Rubella virus as a possible etiological agent of Fuchs heterochromic iridocyclitis

Suzuki, Jun; Gotô, Hiroshi; Komase, Katsuhiro; Abo, Hitoshi; Fujii, Kaoru; Otsuki, Noriyuki; Okamoto, Kazuhira

doi:10.1007/s00417-010-1434-6

Cited by 67 publications

(50 citation statements)

References 22 publications

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“…Rubella virus infection was diagnosed by detection of intraocular antibody production solely, which is similar to previous results. 4,[27][28][29] The clinical sensitivity of PCR and GWC is difficult to assess, as there is no official gold standard defined for these viral uveitis entities. However, from literatures, it is known that PCR has a sensitivity of up to 81% in detecting VZV or HSV in herpetic AU.…”

Section: Discussionmentioning

confidence: 99%

“…5 For Rubella virus, it has been reported consistently that the GWC is positive in virtually 100% of FHUS cases and that this virus is also strongly associated with incomplete cases of FHUS; PCR is of little value for the diagnosis of Rubella virus associated uveitis. 4,5,26,28,29 It has been shown that the sensitivity of diagnostic tests was influenced by the time interval between the onset of symptoms and sample collection. 9 Our study included an insufficient number of patients to investigate these associations.…”

Section: Discussionmentioning

confidence: 99%

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Viral causes of unexplained anterior uveitis in Thailand

Kongyai

Sirirungsi

Pathanapitoon

et al. 2012

Eye

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Aims To assess the possible role of virus infection in patients with unexplained anterior uveitis (AU). Methods Intraocular fluid and plasma samples of 30 HIV-negative AU patients who were unresponsive or poorly responsive to topical steroid therapy were analyzed for nucleic acid of cytomegalovirus (CMV), herpes simplex virus (HSV), and varicella zoster virus (VZV) by realtime polymerase chain reaction (PCR) and for intraocular antibodies against these viruses by Goldmann-Witmer coefficient (GWC) analysis. Of these 30 cases, 21 were tested for rubella virus by GWC analysis, 16 of which also had PCR assessment of aqueous for rubella virus. Results Viral uveitis determined by either real-time PCR and/or GWC was documented in 20 out of 30 patients (67%). Of 30 paired samples tested by both methods for HSV, CMV, and VZV, 15 showed positive results (CMV (10), HSV (4), and VZV (1)). Real-time PCR was positive in 8/15 (53%), whereas GWC was positive in 10/15 (67%). Out of 10 CMV-positive patients, four had endotheliitis, two had Posner-Schlossman syndrome, and one Fuchs heterochromic uveitis syndrome (FHUS). Five out of 21 (24%) samples tested by GWC for Rubella virus were positive, three of which exhibited clinical features of FHUS. Conclusions Our results indicate that CMV is a major cause of AU in Thailand and show that FHUS can be caused by both CMV and Rubella virus.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Viral causes of unexplained anterior uveitis in Thailand

Kongyai

Sirirungsi

Pathanapitoon

et al. 2012

Eye

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“…What triggers inflammation in FHI is still not known; Rubella virus, Toxoplasma gondii, and cytomegalovirus have all been identified as the probable triggers (Suzuki et al, 2010).…”

Section: Introductionmentioning

confidence: 99%

Small-incision cataract surgery in patients with Fuch’s heterochromic iridocyclitis

Bhargava

Kumar

Sharma³

et al. 2014

Nep J Oph

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Introduction: Fuch's heterochromic iridocyclitis (FHI) is often complicated by cataract formation. Objective: To assess the results of small-incision cataract surgery (SICS) in FHI and to study the effect of preoperative factors on postoperative vision. Materials and methods: Sixty-three eyes of 59 patients with Fuchs heterochromic iridocyclitis who had SICS with in-the-bag implantation of intraocular lens (IOL) were evaluated retrospectively; and the primary and secondary outcome measures evaluated were the postoperative vision and complication rate. Results: The mean age was 39.22 ± 4.95 years. The mean pre-operative vision was 0.75 ± 0.24 Log MAR units. The mean final vision was 0.27 ± 0.10 Log MAR units (P = < 0.001). At the final follow-up, 84.1 % of the patients had a final Snellen's vision of 6/12 or better. The mean follow-up period was 12.06 ± 2.06 months. The causes of corrected distance visual acuity (CDVA) worse than 6/60 were vitreous opacities, posterior keratic precipitates (KPs), glaucoma, persistent uveitis and cystoid macular edema (CME). Preoperative factors like iris atrophy (P = 0.973), heterochromia (P = 0.10) and vessels in angle (P = 0.074) did not have a significant effect on the final vision. On the contrary, vitreous opacities (P = 0.002) and posterior KPs (P = 0.009) had a significant effect on the final visual outcome. Conclusion: SICS with in-the-bag implantation of IOL in patients with Fuch's heterochromic iridocyclitis resulted in good visual outcomes. SICS in complicated cataracts can be performed in rural settings and eye camps with minimal instrumentation, obviating the need for referral to tertiary care centres. Pre-operative factors like vitreous opacities and posterior KPs have a significant effect on the final vision.

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“…Suzuki et al [74] demonstrated significant intraocular synthesis of rubella virus antibodies (GWC [ 3) in all ten of the Japanese patients with FHI which were tested, but not in the control group (n = 8); moreover, the rubella genome was detected by nested reverse transcription (RT)-PCR in two of nine patients (22%) tested. Taken together, these laboratory data strongly suggest a relationship between FHI and the rubella virus.…”

Section: Rubella Virusmentioning

confidence: 99%

A new era of uveitis: impact of polymerase chain reaction in intraocular inflammatory diseases

et al. 2016

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Uveitis is a sight-threatening intraocular inflammatory disorder which may occur from both infectious and non-infectious or autoimmune causes. The frequency of infectious uveitis and autoimmune uveitis varies depending on countries and regions. According to a nationwide survey conducted by the Japanese Ocular Inflammation Society, infectious and non-infectious uveitis accounted for 16.4 and 50.1% of new patients, respectively while the remaining 33.5% of new uveitis cases were not classified or were idiopathic uveitis. Infectious uveitis is particularly important because it causes tissue damage to the eye and may result in blindness unless treated. However, it can be treated if the pathogenic microorganisms are identified promptly and accurately. Remarkable advancements in molecular and immunological technologies have been made in the last decade, and the diagnosis of infectious uveitis has been greatly improved by the application of molecular and immunological investigations, particularly polymerase chain reaction (PCR). PCR performed on a small amount of ocular samples provides a prompt, sensitive, and specific molecular diagnosis of pathogenic microorganisms in the eye. This technology has opened a new era in the diagnosis and treatment of uveitis, enabling physicians to establish new clinical entities of uveitis caused by infectious microorganisms, identify pathogens in the eyes of many patients with uveitis, and determine prompt diagnosis and appropriate therapy. Here we review the PCR process, new PCR tests specialized for ocular diseases, microorganisms detected by the PCR tests, diseases in the eye caused by these microorganisms, and the clinical characteristics, diagnosis, and therapy of uveitis.

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Rubella virus as a possible etiological agent of Fuchs heterochromic iridocyclitis

Abstract: Our laboratory data strongly suggest a relationship between FHI and rubella virus.

Cited by 67 publications

References 22 publications

Viral causes of unexplained anterior uveitis in Thailand

Viral causes of unexplained anterior uveitis in Thailand

Small-incision cataract surgery in patients with Fuch’s heterochromic iridocyclitis

A new era of uveitis: impact of polymerase chain reaction in intraocular inflammatory diseases

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