Anterior uveitis with sectoral iris atrophy in the absence of keratitis

Lelij, Allegonda Van der; Ooijman, Francien; Kijlstra, Aize; Rothová, Aniki

doi:10.1016/s0161-6420(00)00115-9

Cited by 146 publications

(114 citation statements)

References 22 publications

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“…29,30 Furthermore, patients with HSV or VZV-associated AU show decreased corneal sensation. 30,32,33 In contrast to HSV, VZV may show involvement of the vitreous. 34 HSV usually affects children and young adults, VZV is more often seen in elderly and immunocompromised patients.…”

Section: Syphilis-associated Anterior Uveitismentioning

confidence: 99%

Challenges of Diagnosing Viral Anterior Uveitis

Groen-Hakan

Babu²,

Tuğal-Tutkun

et al. 2017

Ocular Immunology and Inflammation

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The viral causes of anterior uveitis (AU) emerged with the use of novel molecular diagnostic tests and serologic tests adapted for small volumes (Goldmann-Witmer Coefficient). The viral causes of AU may be underestimated, and some of the presumed idiopathic AU cases will probably be proven to be of viral origin in the coming years. So far, a viral origin of AU was suspected in patients who presented with unilateral hypertensive AU. It is not clear which clinical presentations should raise a suspicion of viral etiology. There is an overlap in the clinical manifestations of AU caused by viruses and other non-viral forms of AU. A viral cause of AU should be suspected in patients with unilateral AU, exhibiting small or medium sized KPs, some form of iris atrophy, high IOP and early development of a cataract and the definitive diagnosis can be proven by aqueous humor analysis.

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Section: Syphilis-associated Anterior Uveitismentioning

confidence: 99%

Challenges of Diagnosing Viral Anterior Uveitis

Groen-Hakan

Babu²,

Tuğal-Tutkun

et al. 2017

Ocular Immunology and Inflammation

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“…In addition to iris involvement in primary inflammatory conditions of various ocular tissues, there had previously been a longstanding question as to whether HSV-induced iritis could occur without concurrent or precedent keratitis. Studies performed since have indicated that HSV may cause iritis that predisposes to glaucoma without necessarily causing keratitis (6). Although these results indicate the possible pathogenesis mediated by primary HSV-1 infection of the iris, primary infection of human iris stromal (HIS) cells has not been previously investigated.…”

mentioning

confidence: 92%

“…The iris, a specialized eye tissue, is affected in various inflammatory ophthalmic conditions (2,3). For instance, inflammation of the iris following HSV-1 infection may be associated with elevated intraocular pressure, ultimately resulting in glaucoma, although the possibility remains that this may be steroid induced (4)(5)(6). The iris has been shown to have histopathologic involvement in HSV-1 infection of the corneal stroma, herpetic stromal keratitis (HSK) (3).…”

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confidence: 99%

Susceptibility of Human Iris Stromal Cells to Herpes Simplex Virus 1 Entry

Baldwin

Park

Zanotti

et al. 2013

J Virol

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Ocular herpes simplex virus 1 (HSV-1) infection can lead to multiple complications, including iritis, an inflammation of the iris. Here, we use human iris stroma cells as a novel in vitro model to demonstrate HSV-1 entry and the inflammatory mediators that can damage the iris. The upregulated cytokines observed in this study provide a new understanding of the intrinsic immune mechanisms that can contribute to the onset of iritis. Herpes simplex virus 1 (HSV-1) is a significant ocular pathogen affecting multiple regions, including the iris (1). The iris, a specialized eye tissue, is affected in various inflammatory ophthalmic conditions (2, 3). For instance, inflammation of the iris following HSV-1 infection may be associated with elevated intraocular pressure, ultimately resulting in glaucoma, although the possibility remains that this may be steroid induced (4-6). The iris has been shown to have histopathologic involvement in HSV-1 infection of the corneal stroma, herpetic stromal keratitis (HSK) (3). Inflammation of the iris is also seen in herpetic anterior uveitis, a condition that often presents as an inflammation of the iris and ciliary body (iridocyclitis) and is the leading cause of infectious anterior uveitis worldwide (2). In addition to iris involvement in primary inflammatory conditions of various ocular tissues, there had previously been a longstanding question as to whether HSV-induced iritis could occur without concurrent or precedent keratitis. Studies performed since have indicated that HSV may cause iritis that predisposes to glaucoma without necessarily causing keratitis (6). Although these results indicate the possible pathogenesis mediated by primary HSV-1 infection of the iris, primary infection of human iris stromal (HIS) cells has not been previously investigated. Likewise, chemokine signaling, which plays a significant role in many inflammatory eye conditions (7), has been poorly studied in the context of HSV-1 infection of HIS cells. The current study demonstrates the potential of an in vitro HIS cell model to uncover the molecular basis of viral entry and the identity of the inflammatory mediators involved.HSV-1 starts its infectious journey into cells via interactions of its envelope glycoproteins with their respective host cell receptors (8). The initial attachment involves glycoprotein B (gB) and glycoprotein C (gC) interactions with host cell surface heparan sulfate proteoglycans (9, 10). HSV-1 glycoprotein D (gD), with its subsequent conformational changes, can bind to any of its host cell receptors, such as nectin-1, herpesvirus entry mediator (HVEM) (11), or 3-O-sulfated heparan sulfate (3-OS HS) (12). This conformational change is important since it allows for the gD-host cell receptor complex to associate with the heterodimer complex of glycoprotein H-glycoprotein L (gH-gL). This allows gH-gL to bind gB, a process that allows the viral and host cell membranes to fuse (12,13).Following infection by HSV-1, the intrinsic inflammatory responses contribute strongly to subsequent di...

