Clinical Features and Diagnosis of Anterior Segment Inflammation Related to <i>Cytomegalovirus</i> in Immunocompetent African, Asian, and Caucasian Patients

Leleu, Igor; Jhanji, Vishal; Touhami, Sara; Westcott, Mark; Angi, Martina; Titah, Chérif; Rousseau, Antoine; Hamard, P.; Brasnu, Emmanuelle; Manicom, Thomas; Blumen-Ohana, E.; Rozenberg, Flore; Vauloup‐Fellous, Christelle; Deback, Claire; Labétoulle, Marc; Sahel, José‐Alain; Bodaghi, Bahram; Merabet, Lilia; Kobal, Alfred B.; Brignole‐Baudouin, Françoise; Errera, Marie‐Hélène

doi:10.1080/09273948.2019.1662059

Cited by 12 publications

(9 citation statements)

References 52 publications

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“…In the treatment of CMV infections, a study found that ganciclovir topical ointment is effective in preventing relapses of CMV-associated uveitis (19,21), whereas oral valganciclovir appears to be more effective in acute episodes (22,23). Another study showed that oral valganciclovir is effective in treating acute symptoms and in reducing the frequency of disease recurrence (24). It was also reported that if anti-CMV therapy can effectively control cytomegalovirus replication, antiglaucoma surgery is rarely required (5).…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Aqueous Humor Laboratory Analysis of Chinese Patients With Rubella Virus-Associated and Cytomegalovirus-Associated Fuchs Uveitis Syndrome

et al. 2020

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Purpose: To describe and compare the clinical characteristics and laboratory analysis results of aqueous humor (AH) in fuchs uveitis syndrome (FUS) patients caused by rubella virus (RV) and cytomegalovirus (CMV).Methods: A retrospective and observation-based study was performed on 32 patients with FUS. Etiologies, clinical characteristics, ocular complications, visual prognoses, inflammatory cytokines, and virus-specific antibodies in AH were compared.Results: Among all the cases involved, 24 had RV FUS and 8 had CMV FUS. The mean age at diagnosis of FUS in the CMV group was older than that of the RV group (P = 0.031). The mean LogMAR best corrected visual acuity (BCVA) at initial presentation and at the final visit were both significantly higher in the CMV FUS group than those in the RV FUS group (P = 0.004, 0.047). The highest intraocular pressure (IOP) was significantly higher in the CMV group (P = 0.040). Consistent with elevated IOP, the CMV FUS patients were significantly more prone to developing glaucoma eventually than the RV FUS patients (P = 0.039). Vitreous opacity was found in 66.7% of the RV patients and 25.0% of the CMV patients (P = 0.038). The gender ratio, initial symptoms, presence and types of keratic precipitates, severity of anterior segment inflammation, iris lesions, and incidence of complicated cataract were similar between the two groups. There was no detectable difference of inflammatory cytokines in AH between RV FUS and CMV FUS.Conclusion: The clinical manifestations and disease prognosis vary between CMV FUS and RV FUS. However, clinical differences are always not obvious enough for differential diagnosis. The laboratory AH analysis is necessary to identify the etiology, determine the therapeutic strategies, and assess the disease prognosis.

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Section: Discussionmentioning

confidence: 99%

Clinical Characteristics and Aqueous Humor Laboratory Analysis of Chinese Patients With Rubella Virus-Associated and Cytomegalovirus-Associated Fuchs Uveitis Syndrome

et al. 2020

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“…With regards to the relative prevalence of CMV- related AU presentations, we showed in our own series of 38 patients that features of Posner-Schlossman syndrome were observed in 50% of the eyes, Fuchs heterochromic iridocyclitis in 13% of the eyes, chronic nonspecific AU in 21% of the eyes, and corneal endotheliitis in 18% of the eyes [ 94 ]. Diagnosis usually relies on aqueous fluid viral PCR or Goldmann-Witmer coefficients positive for CMV [ 2 , 87 , 88 , 95 ].…”

Section: Misdiagnoses Among Uveitis/ Anterior Segment Inflammation En...mentioning

confidence: 99%

Mimickers of anterior uveitis, scleritis and misdiagnoses- tips and tricks for the cornea specialist

