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Feng Hu, Xiaoyan Peng; The Presentations of Posterior Involvement for Diagnosis in Herpetic Posterior Uveitis. Invest. Ophthalmol. Vis. Sci. 2018;59(9):3652.
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© ARVO (1962-2015); The Authors (2016-present)
To explore the value of posterior involvement formations for diagnosis in patients with acute retinal necrosis and cytomegalovirus retinitis.
Detailed clinical presentation especially the formations of posterior involvementwere retrospectively analyzed in patients with herpetic posterior uveitis and patients as control group. Herpetic posterior uveitis included acute retinal necrosis and cytomegalovirus retinitis. The control group included patients with non-infectious uveitis.
Thirteen cases of acute retinal necrosis and four cases of cytomegalovirus retinitis were involved in the study. The control group included eighteen patients whose clinical features did not prove herpetic uveitis and the PCR results were negative for herpetic virus. Optic disc hyperemia was observed in12/17 herpetic posterior uveitis cases and 3/18 cases in control group (P<0.01). Arteritis involving the major branches of retinal artery was observed in 13/17 herpetic posterior uveitis and 2/18 cases in control group (P<0.01). Para-optic disc hemorrhage was observed in 7/17 herpetic posterior uveitis cases and 1/18 cases in control group (P=0.018). In the diagnosis of herpetic posterior uveitis, the optic disc hyperemia is 71% for sensitivity, 83% for specificity, 80% for positive prediction value and 75% for negative prediction value. The arteritis of major branches has the sensitivity of 76%, specificity of 89%, positive prediction value of 87% and negative prediction value of 87% for the diagnosis of herpetic posterior uveitis. The para-optic disc hemorrhage has the specificity of 94% and positive prediction value of 88% for the diagnosis of herpetic posterior uveitis. However, the coexist of optic disc hyperemia, arteritis of major branches, and para-optic disc hemorrhage has 100% specificity and 100% positive prediction value for the diagnosis of herpetic posterior uveitis.
The optic disc hyperemia, arteritis of major branches, and para-optic disc hemorrhage are relatively sensitive and specific signs for herpetic posterior uveitis which can indicate the herpetic infection., especially the coexist of them has high specificity and positive prediction value.
This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.
Figure-1 The fundus of acute retina necrosis patient showing optic disc hypheme and para-optic disc hemorrhage.
Figure-2 Fundus of cytomagalovirus retinisit showing major branches of retinal arteritis.
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