Cytomegalovirus as a cause of anterior uveitis with sectoral iris atrophy.
OBJECTIVE
To report two cases of recurrent anterior uveitis with sectoral iris atrophy and ocular hypertension during attacks caused by cytomegalovirus (CMV).


METHODS
Two observational case reports.


METHODS
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.


METHODS
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.
Markomichelakis
Nikos N
NN
Ocular Inflammation and Immunology Service, Department of Ophthalmology, General Hospital of Athens, Athens, Greece.
Canakis
Christina
C
Zafirakis
Panayotis
P
Marakis
Theodoros
T
Mallias
Ioannis
I
Theodossiadis
George
G
D000328:Adult; D000368:Aged; D000914:Antibodies, Viral / Q000097:blood; D000998:Antiviral Agents / Q000627:therapeutic use; D001082:Aqueous Humor / Q000821:virology; D001284:Atrophy; D003587:Cytomegalovirus / Q000276:immunology / Q000302:isolation & purification*; D003586:Cytomegalovirus Infections / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D015828:Eye Infections, Viral / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D015774:Ganciclovir / Q000627:therapeutic use; D006801:Humans; D007074:Immunoglobulin G / Q000032:analysis; D007075:Immunoglobulin M / Q000032:analysis; D007498:Iris / Q000187:drug effects / Q000473:pathology* / Q000821:virology; D008297:Male; D009798:Ocular Hypertension / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology; D016133:Polymerase Chain Reaction; D012008:Recurrence; D014606:Uveitis, Anterior / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*
D000914:Antibodies, Viral; D000998:Antiviral Agents; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D015774:Ganciclovir