Caplash,

Paez-Escamilla,

Westcott

et al. 2024

J Ophthal Inflamm Infect

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Background Anterior uveitis, inflammation of the anterior chamber and related structures, is a cohort of diseases that can present to almost any general or sub-specialty Ophthalmology practice. Its features classically involve anterior chamber cell and flare. Below the surface of these two signs exist a panoply of diagnoses. Body The purpose of this review is to provide a general framework for diagnoses of anterior uveitis that are often missed as well as non-uveitic pathologies that often mimic anterior uveitis. Diagnostic deviation in either direction can have vision-threatening and rarely life-threatening consequences for patients. Using a comprehensive literature review we have collected a broad spectrum of etiologies of anterior uveitis that are easily missed and non-uveitic pathologies that can masquerade as anterior uveitis. Conclusions We present a focused review on specific misdiagnosed anterior uveitis pathologies and some of the conditions that can masquerade as anterior uveitis and scleritis.

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“…[ 7 ] Furthermore, oral ganciclovir, valganciclovir, or intravitreal ganciclovir have shown satisfactory responses in patients. [ 9 ] Some patients even have relapses after discontinuation of therapy. [ 9 ] A study among Japanese patients suggests a close association of HLA-Bw54 with PSS, thereby indicating an immune-genetic role being played here.…”

mentioning

confidence: 99%

“…[ 9 ] Some patients even have relapses after discontinuation of therapy. [ 9 ] A study among Japanese patients suggests a close association of HLA-Bw54 with PSS, thereby indicating an immune-genetic role being played here.…”

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confidence: 99%

Clinical profile, demographic distribution, and management of Posner–Schlossman syndrome: An electronic medical record-driven data analytics from an eye care network in India

Warjri,

Das,

Senthil

2023

Indian Journal of Ophthalmology

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Purpose: To describe the clinical profile, demographics, and management of Posner–Schlossman syndrome (PSS) in patients presenting to a multitier ophthalmology hospital network in India. Methods: This cross-sectional hospital-based study included 3,082,727 new patients presenting between August 2010 and December 2021. Patients with a clinical diagnosis of PSS in at least one eye were included as cases. The data were collected using an electronic medical record system. Results: Overall, 130 eyes of 126 (0.004%) patients were diagnosed with PSS. The majority of the patients were male (81.75%) and had unilateral (96.83%) affliction. The most common age group at presentation was during the fourth decade of life, with 46 (36.5%) patients. The overall prevalence was higher in patients from a higher socioeconomic status (0.005%) presenting from the metropolitan geography (0.008%) and in professionals (0.014%). A significant number of patients (108; 83.08%) had a raised intraocular pressure of >30 mm of Hg. The majority of the eyes had mild or no visual impairment (better than 20/70) in 99 (76.15%) eyes. Keratic precipitates were found in 59 (45.38%) eyes, anterior chamber cells in 43 (33.08%) eyes, and iris atrophy in seven (5.38%) eyes. The majority of eyes (127; 97.69%) had open angles on gonioscopy. The average duration of use of topical steroids was 1.70 ± 0.76 months, and the average duration of use of topical antiglaucoma medications (AGMs) was 1.66 ± 0.81 months, with 35 eyes (26.92%) requiring continued AGMs. Among the surgical interventions, trabeculectomy was performed in nine (6.92%) eyes and cataract surgery in five (3.85%) eyes. Conclusion: PSS more commonly affects males presenting during the fourth decade of life from higher socioeconomic status and is predominantly unilateral. The majority of the eyes have mild or no visual impairment, open angles, and require surgical intervention in a tenth of the eyes.

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Clinical Features and Diagnosis of Anterior Segment Inflammation Related to Cytomegalovirus in Immunocompetent African, Asian, and Caucasian Patients

Cited by 12 publications

References 52 publications

Clinical Characteristics and Aqueous Humor Laboratory Analysis of Chinese Patients With Rubella Virus-Associated and Cytomegalovirus-Associated Fuchs Uveitis Syndrome

Clinical Characteristics and Aqueous Humor Laboratory Analysis of Chinese Patients With Rubella Virus-Associated and Cytomegalovirus-Associated Fuchs Uveitis Syndrome

Mimickers of anterior uveitis, scleritis and misdiagnoses- tips and tricks for the cornea specialist

Clinical profile, demographic distribution, and management of Posner–Schlossman syndrome: An electronic medical record-driven data analytics from an eye care network in India

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