Clinical features of cytomegalovirus anterior uveitis in immunocompetent patients.
OBJECTIVE
To describe the clinical presentation of cytomegalovirus (CMV) anterior uveitis in human immunodeficiency virus (HIV)-negative patients.


METHODS
Retrospective, interventional case series.


METHODS
HIV-negative patients with anterior uveitis associated with elevated intraocular pressure (hypertensive anterior uveitis) seen at the Singapore National Eye Centre had their aqueous analyzed for viral deoxyribonucleic acid by polymerase chain reaction, and their records were reviewed for demographic data, ocular findings, laboratory results, and treatment.


RESULTS
Aqueous was obtained from 105 of 106 eligible eyes. Twenty-four eyes demonstrated positive results for CMV (22.8%). Eighteen eyes had Posner-Schlossman syndrome (PSS; 75%) at presentation, five eyesba had Fuchs heterochromic iridocyclitis (FHI; 20.8%), and one eye had a presumed herpetic anterior uveitis. Twelve of the 24 eyes were treated with ganciclovir. Of the 12 who completed treatment, all responded clinically, and their aqueous demonstrated negative results for CMV on repeat testing. However, nine had recurrences within eight months of stopping treatment and required further courses of ganciclovir. The 81 CMV-negative eyes included 30 with PSS, 11 with FHI, 27 with uveitic glaucomas of unknown cause, and 13 with presumed herpetic anterior uveitis.


CONCLUSIONS
CMV anterior uveitis is not uncommon in our immunocompetent patients and it may present as a recurrent acute or chronic inflammation, resembling PSS, herpetic anterior uveitis, or FHI.
Chee
Soon-Phaik
SP
Singapore National Eye Centre, Singapore, Republic of Singapore. chee.soon.phaik@snec.com.sg
Bacsal
Kristine
K
Jap
Aliza
A
Se-Thoe
Su-Yun
SY
Cheng
Ching Li
CL
Tan
Ban Hock
BH
D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D001082:Aqueous Humor / Q000821:virology; D003587:Cytomegalovirus / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000821:virology; D004279:DNA, Viral / Q000032:analysis; D015828:Eye Infections, Viral / Q000175:diagnosis* / Q000188:drug therapy / Q000821:virology; D005260:Female; D015774:Ganciclovir / Q000627:therapeutic use; D006801:Humans; D007121:Immunocompetence; D007429:Intraocular Pressure; D015863:Iridocyclitis / Q000175:diagnosis* / Q000188:drug therapy / Q000821:virology; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000175:diagnosis* / Q000188:drug therapy / Q000821:virology; D016133:Polymerase Chain Reaction; D012008:Recurrence; D012189:Retrospective Studies; D013577:Syndrome
D000998:Antiviral Agents; D004279:DNA, Viral; D015774:Ganciclovir