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“…BAİD'te iridosiklitlerden farklı olarak ön kamarada inflamatuar hücre bulunmaz, kornea endotelinde biriken pigmentler inflamatuvar hücre içer-mez, kolaret ile iris kökü arasında difüz iris depigmentasyonu ve ön kamara açısında yaygın pigment birikimi görülür (1)(2)(3) . Herpetik iridosiklitler ise aynı gözde unilateral rekürrensler, iriste sektörel veya yamalı atrofi ve göz içi basıncında akut yükselmeler ile karakterizedir (4)(5)(6) . BAİD'li hastaların hepsinde bilateral simetrik tutulum görülürken herpetik iridosiklitlerde bilateral tutulum enderdir (2,7) .…”

Section: Introductionunclassified

Bilateral acute depigmentation of iris: A report of two cases

Ersöz¹,

Doğan²,

Nacaroğlu³

et al. 2016

Terh

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ÖZBilateral akut iris depigmentasyonu ön kamarada pigment dispersiyonu, iris depigmentasyonu ve diskolorasyonu, inflamatuvar kompanentlerin bulunmaması ve ön kamara açısında pigment birikimi ile karakterize yeni tanımlanmış bir tablodur. Bu çalışmada kliniğimize birer hafta arayla kızarıklık, ağrı ve ışık hassasiyeti yakınmalarıyla başvuran ve bilateral akut iris depigmentasyonu tanısı konulan 24 ve 22 yaşlarında iki kadın olgunun seyrini sunmayı amaçladık. İki olgunun muayene bulguları benzerdi. Biomikroskopide bilateral konjonktival hiperemi, kornea endotelinde iris pigmentleri, ön kamarada yüzen iris pigmentleri, kolaret ile iris kökü arasında diffüz iris depigmentasyonu mevcuttu. Hastaların gonioskopisinde ön kamara açısında yaygın pigment birikimi olduğu görüldü. Aközde inflamatuar hücre, posterior sineşi, iris transilluminasyon defekti, lens ön kapsül-ünde pigment birikimi izlenmedi. Sekiz aylık takip süresince nüks izlenmedi. İris depigmentasyon alanlarında repigmentasyon başladı. Olgu 1'de repigmentasyon sırasında sağ gözde iris nevüsü gelişti. Bilateral akut iris depigmentasyonu, iridosiklitler, pigment dispersiyonu yapan hastalıklar ve iris atrofisinin görüldüğü durumlarla karışabilmektedir. Bu hastalıkların ayrıcı tanısı yapılırken kesinlikle bilateral akut iris depigmentasyonu da göz önünde bulundurulmalıdır. Anahtar kelimeler: iridosiklit, iris atrofisi, iris depigmentasyonu, pigment dispersiyonu ABSTRACTBilateral acute depigmentation of the iris is a new condition characterized by pigment dispersion in the anterior chamber, iris depigmentation and lack of inflammatory components. We report two female cases aged 24 and 22 years who presented at two weekintervals with redness, pain, photophobia and diagnosed as bilateral acute depigmentation of the iris. Ocular examinations of two cases were similar. Bilateral conjunctival hyperemia iris pigment precipitates on the cornea endothelium, floating iris pigment deposits in the anterior chamber and diffuse iris depigmentation between collarette and iris root were seen. In gonioscopic examination of patients, there was diffuse pigment deposition in the anterior chamber. Inflammatory cells in aqueous humour, posterior synechiae, iris transillumination defect or pigment deposition on the anterior capsule of lens weren't detected. During 8 months of follow-up any incident of recurrence was not detected. Iris repigmentation started on areas of iris depigmentation. A new iris nevus developed on the right eye of Case 1. Bilateral acute depigmentation of the iris may be misdiagnosed as iridocyclitis and the conditions with pigment dispersion or iris atrophy. Bilateral acute depigmentation of the iris should be definitely considered in the differential diagnosis of these conditions.

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Anterior uveitis with sectoral iris atrophy in the absence of keratitis

Cited by 146 publications

References 22 publications

Challenges of Diagnosing Viral Anterior Uveitis

Challenges of Diagnosing Viral Anterior Uveitis

Susceptibility of Human Iris Stromal Cells to Herpes Simplex Virus 1 Entry

Bilateral acute depigmentation of iris: A report of two cases

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