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Yukiko Terada, Toshikatsu Kaburaki, Hiroshi Takase, Satoko Nakano, Hiroshi Goto, Yoshitsugu Inoue, Kazuichi Maruyama, Kazunori Miyata, Kenichi Namba, Koh-hei Sonoda, Yutaka Kaneko, Jiro Numaga, Manabu Mochizuki; A multi-center retrospective study on clinical characteristics of herpetic anterior uveitis in Japan. Invest. Ophthalmol. Vis. Sci. 2020;61(7):5385.
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© ARVO (1962-2015); The Authors (2016-present)
To identify clinical characteristics of anterior uveitis (AU) caused by herpes simplex virus (HSV), varicella-zoster virus (VZV) and cytomegalovirus (CMV).
Study design was a multi-center retrospective chart-review study at 11 centers in Japan. Subjects were consecutive patients with herpetic AU between January 2012 and December 2017, and followed longer than 3 months at each center. Diagnosis was made based on positive results of polymerase chain reaction for HSV, VZV or CMV of aqueous humor or skin blister at 1st branch of V nerve (herpes zoster ophthalmicus). Demographics, symptoms, clinical manifestations and complications were compared among the three herpesviruses.
A total of 264 eyes of 259 patients (264/259) consisting of 30/30 of HSV, 82/82 of VZV and 152/147 of CMV were enrolled in the study, Gender (M/F ratio) was 0.88 (HSV), 0.82 (VZV), and 2.62 (CMV) (p<0.01, HSV vs CMV, VZV vs CMV, Fisher’s exact test), and average age was 68.4 years (HSV), 60.8 (VZV) and 62.7 (CMV) (p=0.05, ANOVA). Blurring of vision was recorded in 83% (HSV) and 62% (VZV), but only 10% in CMV (p<0.0001, HSV vs CMV, VZV vs CMV). Onset was sudden in more than 60% of all three herpetic AU and recurrence was seen in 33% (HSV), 10% (VZV) and 51% (CMV) (p<0.01, HSV vs VZV, VZV vs CMV). Elevated intraocular pressure (IOP) ≧21mmHg was recorded in 67% (HSV), 62% (VZV) and 93% (CMV) (p<0.001, HSV vs CMV, VZV vs CMV). Average of maximum IOP was 28.1 (HSV), 26.1 (VZV) and 36.5mmHg (CMV) (p<0.0001, Kruskal-Wallis). Ciliary injection was seen in 70% (HSV), 65% (VZV) and 26% (CMV) (p<0.0001, HSV vs CMV, VZV vs CMV). Mutton-fat keratic precipitates was recorded in 93% (HSV), 68% (VZV) and 89% (CMV). Corneal endothelial cell loss (<1000/mm2) was recorded in 10% (HSV), 6% (VZV) and 19% (CMV) and bullous keratopathy was recorded in 10% (HSV), 4% (VZV) and 12% (CMV). Iris atrophy was recorded in 23% (HSV), 29% (VSV) and 20% (CMV), in which 43% of HSV was small patchy, 54% of VZV was sectoral and 80% of CMV was diffuse iris atrophy. Glaucoma surgery was performed in 7% (HSV), 9% (VZV) and 45% (CMV) (p<0.0001, HSV vs CMV, VZV vs CMV). Interval between disease onset and diagnosis longer than 1 year was 27% (HSV), 2% (VZV) and 70% (CMV) (p<0.001, HSV vs CMV, VZV vs CMV).
A multicenter retrospective study identified clinical characteristics of HSV-AU, VZV-AU and CMV-AU.
This is a 2020 ARVO Annual Meeting abstract.
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