High Prevalence of Anelloviruses in Vitreous Fluid of Children With Seasonal Hyperacute Panuveitis

Abstract

Seasonal hyperacute panuveitis (SHAPU) is a potentially blinding ocular disease occurring in Nepal that principally affects young children. Random amplification of partially purified vitreous fluid (VF)-derived nucleic acid revealed the presence of human anelloviruses in VF of SHAPU patients. In a comparative study of patients with different ocular pathologies, SHAPU patients were at highest risk of harboring anelloviruses in their eyes. The majority of SHAPU patients had multiple anelloviruses in their VF. The ocular anellovirus load in SHAPU and non-SHAPU patients did not differ and no SHAPU-specific anellovirus variant was detected. Analysis of paired serum and VF samples from SHAPU and non-SHAPU patients showed that the anellovirus detected in VF samples most likely originated from the systemic viral pool during viremia, potentially through breakdown of the blood-ocular barrier. The detection of anelloviruses in VF samples of uveitis patients, profoundly so in SHAPU patients, is imperative and warrants elucidation of its clinical significance.

Identification of Torque Teno Virus in Culture-Negative Endophthalmitis by Representational Deep DNA Sequencing

“…In two previous survey studies, TTV was isolated from the tears of 59% 34 and 66% 35 of subjects. Recently Smits et al 36 described recovery of TTV from the vitreous of children affected seasonal hyperacute panuveitis (SHAPU), a severe form of panuveitis that resembles endophthalmitis, which is endemic to Nepal. 37 The authors reported that TTV was found in~90% of vitreous samples from SHAPU patients, as well as ~50% of endophthalmitis samples, but not in vitreous samples recovered from retinal detachment surgery.…”

Patterns of Uveitis and Scleritis in Nepal: A Tertiary Referral Center Study

“…Recently, bacterial growth (mainly Streptococcus pneumoniae) has been found in the vitreous culture of some affected eyes and Anello viruses have been isolated from vitreous of many eyes. 28,29 In pediatrics, the commonest identified cause was either JRA or Toxoplasmosis in previous studies. 30,31 But in this study, SHAPU was the commonest cause.…”

Emerging Causes of Viral-associated Uveitis

“…It has been described previously in Nepal and most often affects young, healthy children 29 . The etiology remains unclear, although a viral cause has been proposed 29,30 . Epidemics appear to follow a 2 year cycle and an association with white Tussock moths has been postulated.…”

“…Epidemics appear to follow a 2 year cycle and an association with white Tussock moths has been postulated. 29,31 …”

“…A hypopyon with a dense fibrinoid reaction in the anterior chamber is commonly observed 29 . Intraocular pressure decreases resulting in hypotony 31 .…”