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Jun Suzuki, Junichi Sakai, Yoshihiko Usui, Takeshi Kezuka, Hiroshi Goto; Clinical features of anterior uveitis caused by three different types of herpes virus. Invest. Ophthalmol. Vis. Sci. 2013;54(15):2909.
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To compare clinical findings in patients with anterior uveitis caused by herpes simplex virus (HSV), varicella zoster virus (VZV) and cytomegalovirus (CMV).
Forty-three patients (45 eyes) with viral anterior uveitis diagnosed by polymerase chain reaction using aqueous humor were studied. Clinical profiles of HSV iritis (HSV-I: 10 cases), VZV iritis (ZSH-I: 17 cases) and CMV iritis (CMV-I: 16 cases) were compared.
Only 2 patients with CMV-I had bilateral disease. Intraocular pressure was elevated in all patients. Keratic precipitate was seen in all patients and mutton-fat type was observed mostly in HSV-I (100%) and ZSH-I (82%). Iris atrophy was seen in HSV-I (67%) and ZSH-I (71%), which was typically round and sector shaped, respectively. Anterior chamber inflammation was severer in patients with HSV-I and ZSH-I compared to CMV-I. The number of viral copies in aqueous humor was high in patients with ZSH-I. In CMV-I, characteristic keratic precipitates (coin-shaped lesion) was seen in 50% and reduced number of corneal endothelial cell was detected in 93% of the patients. Viral DNA was detected in iris and trabecular meshwork in two patients with CMV-I who underwent trabeclectomy.
Anterior uveitis caused by various types of herpes virus share common features, but has some characteristic features for each type.
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