title: Corneal endotheliitis associated with evidence of cytomegalovirus infection.
abstract: OBJECTIVE
  To describe the clinical presentation of cytomegalovirus (CMV) corneal endotheliitis in human immunodeficiency virus (HIV)-negative patients.
  
  
  METHODS
  Retrospective interventional case series.
  
  
  METHODS
  Twelve consecutive patients with corneal endotheliitis diagnosed between 2002 and 2005.
  
  
  METHODS
  Aqueous of eyes with corneal endotheliitis was analyzed for viral DNA by polymerase chain reaction (PCR), and patient records were reviewed for demographic data, medical and ocular history, best-corrected Snellen visual acuity, intraocular pressure (IOP), anterior and posterior segment findings, laboratory workup, diagnosis, and treatment.
  
  
  METHODS
  Presence of CMV DNA.
  
  
  RESULTS
  Corneal endotheliitis was seen in 12 eyes of 10 patients during the study period. There were 8 men and 2 women, and all were Chinese. Their mean age was 49 years (range, 25-61 years). The corneal involvement ranged from small areas of focal endotheliitis to diffuse bullous keratopathy. The keratic precipitates had a variable appearance. There was only mild anterior chamber inflammation with no posterior synechiae. Two thirds of eyes had diffuse iris atrophy. All the eyes had elevated IOP. Eleven of the 12 eyes were positive for CMV DNA. None of the patients were positive for HIV. All patients had received local or systemic immunosuppression, or both, before corneal endotheliitis developed. Ten eyes of 8 patients were treated with systemic antiviral therapy. After treatment, the endotheliitis resolved completely in 7 eyes, and 3 eyes had significant improvement in corneal translucency. The IOP was normal, with no medications in all but 1 eye. Repeat PCR analysis in all the treated eyes was negative for CMV DNA.
  
  
  CONCLUSIONS
  Cytomegalovirus infection is an important cause of corneal endotheliitis in our patients, and appropriate antiviral therapy may prevent more ocular damage.
authors.affiliation: Singapore National Eye Centre, Singapore. chee.soon.phaik@snec.com.sg
authors.forename: Soon-Phaik
authors.initials: SP
authors.lastname: Chee
authors.forename: Kristine
authors.initials: K
authors.lastname: Bacsal
authors.forename: Aliza
authors.initials: A
authors.lastname: Jap
authors.forename: Su-Yun
authors.initials: SY
authors.lastname: Se-Thoe
authors.forename: Ching Li
authors.initials: CL
authors.lastname: Cheng
authors.forename: Ban Hock
authors.initials: BH
authors.lastname: Tan
mesh_terms: D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D001082:Aqueous Humor / Q000821:virology; D003587:Cytomegalovirus / Q000235:genetics / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D004279:DNA, Viral / Q000032:analysis; D004728:Endothelium, Corneal / Q000187:drug effects / Q000473:pathology / Q000821:virology*; D015828:Eye Infections, Viral / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D005260:Female; D018023:HIV Seronegativity; D006801:Humans; D007429:Intraocular Pressure; D007634:Keratitis / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012189:Retrospective Studies; D014792:Visual Acuity
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral