JG, Russ C, et al. [Diagnosis of herpetic uveitis and keratouveitis]. Klin Monbl Augenheilkd. 1998;212(5):359-62.
Schacher, S., Garweg, J. G., Russ, C., & Böhnke, M. (1998). [Diagnosis of herpetic uveitis and keratouveitis]. Klinische Monatsblatter Fur Augenheilkunde, 212(5), 359-62.
Schacher S, et al. [Diagnosis of Herpetic Uveitis and Keratouveitis]. Klin Monbl Augenheilkd. 1998;212(5):359-62. PubMed PMID: 9677579.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - [Diagnosis of herpetic uveitis and keratouveitis]. AU - Schacher,S, AU - Garweg,J G, AU - Russ,C, AU - Böhnke,M, PY - 1998/7/25/pubmed PY - 1998/7/25/medline PY - 1998/7/25/entrez SP - 359 EP - 62 JF - Klinische Monatsblatter fur Augenheilkunde JO - Klin Monbl Augenheilkd VL - 212 IS - 5 N2 - BACKGROUND: In epithelial viral keratitis as in viral retinitis, the diagnosis is made on the basis of typical clinical findings. A laboratory confirmation is achieved in over 80% using routine laboratory methods. In contrast, it is almost impossible to confirm the diagnosis of stromal herpetic keratitis in vivo using the currently available laboratory methods. Nothing is known about the situation in cases of viral anterior uveitis. METHODS: Of 52 patients with granulomatous anterior uveitis, 31 were diagnosed on the basis of clinical findings as active herpetic uveitis (group 1), 14 as active granulomatous uveitis of unknown origin (group 2), and 7 had inactive disease after quietening down of herpetic uveitis (group 3). From all patients, aqueous humor was collected at the time of diagnosis and processed for viral culture, Herpes antigen ELISA, and amplification of viral DNA of HSV-1 and VZV. RESULTS: Viral growth in culture was found in only one case in group 3. In this group, viral antigen or viral DNA were detected in no case. Herpes antigen was found in 5/31 cases (16%) in group 1 and in 1/11 cases (9%) in group 2, and viral DNA was found in 8/31 cases from group 1 (5x HSV-1 and 3x VZV) and in 5/14 cases (31%) from group 2. After combination of antigen detection and DNA amplification, the presence of virus was confirmed in 14/45 cases (29%). CONCLUSION: Virus culture has not proven useful in the diagnosis of viral anterior segment disease. Despite their high overall sensitivity, neither antigen ELISA nor the amplification of viral DNA proved sensitive enough to establish a viral etiology. Nevertheless, a laboratory confirmation should be attempted in granulomatous uveitis of unknown origin after preclusion of an underlying systemic disease because of the consequences of a diagnosis of viral anterior segment disease for treatment and prognosis. SN - 0023-2165 UR - https://www.unboundmedicine.com/medline/citation/9677579/[Diagnosis_of_herpetic_uveitis_and_keratouveitis]_ L2 - http://www.thieme-connect.com/DOI/DOI?10.1055/s-2008-1034906 DB - PRIME DP - Unbound Medicine ER -