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Comparison of Clinical Characteristics between Patients with Cytomegalovirus Positive and Negative Hypertensive Uveitis
거대세포바이러스 양성 및 음성 고안압포도막염환자군들의 임상적 특징 비교
JKOS 2020 Mar;61(3):258-66
Published online March 15, 2020;  https://doi.org/10.3341/jkos.2020.61.3.258
Copyright © 2020 The Korean Ophthalmological Society.
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Jin-Ho Kim, MD, Ji-Young Lee, MD, Jin-A Choi, MD, PhD
김진호⋅이지영⋅최진아

Department of Ophthalmology, College of Medicine, The Catholic University, Seoul, Korea
가톨릭대학교 의과대학 안과학교실
Received May 30, 2019; Revised August 7, 2019; Accepted February 21, 2020.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
 Abstract
Purpose: To compare the clinical characteristics of hypertensive uveitis patients, with and without cytomegalovirus (CMV) infection.
Methods: CMV polymerase chain reaction (PCR) was performed on the aqueous humor of 61 patients with hypertensive uveitis. Patients were divided into CMV positive and negative groups. Sex, age, age at first attack and at first diagnosis, duration of attack, number of attacks, interval between attacks, and surgical history were investigated, and the visual acuity, intraocular pressure (IOP), and corneal endothelial cell density were measured. Blood tests were conducted to determine the inflammation index, antibody titers of CMV, and herpes simplex virus, with toxoplasma and toxocariasis evaluations. With these results, the differences between the two groups were confirmed.
Results: Compared with the CMV negative group, the CMV positive group showed a significantly higher trough IOP (p = 0.007) and a greater difference in corneal endothelial cell counts of the affected eye and the fellow eye (p = 0.048). The CMV positive group exhibited iris degeneration (73.3%), whereas the CMV negative group showed lesions in 47.8% (p = 0.085). No statistically significant differences between the two groups were evident in terms of leukocyte count, inflammation index, antibody titers to CMV, HSV, toxoplasma, or toxocariasis.
Conclusions: CMV anterior uveitis was characterized by high IOP and corneal endothelial cell loss in the affected eyes. The CMV positive group had more corneal lesions and iris degeneration than the CMV negative group; however, the two groups showed no significant serological differences. When the clinical features of hypertensive uveitis are present, a routine corneal endothelium test and CMV PCR should be performed periodically, to initiate antiviral agent treatments along with IOP and inflammation controls.
Keywords : Cytomegalovirus, Ocular hypertension, Uveitis, Uveitic glaucoma

 

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