March 2012
Volume 53, Issue 14
ARVO Annual Meeting Abstract  |   March 2012
Etiologic Diversity Of Atypical And Severe Anterior Uveitis
Author Affiliations & Notes
  • Audrey Fel
    Ophthalmology, Hopital la Pitié Salpétrière, Paris, France
  • Magdalena Bojanova
    Virology, Hopital Cochin, Paris, France
  • Valérie Touitou
    Ophthalmology, Hopital la Pitié Salpétrière, Paris, France
  • Phuc Le Hoang
    Ophthalmology, Hopital la Pitié Salpétrière, Paris, France
  • Flore Rozenberg
    Virology, Hopital Cochin, Paris, France
  • Bahram Bodaghi
    Ophthalmology, Hopital la Pitié Salpétrière, Paris, France
  • Footnotes
    Commercial Relationships  Audrey Fel, None; Magdalena Bojanova, None; Valérie Touitou, None; Phuc Le Hoang, None; Flore Rozenberg, None; Bahram Bodaghi, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science March 2012, Vol.53, 6190. doi:
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      Audrey Fel, Magdalena Bojanova, Valérie Touitou, Phuc Le Hoang, Flore Rozenberg, Bahram Bodaghi; Etiologic Diversity Of Atypical And Severe Anterior Uveitis. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6190.

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      © ARVO (1962-2015); The Authors (2016-present)

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Purpose: : To analyse the etiological distribution of long-lasting and severe anterior uveitis based on the analysis of the aqueous humor.

Methods: : Retrospective study of patients presenting with atypical, severe anterior uveitis and managed in a tertiary referral centre, between January 2008 and December 2009. Patients with panuveitis, intermediate and posterior uveitis and those with typical B27-associated uveitis or herpes zoster ophthalmicus were excluded. Patients were divided into three groups : atypical viral uveitis (group 1), typical herpetic uveitis (group 2), Fuchs uveitis (group 3). An anterior chamber paracentesis was performed in all cases to exclude a viral etiology.

Results: : The medical files of 153 patients were analysed. The mean age was 49 years (range 8-83 Years), the M/F sex ratio was 1.22. Uveitis was unilateral in 86.5% of cases. Group 1 included 42 patients with sarcoidosis (13 cases), tuberculosis (7 cases), endophthalmitis (6 cases), spondylarthropathy (10 cases), syphilis (2 cases), neoplasia (2 cases) and multiple sclerosis (2 cases). Group 2 included 83 cases. A viral agent was definitely identified in 33 cases (39.8%). The distribution of herpes viruses was the following : CMV (19 cases), HSV-1 (8 cases) and VZV (6 cases). The yield of anterior chamber paracentesis is increased by repetition of the procedure (up to 77.4% for CMV). The PCR-negative patients in Group 2 responded well to a specific antiviral treatment. None of the patients with Fuchs uveitis (Group 3) had a positive PCR for CMV. HSV-2 and EBV were not identified in this group of patients.

Conclusions: : Most cases of atypical anterior uveitis, especially when unilateral, are viral-induced. Molecular tools applied to ocular fluids can confirm a viral infection, leading to a specific antiviral therapy and an optimal control of the disease.

Keywords: inflammation • uveitis-clinical/animal model • herpes simplex virus 

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