Skip to main content

Advertisement

SpringerLink
Log in

Comparison of the ocular characteristics of anterior uveitis caused by herpes simplex virus, varicella-zoster virus, and cytomegalovirus

  • Clinical Investigation
  • Published:
Japanese Journal of Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To compare the clinical characteristics of anterior uveitis (AU) caused by herpes simplex virus (HSV), varicella-zoster virus (VZV), or cytomegalovirus (CMV).

Methods

The medical records were reviewed of 46 patients whose diagnoses were based on their clinical characteristics [e.g., unilateral involvement, presence of keratic precipitates (KPs), and elevation of intraocular pressure (IOP)] and on PCR detection of herpes virus DNA in the aqueous humor. The demographics, chief complaints, and clinical characteristics of the three types of herpetic AU were compared.

Results

Of the 46 patients with AU, eight had HSV-AU, 20 had VZV-AU, and 18 had CMV-AU. HSV-AU and VZV-AU shared common features, i.e., a relatively acute disease process and the presence of large KPs. Among the three groups of patients, the characteristic features of those with VZV-AU were severe intraocular inflammation, as shown by severe aqueous flare, highest viral load in the aqueous humor, and presence of segmental iris atrophy. In comparison, patients with CMV-AU had the mildest intraocular inflammation, lowest corneal endothelial cell density, and highest IOP.

Conclusions

Although the AU caused by each of the three types of herpes viruses has a number of common features, each disease also has distinct features that should facilitate an accurate diagnosis.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Goto H, Mochizuki M, Yamaki K, Kotake S, Usui M, Ohno S. Epidemiological survey of intraocular inflammation in Japan. Jpn J Ophthalmol. 2007;51:41–4.

    Article  PubMed  Google Scholar 

  2. Ohguro N, Sonoda KH, Takeuchi M, Matsumura M, Mochizuki M. The 2009 prospective multi-center epidemiologic survey of uveitis in Japan. Jpn J Ophthalmol. 2012;56:432–5.

    Article  PubMed  Google Scholar 

  3. Jap A, Chee SP. Viral anterior uveitis. Curr Opin Ophthalmol. 2011;22:483–8.

    Article  PubMed  Google Scholar 

  4. Chee SP, Bacsal K, Jap A, Se-Thoe SY, Cheng CL, Tan BH. Clinical features of cytomegalovirus anterior uveitis in immunocompetent patients. Am J Ophthalmol. 2008;145:834–40.

    Article  PubMed  Google Scholar 

  5. Chee SP, Jap A. Presumed fuchs heterochromic iridocyclitis and Posner–Schlossman syndrome: comparison of cytomegalovirus-positive and negative eyes. Am J Ophthalmol. 2008;146:883.e1–889.e1.

    Google Scholar 

  6. de Schryver I, Rozenberg F, Cassoux N, Michelson S, Kestelyn P, Lehoang P, et al. Diagnosis and treatment of cytomegalovirus iridocyclitis without retinal necrosis. Br J Ophthalmol. 2006;90:852–5.

    Article  PubMed Central  PubMed  Google Scholar 

  7. Hwang YS, Lin KK, Lee JS, Chang SH, Chen KJ, Lai CC, et al. Intravitreal loading injection of ganciclovir with or without adjunctive oral valganciclovir for cytomegalovirus anterior uveitis. Graefes Arch Clin Exp Ophthalmol. 2010;248:263–9.

    Article  CAS  PubMed  Google Scholar 

  8. Kawaguchi T, Sugita S, Shimizu N, Mochizuki M. Kinetics of aqueous flare, intraocular pressure and virus-DNA copies in a patient with cytomegalovirus iridocyclitis without retinitis. Int Ophthalmol. 2007;27:383–6.

    Article  PubMed  Google Scholar 

  9. Koizumi N, Suzuki T, Uno T, Chihara H, Shiraishi A, Hara Y, et al. Cytomegalovirus as an etiologic factor in corneal endotheliitis. Ophthalmology. 2008;115:292.e3–297.e3.

