Cytomegalovirus as a cause of anterior uveitis with sectoral iris atrophy

Markomichelakis, Nikos N.; Canakis, Christina; Zafirakis, Panayotis; Marakis, Theodoros P; Mallias, Ioannis; Theodossiadis, George

doi:10.1016/s0161-6420(02)00961-2

Cited by 116 publications

(63 citation statements)

References 14 publications

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“…12 Our findings correspond well to previous reports, 7,10,13 which described CMV-associated AU in the immunocompetent host, presenting mostly as a recurrent unilateral hypertensive AU, sometimes associated with typical corneal endothelial precipitates, iris atrophy, and the absence of posterior synechiae. 6,7,14,15 In these previous studies, PCR was used as a main diagnostic tool. Our data demonstrate that GWC analysis can contribute to the diagnosis of CMV AU as 4/10 patients were diagnosed solely by GWC.…”

Section: Discussionmentioning

confidence: 99%

Viral causes of unexplained anterior uveitis in Thailand

Kongyai

Sirirungsi

Pathanapitoon

et al. 2012

Eye

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Aims To assess the possible role of virus infection in patients with unexplained anterior uveitis (AU). Methods Intraocular fluid and plasma samples of 30 HIV-negative AU patients who were unresponsive or poorly responsive to topical steroid therapy were analyzed for nucleic acid of cytomegalovirus (CMV), herpes simplex virus (HSV), and varicella zoster virus (VZV) by realtime polymerase chain reaction (PCR) and for intraocular antibodies against these viruses by Goldmann-Witmer coefficient (GWC) analysis. Of these 30 cases, 21 were tested for rubella virus by GWC analysis, 16 of which also had PCR assessment of aqueous for rubella virus. Results Viral uveitis determined by either real-time PCR and/or GWC was documented in 20 out of 30 patients (67%). Of 30 paired samples tested by both methods for HSV, CMV, and VZV, 15 showed positive results (CMV (10), HSV (4), and VZV (1)). Real-time PCR was positive in 8/15 (53%), whereas GWC was positive in 10/15 (67%). Out of 10 CMV-positive patients, four had endotheliitis, two had Posner-Schlossman syndrome, and one Fuchs heterochromic uveitis syndrome (FHUS). Five out of 21 (24%) samples tested by GWC for Rubella virus were positive, three of which exhibited clinical features of FHUS. Conclusions Our results indicate that CMV is a major cause of AU in Thailand and show that FHUS can be caused by both CMV and Rubella virus.

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Section: Discussionmentioning

confidence: 99%

Viral causes of unexplained anterior uveitis in Thailand

Kongyai

Sirirungsi

Pathanapitoon

et al. 2012

Eye

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“…We had a case of clinical diagnosis of CMV and the result of real-time PCR was positive for VZV. Clinical examination leaned CMV because the patient is HIV + and these patients are suffering from recurrence of cytomegalovirus due to antiretroviral treatment, and clinical characteristics are indistinguishable from previously (19,20) . Arora and collaborators (1999) evaluated the role of real-time PCR for detection of Mycobacterium tuberculosis in the aqueous humor samples obtained from eyes with active uveitis and showed that it can be effectively used for the diagnosis of intraocular tuberculosis (21) .…”

Section: Discussionmentioning

confidence: 99%

Real-time PCR in infectious uveitis as an alternative diagnosis

Santos¹,

Commodaro²,

Souza³

et al. 2011

Arq. Bras. Oftalmol.

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Purpose: Uveitis is a major visual impairment disease affecting parts or the entire uveal tract and occasionally the sclera, the cornea or the optic nerve. The disease is a major cause of ocular morbidity and blindness in immunocompetent and immunocompromised patients. In this work we analyzed the sensitivity and specificity of realtime PCR to detect the etiological agent from blood, plasma, vitreous and aqueous humor and compared with the diagnostic hypothesis. Methods: Twenty-seven patients (13 male) were studied and Real-time PCR method was used for the detection of herpes simplex virus 1 (HSV-1), herpes simplex virus 2 (HSV-2), varicella zoster virus (VZV), cytomegalovirus (CMV), Mycobacterium tuberculosis (TB) and Toxoplasma gondii (Toxo) in the aqueous humor as well as in the vitreous, blood and plasma. Results: Our results showed the presence of Toxo, CMV, VZV or HSV-2 in 19.2% of aqueous humor samples, and in 30% of vitreous humor samples. In plasma and blood samples, only CMV was detected (11.1% and 3.7%, respectively). Conclusion: Real-time PCR was able to detect and to confirm diagnostic hypothesis in uveitis. Our data also confirms that vitreous humor is the best source for molecular diagnosis of infectious uveitis but indicates aqueous humor samples that are easier to obtain may also be appropriate to be tested by Real-time PCR. Keywords

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“…7,9 The elevated IOP can result from anterior uveitis, which is not uncommon in CMV infection. 10,11 The clinical observation that corneal endothelial lesions always start from the periphery and move toward the center of the cornea implies that tissues surrounding the cornea, such as the trabecular meshwork or ciliary body, may be the reservoir for CMV. 7 CMV infects the CD34+ myeloid progenitor cells of the bone marrow, in which specific human cellular DNA binding proteins in the nucleus bind to the CMV immediateearly promoter and inhibit transcription.…”

Section: Congenital Symptomatic Cytomegalovirusmentioning

confidence: 99%