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Uwe Pleyer, Therese Walla, Matthias Lenglinger; Biomorphological findings in CMV-associated anterior uveitis. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6684.
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© ARVO (1962-2015); The Authors (2016-present)
Cytomegalovirus (CMV)-associated acute anterior uveitis (AU) is characterized by recurrent, unilateral episodes of increased intraocular pressure (IOP) and is often synonymously referred to as Posner-Schlossman syndrome (PSS). Only few studies focused so far on morphological changes. Therefore we evaluated biomorphological findings on corneal endothelium and optic nerve changes.
Patients and MethodsIn total, 52 patients (34 males) were analyzed, presenting as PSS between 2007-2018 at Charité, Berlin. All individuals underwent aqueous humor analysis to confirm intraocular viral infection. specific intraocular antibody synthesis against CMV. Clinical findings and morphological changes of the optic nerve head were documented by Spectral Domain Optical Coherence Tomography (SD-OCT). Corneal endothelial cell density was evaluated using specular microscopy. Changes of the affected eye were compared with the contralateral eye at initial presentation and during the course of the disease.Collected data were analyzed using SPSS and underwent multivariate analysis of variance (MANOVA).
At the time of initial examination patients presented with unilateral markedly elevated IOP (45 ± 11 mmHg). In all affected eyes specific intraocular antibody synthesis against CMV was confirmed. SD-OCT revealed a significantly thinner peripapillary retinal nerve fiber layer (RNFL) in the affected as compared to the contralateral eye (MANOVA; F = 9.11; DF (1; 38); p <0.01; n2 = 0.19). During follow-up (mean 24.6 months), there was a significant further decrease in RNFL in 17 patients (MANOVA, F = 6.13, DF (1; 16), p <0.05, n2 = 0.28).Endothelial cell count indicated a significantly lower cell density in the affected eye (MANOVA; F = 20.56; DF (1; 28); p <0.01; n2 = 0.42), while there was no further decline during follow-up.
Our observations indicate that morphological changes to the optic nerve head and endothelial cells may occur even early in the course of the disease. Since these changes are irreversible, better therapeutic and preventive strategies are needed.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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