Distinguishing Features of Anterior Uveitis Caused by- Herpe
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A Study was conducted to determine distinguishing features of the clinical characteristics of anterior uveitis (AU) caused by herpes simplex virus (HSV), varicella-zoster virus (VZV) and cytomegalovirus (CMV).

Consecutive patients with herpetic AU examined at 11 tertiary centers and who were followed for 3 months or longer were evaluated. Diagnosis was made by polymerase chain reaction (PCR) for HSV, VZV or CMV in the aqueous humor, or classical signs of herpes zoster ophthalmicus.

--This study enrolled 259 herpetic AU patients, including PCR-proven HSV-AU (30 patients), VZV-AU (50) and CMV-AU (147); and herpes zoster ophthalmicus (32).

--All HSV-AU and VZV-AU patients were unilateral, while 3% of CMV-AU patients were bilateral.

--Most HSV-AU and VZV-AU patients were sudden onset with an acute clinical course, while CMV-AU had a more insidious onset and chronic course.

--There were no significant differences for all surveyed symptoms, signs and complications between HSV-AU and VZV-AU.

--However, significant differences were detected for many items between CMV-AU and the other two herpetic AU types.

--Ocular hyperemia and pain, blurring of vision, ciliary injection, medium to large keratic precipitates (KPs), cells and flare in the anterior chamber, and posterior synechia occurred significantly more often in HSV-AU and VZV-AU versus CMV-AU.

--In contrast, small KPs, coin-shaped KPs, diffuse iris atrophy, elevated intraocular pressure and glaucoma surgery were significantly more frequent in CMV-AU versus HSV-AU and VZV-AU.

Conclusively, this multicenter retrospective study identified distinguishing features of HSV-AU, VZV-AU and CMV-AU.

Source: https://www.sciencedirect.com/science/article/abs/pii/S0002939421001331?dgcid=rss_sd_all