Cytomegalovirus-related Scleritis

Accorinti, Massimo; Abbouda, Alessandro; Gilardi, Marta; Zito, Roberta; Iannetti, Ludovico

doi:10.3109/09273948.2013.805787

Cited by 11 publications

(4 citation statements)

References 7 publications

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“…Although rare, other viruses in the Herpesviridae family such as Epstein-Barr virus and cytomegalovirus have also been reported to cause IS. 74,75…”

Section: Virusesmentioning

confidence: 99%

Infectious Scleritis: Pathophysiology, Diagnosis, and Management

Syed

Rapuano

2021

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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Infectious scleritis (IS) is a rare and severe ocular disorder responsible for approximately 5%-15% of all scleritis cases. It is often associated with a poor prognosis due to its similar clinical presentation to autoimmune scleritis, resulting in a delayed diagnosis and treatment. Therefore, differentiating between infectious and noninfectious entities is critical. Several details extracted from the patient's history and clinical examination can raise suspicion for infection. The most common predisposing factor is previous ocular surgery, especially pterygium, cataract, and vitreoretinal surgeries. Ocular trauma, poor contact lens hygiene, "eye-whitening" procedures, and subtenon triamcinolone injections have also been implicated. Clinical features of infection include the presence of scleral necrosis, hypopyon, unifocal or multifocal scleral abscesses, and mucopurulent discharge. Thorough diagnostic testing is essential before excluding infection as a possibility. Empiric broad-spectrum topical and systemic antibiotic therapy should be initiated while awaiting laboratory results and adjusted accordingly. Most IS cases require both aggressive medical and surgical treatment, and various studies have reported favorable outcomes with this combination. At this time, there is no consensus on the management of this severe ocular condition, and future studies are needed to establish clear treatment guidelines.

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“…Although rare, other viruses in the Herpesviridae family such as Epstein-Barr virus and cytomegalovirus have also been reported to cause IS. 74,75…”

Section: Virusesmentioning

confidence: 99%

Infectious Scleritis: Pathophysiology, Diagnosis, and Management

Syed

Rapuano

2021

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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“… 18 Scleritis has also been reported as an ocular manifestation of viral diseases. Although the members of Herpesviridae family, such as herpes simplex virus type-1 and varicella zoster virus, are more commonly reported to be associated with scleritis, 19 cytomegalovirus, 20 Epstein–Barr virus, 21 and dengue fever virus 22 have also been implicated. Our cases illustrate anterior scleritis as a possible late ocular manifestation of COVID-19.…”

Section: Discussionmentioning

confidence: 99%

Anterior Scleritis Manifesting After Coronavirus Disease 2019: A Report of Two Cases

Feizi

Meshksar

Naderi

et al. 2021

Cornea

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Purpose: The purpose of this study was to report 2 patients with anterior scleritis manifesting after coronavirus disease 2019 (COVID-19). Methods: The patients with confirmed COVID-19 developed anterior scleritis after their systemic symptoms were markedly improved. A thorough systemic workup identified no underlying autoimmune diseases. Ocular characteristics and safety and efficacy of systemic immunosuppressive therapy were evaluated. Results: Case 1 was a 67-year-old woman who presented with necrotizing anterior scleritis in both eyes 3 weeks after the onset of COVID-19. One-week treatment with topical betamethasone and oral prednisolone (65 mg daily) did not result in improvement, so she was started on intravenous cyclophosphamide and subcutaneous adalimumab in addition to oral prednisolone. Necrotizing scleritis was gradually improved over 3 months. Case 2 was a 33-year-old man who presented with sectoral anterior scleritis in his right eye 2 weeks after the onset of COVID-19. He was started on topical betamethasone and oral prednisolone (85 mg daily). One week later, all signs and symptoms disappeared, and topical and oral corticosteroids were gradually tapered off over 2 weeks. There was no recurrence of respiratory symptoms or active scleritis in any cases after discontinuation of treatment. Conclusions: These cases suggest that COVID-19 can be associated with anterior scleritis, which responds to immunosuppressive and biologic agents. Ophthalmologists should consider anterior scleritis in patients with COVID-19 who present with ocular pain and redness during the convalescent phase of the illness.

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“…This manifestation is especially prevalent with decreased CD4 lymphocyte counts, serving as a potential marker for monitoring disease progression and severity. Additionally, viral infections such as CMV retinitis, present with distinctive retinal findings, including vascular-distributed, hemorrhagic, or granular retinitis, providing a diagnostic marker, especially crucial in contexts of immunosuppression, whether due to HIV or other etiologies like organ transplantation [45,46]. Detection of CMV infection in the eye, beyond its ocular implications, signals a vital alert for possible life-threatening systemic involvement, thereby underscoring the importance of ocular assessments in comprehensive patient management, especially amidst immunosuppressive conditions [47,48].…”

Section: Systemic Viral Infectionsmentioning

confidence: 99%

From Bedside to Diagnosis: The Role of Ocular Fundus in Systemic Infections

Visioli,

Zeppieri,

Iannucci

et al. 2023

JCM

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In this comprehensive review, we delve into the significance of the ocular fundus examination in diagnosing and managing systemic infections at the bedside. While the utilization of advanced ophthalmological diagnostic technologies can present challenges in bedside care, especially for hospitalized patients confined to their beds or during infection outbreaks, the ocular fundus examination often emerges as an essential, and sometimes the only practical, diagnostic tool. Recent discussions have highlighted that the role of an ocular fundus examination might not always be advocated as a routine diagnostic procedure. With this context, we introduce a decision tree tailored for assessing the ocular fundus in inpatients with systemic infections. We also present an overview of systemic infections that impact the eye and elucidate key signs detectable through a bedside ocular fundus examination. Targeted primarily at non-ophthalmology clinicians, this review seeks to offer a comprehensive insight into a multifaceted approach and the enhancement of patient clinical outcomes.

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Cytomegalovirus-related Scleritis

Cited by 11 publications

References 7 publications

Infectious Scleritis: Pathophysiology, Diagnosis, and Management

Infectious Scleritis: Pathophysiology, Diagnosis, and Management

Anterior Scleritis Manifesting After Coronavirus Disease 2019: A Report of Two Cases

From Bedside to Diagnosis: The Role of Ocular Fundus in Systemic Infections

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