    Article  Google Scholar 

  10. Miyanaga M, Sugita S, Shimizu N, Morio T, Miyata K, Maruyama K, et al. A significant association of viral loads with corneal endothelial cell damage in cytomegalovirus anterior uveitis. Br J Ophthalmol. 2010;94:336–40.

    Article  PubMed  Google Scholar 

  11. Sugita S, Shimizu N, Watanabe K, Mizukami M, Morio T, Sugamoto Y, et al. Use of multiplex PCR and real-time PCR to detect human herpes virus genome in ocular fluids of patients with uveitis. Br J Ophthalmol. 2008;92:928–32.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  12. Kongyai N, Pathanapitoon K, Sirirungsi W, Kunavisarut P, de Groot-Mijnes JD, Rothova A. Infectious causes of posterior uveitis and panuveitis in Thailand. Jpn J Ophthalmol. 2012;56:390–5.

    Article  PubMed  Google Scholar 

  13. De Groot-Mijnes JD, Rothova A, Van Loon AM, Schuller M, Ten Dam-Van Loon NH, De Boer JH, et al. Polymerase chain reaction and Goldmann–Witmer coefficient analysis are complimentary for the diagnosis of infectious uveitis. Am J Ophthalmol. 2006;141:313–8.

    Article  PubMed  Google Scholar 

  14. Zhang Y, Kimura T, Fujiki K, Sakuma H, Murakami A, Kanai A. Multiplex polymerase chain reaction for detection of herpes simplex virus type 1, type 2, cytomegalovirus, and varicella-zoster virus in ocular viral infections. Jpn J Ophthalmol. 2003;47:260–4.

    Article  CAS  PubMed  Google Scholar 

  15. Marsh RJ, Easty DL, Jones BR. Iritis and iris atrophy in Herpes zoster ophthalmicus. Am J Ophthalmol. 1974;78:255–61.

    Article  CAS  PubMed  Google Scholar 

  16. Hogan MJ, Kimura SJ, Thygeson P. Pathology of Herpes simplex kerato-iritis. Trans Am Ophthalmol Soc. 1963;61:75–99.

    CAS  PubMed Central  PubMed  Google Scholar 

Download references

Acknowledgments

We thank Professor Duco Hamasaki for his critical review of the manuscript. We also thank Dr. Takashi Komizo for his assistance in collecting the data.

Conflicts of interest

H. Takase, None; R. Kubono, None; Y. Terada, None; A. Imai, None; S. Fukuda, None; M. Tomita, None; M. Miyanaga, None; K. Kamoi, None; S. Sugita, None; K. Miyata, None; M. Mochizuki, None.

Author information

Authors and Affiliations

  1. Department of Ophthalmology & Visual Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan

    Hiroshi Takase, Reo Kubono, Yukiko Terada, Ayano Imai, Shoko Fukuda, Masaru Miyanaga, Koju Kamoi & Manabu Mochizuki

  2. Miyata Eye Hospital, 6-3 Kurahara-cho, Miyakonojo, Miyazaki, 885-0051, Japan

    Yukiko Terada & Kazunori Miyata

  3. Tokyo Medical and Dental University Hospital of Medicine Clinical Research Center, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519, Japan

    Makoto Tomita

  4. Laboratory for Retinal Regeneration, RIKEN Center for Development Biology, 2-2-3 Minatojima-minami Machi, Chuo-ku, Kobe, Hyogo, 650-0047, Japan

    Sunao Sugita

Authors
  1. Hiroshi Takase
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Reo Kubono
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yukiko Terada
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ayano Imai
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Shoko Fukuda
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Makoto Tomita
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Masaru Miyanaga
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Koju Kamoi
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Sunao Sugita
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Kazunori Miyata
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Manabu Mochizuki
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hiroshi Takase.

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Takase, H., Kubono, R., Terada, Y. et al. Comparison of the ocular characteristics of anterior uveitis caused by herpes simplex virus, varicella-zoster virus, and cytomegalovirus. Jpn J Ophthalmol 58, 473–482 (2014). https://doi.org/10.1007/s10384-014-0340-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10384-014-0340-6

Keywords

Search

Navigation