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LL Lim, R Stawell, A Hall; "Presumed" Herpetic Uveitis - Infective or Auto-immune? Dectecting Human Herpes Virus in Suspected Cases Using PCR on Aqueous Humour Samples . Invest. Ophthalmol. Vis. Sci. 2002;43(13):4308.
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Purpose: To determine the prevalence of Human Herpes Viral DNA in the aqueous humour of patients with "presumed" herpetic uveitis and to correlate the presence of viral DNA with the clinical features. Methods: Patients with unilateral anterior uveitis with iris atrophy but without evidence of active or past herpetic keratitis or zoster ophthalmicus were prospectively enrolled. All patients underwent an anterior chamber paracentesis according to a standardized protocol. All aqueous samples were analyzed with the Polymerase Chain Reaction (PCR) for HSV types 1 and 2, VZV and CMV via a nested multiplex PCR. The results of the PCR were then correlated with the clinical features of each patient. Results:7 patients were recruited in a 12 month period. 2 had chronic uveitis (≷3 months) and 5 had acute (<3 months) recurrent uveitis. Of the 2 patients with chronic uveitis, both had a duration of ≷1 year and mild inflammation at the time of their paracentesis. The PCR in these patients was negative. Of the patients with recurrent, acute uveitis, 4 had moderate to severe inflammation at the time of their paracentesis, with 2 of these patients having a history of oral/facial cold sores. These 2 patients had HSV type 1 detected in their aqueous, whilst the third was negative. The fourth patient had uveitis for 8 weeks, raised intraocular pressure and moderate inflammation. The PCR in this patient was positive for VZV . The fifth patient had mild inflammation and a negative PCR result. Conclusion:A subset of patients with recurrent acute uveitis and iris atrophy harbour herpetic viral DNA and their inflammation may be the result of active viral infection from either HSV or VZV. A finding of viral DNA was more likely if there was a shorter duration of inflammation and more severe inflammation. Correlation of uveitis characteristics and PCR results View OriginalDownload SlideView OriginalDownload Slide
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