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K Scott, P Mackenzie, K Parkinson, F Mikelberg, D Rollins, M Dobrogowski, NK Wade; Posner-Schlossman Syndrome - The Pacific Northwest Experience . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4257.
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Purpose: To describe the clinical course of Posner-Schlossman Syndrome (PSS) (Glaucomatocyclitic crisis) in the Pacific Northwest and to evaluate the possible role of herpes simplex virus in the pathogenesis. Method: A retrospective chart review was conducted on 978 uveitis patients. Twenty-three patients were selected as having a diagnosis of PSS based on criteria that included initially acute, episodic presentations of nongranulomatous anterior uveitis with elevated intraocular pressures. Characteristic features and trends were identified and patients for whom relevant data was missing were brought in to complete the data set. Results: There were 12 males and 11 females with a racial distribution of 14 Asians, 8 Caucasians and 1 East-Indian. Mean age of onset was 37.9 years with 20 (86.9%) unilateral cases. Seven (30.4%) cases were initially diagnosed and treated as acute angle closure glaucoma before referral was made. Number of relapses varied from 1 to 60 (Median = 5.1). Six patients described HSV oral or labial symptoms with reactive IgG titres measured in 62.5% of patients. Four patients underwent therapeutic trials of oral Acyclovir in addition to traditional pressure-lowering and anti-inflammatory regimens. Conclusion: Posner-Schlossman Syndrome is a rare form of uveitis with secondary elevated intraocular pressure. Presenting features often overlap with other uveitic conditions, particularily HSV uveitis. This study demonstrates an association between PSS and HSV based on systemic HSV titres. However not all patients had positive serum titres despite a high sensitivity. Many classic findings of HSV anterior uveitis such as decreased corneal sensation, iris transillumination, mydriasis, granulomatous KP were rarely observed. This suggests the presence of other etiologic factors for PSS which further study may help to define.
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