Cytomegalovirus as a cause of anterior uveitis with sectoral iris atrophy
Received 8 November 2000; accepted 24 August 2001.
Abstract
Objective
To report two cases of recurrent anterior uveitis with sectoral iris atrophy and ocular hypertension during attacks caused by cytomegalovirus (CMV).
Design
Two observational case reports.
Participants
Two immunocompetent patients with a history of recurrent unilateral hypertensive anterior uveitis with sectoral iris atrophy were referred to us with the presumptive diagnosis of herpetic uveitis.
Main outcome measures
Comprehensive ophthalmic examination, aqueous humor polymerase chain reaction (PCR), and peripheral blood serologic studies were performed on both patients.
Results
Examination of aqueous humor by PCR was positive for CMV and negative for herpesvirus. Serum IgG/IgM titers disclosed past CMV infection. Both patients responded well to antiviral therapy with ganciclovir. The final visual acuity level was 20/20 in both eyes of both patients.
Conclusions
CMV infection can produce recurrent attacks of anterior uveitis with clinical characteristics indistinguishable from those previously considered highly suggestive or even pathognomonic for herpetic infection. This observation has implications for the therapeutic management of such patients.
Manuscript no. 200786.
1Ocular Inflammation and Immunology Service, Department of Ophthalmology, General Hospital of Athens, Athens, Greece
2Vitreoretinal Service, Department of Ophthalmology, Tulane University, New Orleans, Louisiana, USA
3Department of Ophthalmology, General Hospital of Athens, Athens Medical School, Athens, Greece
Reprint requests to Nikos N. Markomichelakis, MD, Ocular Inflammation and Immunology Service, Department of Ophthalmology, General Hospital of Athens, Athens, Greece
1 The authors have no proprietary interest in any aspect of this study.
ABSTRACT