Cytomegalovirus-associated anterior segment infection

Lassa Virus Targeting of Anterior Uvea and Endothelium of Cornea and Conjunctiva in Eye of Guinea Pig Model

“…The lack of reported ocular disease in LF survivors, along with the presence of only minimal or mild pathology in surviving animals, suggests less frequent or less severe ocular sequelae of LF than described in other viral hemorrhagic fever diseases. However, because similar mild inflammation has been associated with iris atrophy and ocular hypertension in other viral infections ( 31 , 32 ), the low degree of inflammation seen in our study is not necessarily innocuous. Although these data and the few clinical reports of ocular involvement in survivors of human LF disease support minimal long-term effects on vision, careful ophthalmologic observation of LF survivors is warranted, along with further longitudinal studies in the subpopulation of animal models that survive LASV infection despite clinical signs.…”

“…Another feature of ocular LASV infection noted in this study was the associated chronic inflammation, composed primarily of T-lymphocytes, in the anterior uvea, conjunctiva, and cornea in animals that died at later time points in the infection (>17 dpi). Lymphocytic anterior uveitis has been described in ocular infections with other viruses (e.g., rubella virus, cytomegalovirus, herpes simplex virus, and chikungunya virus) and can indicate a secondary immune response to viral antigens ( 31 , 32 ), although the pyknotic debris and swollen endothelium in the new vessels at the corneal margin in LASV-infected guinea pigs suggest a more acute insult. A predominantly T-lymphocyte response has been documented as a particularly important component of the systemic immune response to LASV infection ( 33 ).…”

Cytomegalovirus Retinitis and Uveitis

“…Disease course was characterized as recurrent in nine patients (56.3%) and chronic in seven (43.7%). These findings were generally consistent with those reported by others [5][6][17][18][19][20] and highlight several important facts: First, for reasons that are not entirely clear, CMV-associated anterior uveitis appears to occur far more often in Asians than non-Asians; second, the clinical presentation of CMV-associated anterior uveitis can be quite variable, and is often initially diagnosed as PSS, FHI/FUS, or herpetic anterior uveitis due to either herpes simplex virus (HSV) or varicella zoster virus (VZV) infection; 1,21 and third, both the inflammation and IOP in eyes with CMV-associated uveitis can be quite difficult to control, with many patients requiring long-term topical nonsteroidal anti-inflammatory drugs (NSAIDs) together with topical or systemic ganciclovir therapy. 22 …”

“…4 Equally uncommon is CMV-associated anterior uveitis in non-HIV-positive patients, reports of which have emerged predominantly, although not exclusively, from Asia. 1,[5][6][7] Four research articles [8][9][10][11] in this issue of Ocular Immunology & Inflammation present important findings relevant to the clinical presentation, progression, and management of CMVassociated retinitis and uveitis. Shah et al 8 studied a cohort of 176 HIV-positive patients seen in the Department of Ophthalmology at the Center for Communicable Diseases -The National Center for HIV Management in Singapore to determine the likelihood of identifying active CMVR during screening based on four widely accepted risk factors, including: 1) visual symptoms; 2) a CD4+ T-cell count 550 cells/mL; 3) the presence of one or more AIDS-defining illness (ADI); and 4) the presence of one or more opportunistic infection (OI).…”

Infectious uveitis: Recent advances in diagnosis and treatment

“…However, the overall recurrence rate is about 75.0% following antiviral therapy and do not greatly differ from eyes that did not receive antiviral treatment. Topical ganciclovir gel has a lower response rate, a lower relapse rate (25-50%) and fewer adverse effects (Jap & Chee, 2011).…”