Viral posterior uveitis

Abstract

The causes of posterior uveitis can be divided into infectious, autoimmune, or masquerade syndromes. Viral infections, a significant cause of sight-threatening ocular diseases in the posterior segment, include human herpesviruses, measles, rubella, and arboviruses such as dengue, West Nile, and chikungunya virus. Viral posterior uveitis may occur as an isolated ocular disease in congenital or acquired infections or as part of a systemic viral illness. Many viruses remain latent in the infected host with a risk of reactivation that depends on various factors, including virulence and host immunity, age, and comorbidities. Although some viral illnesses are self-limiting and have a good visual prognosis, others, such as cytomegalovirus retinitis or acute retinal necrosis, may result in serious complications and profound vision loss. Since some of these infections may respond well to antiviral therapy, it is important to work up all cases of posterior uveitis to rule out an infectious etiology. We review the clinical features, diagnostic tools, treatment regimens, and long-term outcomes for each of these viral posterior uveitides.

Epidemiology and pathogenesis of uveitis: A review

“…Several viruses can affect the retina. 46 These include human herpes viruses, measles, rubella, dengue, West Nile, chikungunya, influenza and Zika virus. 47,48 It can affect patients with immunocompromised conditions like AIDS, organ transplantation, and malignancy as well as immune competent subjects.…”

Infectious uveitis: an Asian perspective

“…Anterior segment features of dengue infection include subconjunctival hemorrhage, keratitis, anterior uveitis, and angle closure glaucoma. Most common posterior segment manifestations of dengue fever include macular edema, hemorrhages, foveolitis, cotton wool spots, and microaneurysms [111][112][113].…”

“…There may be concomitant corneal involvement with dendritic pattern of keratic precipitates. Other features include raised intraocular pressure, episcleritis, and lagophthalmos [111,134,135].…”

Ocular findings in patients with novel A/H1N1 infection: an observational cross-sectional study

“…Systemic viral infections (human immunodeficiency virus (HIV), cytomegalovirus, herpes simplex, herpes zoster, chikungunya and West Nile virus) are commonly associated with ocular lesions, usually posterior uveitis, due to their hematogenous dissemination. HIV infection, additionally, shows a classic microvasculopathy (cotton wool spots or hemorrhages) that reflect direct endothelial infection 4 . However, reports of ocular lesions (infective or vasculopathic) in A/H1N1 infections are limited.…”