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. 2022 Mar 22;22(1):130.
doi: 10.1186/s12886-022-02348-4.

Clinical characteristics of virus-related uveitic secondary glaucoma: focus on cytomegalovirus and varicella zoster virus

Xintong Fan #  1   2   3 , Zhizhe Li #  4 , Ruyi Zhai  1   2   3 , Qilian Sheng  1   2   3 , Xiangmei Kong  5   6   7
Affiliations

Clinical characteristics of virus-related uveitic secondary glaucoma: focus on cytomegalovirus and varicella zoster virus

Xintong Fan et al. BMC Ophthalmol. .

Abstract

Background: We aimed to analyze the clinical characteristics of secondary glaucoma related to cytomegalovirus (CMV)- and varicella zoster virus (VZV)-positive uveitis.

Methods: In this retrospective study, we enrolled patients with anterior uveitic secondary glaucoma. All the patients underwent aqueous and serum analyses for viral antibody through enzyme-linked immunosorbent assay. Among the 60 included patients, 22 had CMV-negative Posner-Schlossman syndrome (CMV-negative PSS), 25 had CMV-positive PSS, and 13 had VZV-positive anterior uveitis secondary glaucoma (VZV-AUSG). We evaluated the following main indicators: age, disease duration, intraocular pressure (IOP), cup-to-disc ratio, best corrected visual acuity (BCVA), corneal endothelial cell (CEC) count, ocular morphological changes, and medical treatments.

Results: We found that 53.2% (25/47) patients with PSS were CMV-positive. Patients with CMV-positive PSS had a larger cup-to-disc ratio (p = .043), lower CEC density (p = .017), more severe CEC loss (p < .001), and more iris depigmentation (p = .006) than CMV-negative PSS patients. Compared with patients with CMV-positive PSS, those with VZV-AUSG were older (p = .003), presented a higher IOP (p = .015), and had poorer BCVA (p < .001). Patients with CMV-positive PSS and VZV-AUSG all accepted ganciclovir treatment, and those with CMV-positive PSS used fewer antiglaucoma agents simultaneously compared with CMV-negative PSS (p = .005) and VZV-AUSG (p < .001). All three groups had a comparable proportion of patients requiring antiglaucoma surgery.

Conclusions: We observed some distinctive clinical features in CMV-positive PSS compared with CMV-negative PSS. Further, we found that patients with VZV-AUSG presented with a higher IOP and worse visual acuity, and required more antiglaucoma medication than those with CMV-positive PSS.

Keywords: Cytomegalovirus; Posner-Schlossman syndrome; Secondary glaucoma; Uveitic glaucoma; Varicella zoster virus.

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Conflict of interest statement

The authors declare that they have no competing interest.

Figures

Fig. 1
Fig. 1
The flow chart of the patient inclusion
Fig. 2
Fig. 2
Typical morphology of keratic precipitates (KPs) in patients with cytomegalovirus (CMV)- and varicella zoster virus (VZV)-positive secondary glaucoma. A The yellow arrow indicates mutton-fat KPs observed in CMV-positive patients. B The blue arrow indicates pigmented KPs observed in VZV-positive patients
See this image and copyright information in PMC

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References

    1. Posner A, Schlossman A. Syndrome of unilateral recurrent attacks of glaucoma with cyclitic symptoms. Arch Ophthal. 1948;39(4):517–535. doi: 10.1001/archopht.1948.00900020525007. - DOI - PubMed
    1. Jap A, Sivakumar M, Chee SP. Is Posner Schlossman syndrome benign? Ophthalmology. 2001;108(5):913–918. doi: 10.1016/S0161-6420(01)00551-6. - DOI - PubMed
    1. Kass MA, Becker B, Kolker AE. Glaucomatocyclitic crisis and primary open-angle glaucoma. Am J Ophthalmol. 1973;75(4):668–673. doi: 10.1016/0002-9394(73)90818-0. - DOI - PubMed
    1. Raitta C, Vannas A. Glaucomatocyclitic Crisis. JAMA Ophthalmol. 1977;95(4):608–612. - PubMed
    1. van Boxtel LA, van der Lelij A, van der Meer J, Los LI. Cytomegalovirus as a cause of anterior uveitis in immunocompetent patients. Ophthalmology. 2007;114(7):1358–1362. doi: 10.1016/j.ophtha.2006.09.035. - DOI - PubMed

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