TY - JOUR
T1 - Distinguishing Features of Anterior Uveitis Caused by Herpes Simplex Virus, Varicella-Zoster Virus, and Cytomegalovirus
AU - Terada, Yukiko
AU - Kaburaki, Toshikatsu
AU - Takase, Hiroshi
AU - Goto, Hiroshi
AU - Nakano, Satoko
AU - Inoue, Yoshitsugu
AU - Maruyama, Kazuichi
AU - Miyata, Kazunori
AU - Namba, Kenichi
AU - Sonoda, Koh Hei
AU - Kaneko, Yutaka
AU - Numaga, Jiro
AU - Fukushima, Masaya
AU - Horiguchi, Noe
AU - Ide, Mitsunao
AU - Ehara, Fumie
AU - Miyazaki, Dai
AU - Hasegawa, Eiichi
AU - Mochizuki, Manabu
N1 - Funding Information:
Funding/Support: This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Financial Disclosures: Kaburaki T received grants from Eisai, Novaritis, and Santen. Nakano S received a grant from Novartis. Inoue Y is a consultant for M's Science Co. and received a grant from Santen. Maruyama K received a grant from SEED. Miyata K received grants from Alcon, Senju, Santen, AMO, Kissei, Chugai, Bayer, M's Science Co., and Novartis. Sonoda KH received grants from Santen, Alcon, and HOYA Co. Hasegawa E received grants from Santen and AbbVie GK. The remaining authors report no conflicts of interest. All authors attest that they meet the current ICMJE criteria for authorship.
Publisher Copyright:
© 2021 Elsevier Inc.
PY - 2021/7
Y1 - 2021/7
N2 - Purpose: To determine distinguishing features of the clinical characteristics of anterior uveitis (AU) caused by herpes simplex virus (HSV), varicella-zoster virus (VZV), and cytomegalovirus (CMV). Design: Retrospective, multicenter case series. Methods: Consecutive patients with herpetic AU examined at 11 tertiary centers in Japan between January 2012 and December 2017 and who were followed for ≥3 months were evaluated. Diagnosis was made by polymerase chain reaction (PCR) for HSV, VZV, or CMV in the aqueous humor, or classical signs of herpes zoster ophthalmicus. Results: This study enrolled 259 herpetic AU patients, including PCR-proven HSV-AU (30 patients), VZV-AU (50), and CMV-AU (147), and herpes zoster ophthalmicus (32). All HSV-AU and VZV-AU patients were unilateral, while 3% of CMV-AU patients were bilateral. Most HSV-AU and VZV-AU patients were sudden onset with an acute clinical course, while CMV-AU had a more insidious onset and chronic course. There were no significant differences for all surveyed symptoms, signs, and complications between HSV-AU and VZV-AU. However, significant differences were detected for many items between CMV-AU and the other two herpetic AU types. Ocular hyperemia and pain, blurring of vision, ciliary injection, medium-to-large keratic precipitates (KPs), cells and flare in the anterior chamber, and posterior synechia significantly more often occurred in HSV-AU and VZV-AU vs CMV-AU. In contrast, small KPs, coin-shaped KPs, diffuse iris atrophy, elevated intraocular pressure, and glaucoma surgery were significantly more frequent in CMV-AU vs HSV-AU and VZV-AU. Conclusion: This multicenter, retrospective study identified distinguishing features of HSV-AU, VZV-AU, and CMV-AU.
AB - Purpose: To determine distinguishing features of the clinical characteristics of anterior uveitis (AU) caused by herpes simplex virus (HSV), varicella-zoster virus (VZV), and cytomegalovirus (CMV). Design: Retrospective, multicenter case series. Methods: Consecutive patients with herpetic AU examined at 11 tertiary centers in Japan between January 2012 and December 2017 and who were followed for ≥3 months were evaluated. Diagnosis was made by polymerase chain reaction (PCR) for HSV, VZV, or CMV in the aqueous humor, or classical signs of herpes zoster ophthalmicus. Results: This study enrolled 259 herpetic AU patients, including PCR-proven HSV-AU (30 patients), VZV-AU (50), and CMV-AU (147), and herpes zoster ophthalmicus (32). All HSV-AU and VZV-AU patients were unilateral, while 3% of CMV-AU patients were bilateral. Most HSV-AU and VZV-AU patients were sudden onset with an acute clinical course, while CMV-AU had a more insidious onset and chronic course. There were no significant differences for all surveyed symptoms, signs, and complications between HSV-AU and VZV-AU. However, significant differences were detected for many items between CMV-AU and the other two herpetic AU types. Ocular hyperemia and pain, blurring of vision, ciliary injection, medium-to-large keratic precipitates (KPs), cells and flare in the anterior chamber, and posterior synechia significantly more often occurred in HSV-AU and VZV-AU vs CMV-AU. In contrast, small KPs, coin-shaped KPs, diffuse iris atrophy, elevated intraocular pressure, and glaucoma surgery were significantly more frequent in CMV-AU vs HSV-AU and VZV-AU. Conclusion: This multicenter, retrospective study identified distinguishing features of HSV-AU, VZV-AU, and CMV-AU.
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U2 - 10.1016/j.ajo.2021.03.020
DO - 10.1016/j.ajo.2021.03.020
M3 - Article
C2 - 33773985
AN - SCOPUS:85105326486
VL - 227
SP - 191
EP - 200
JO - American Journal of Ophthalmology
JF - American Journal of Ophthalmology
SN - 0002-9394
ER -