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Laure E Caspers, Joelle Antoun, Jolanda de Groot-Mijnes, Elie Motulsky, N.H.ten Dam-van Loon, François Willermain, Lia Judice Relvas; Diagnosis cytomegalovirus anterior uveitis/endothelitis in immunocompetent patients.. Invest. Ophthalmol. Vis. Sci. 2016;57(12):2338.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: To evaluate the diagnostic methods and clinical signs leading the diagnosis of CMV anterior uveitis (AU) and/or endothelitis from 2 uveitis tertiary referral center in Brussels (Belgium) and in Utrecht (Nederland).
A retrospective study of patients with a clinical diagnosis of CMV AU and endothelitis with positive polymerase chain reaction (PCR) and or Goldmann-Witmer coefficient (GWc) positive.
Results: We report a series of 19 patients presenting clinical characteristics of CMV AU and /or endothelitis including ring-shaped (coin-shaped) KPs, Posner-Shlossman syndrome and Fuchs heterochromic iridocyclitis with a positive PCR and/or GWc for CMV. There was 13/19 (68.4 %) males, 2 Asian (10.5%). At diagnosis, the mean was 37.0 years [14-62], all (100%) were unilateral and 16/18 (88.9%) had elevated intraocular pressure (IOP) > 25 mm Hg (mean elevated IOP: 41.6 mm Hg). PCR was tested in all the 19 patients while GWc was only tested in 8 patients. PCR was positive for CMV in 14/19 patients (73.7 %) and GWc was positive for CMV in 7/8 patients (87.5%), both PCR and GW were positive for CMV in 2 patients. Aqueous tap was repeated in 8 patients (2 times in 5 cases, 3 times in 2 cases) to be able to confirm the clinical diagnosis of CMV anterior uveitis/endothelitis.
Conclusion: the biological confirmation by PCR of clinical diagnosis of CMV AU/ endothelitis remains difficult and can be improved by repeated aqueous taps and GWc measurement..
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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