A significant association of viral loads with corneal endothelial cell damage in cytomegalovirus anterior uveitis.
OBJECTIVE
The aim of the study was to investigate the correlation between the clinical manifestation and the cytomegalovirus (CMV) viral load in the aqueous humour of patients with CMV anterior uveitis.


METHODS
Seven patients with CMV-associated iridocyclitis and four patients with CMV-associated corneal endotheliitis were enrolled. Presence of CMV, but not other human herpes viruses, was confirmed by multiplex polymerase chain reaction (PCR). Viral load was measured using real-time PCR. Clinical manifestations were examined using a slit-lamp microscope and ophthalmoscope, applanation tonometer and specular microscope.


RESULTS
All 11 patients had unilateral recurrent anterior uveitis with high intraocular pressure and mutton fat keratic precipitates with pigmentation. Stromal oedema of the cornea was found in CMV-associated endotheliitis, but not in CMV-associated iridocyclitis patients. A significant corneal endothelium cell loss was recorded in all 11 patients with CMV-associated endotheliitis and iridocyclitis patients. High viral loads of CMV were detected in the aqueous humour of all 11 patients. A significant association was found between the corneal endothelial cell loss intensity and CMV viral load in the aqueous humour.


CONCLUSIONS
There is a significant correlation between the CMV viral load and corneal endothelial cell loss in both CMV-associated iridocyclitis and corneal endotheliitis.
Miyanaga
Masaru
M
Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Tokyo, Japan.
Sugita
Sunao
S
Shimizu
Norio
N
Morio
Tomohiro
T
Miyata
Kazunori
K
Maruyama
Kazuichi
K
Kinoshita
Shigeru
S
Mochizuki
Manabu
M
D000328:Adult; D000368:Aged; D001082:Aqueous Humor / Q000821:virology; D055954:Corneal Endothelial Cell Loss / Q000473:pathology / Q000821:virology*; D003587:Cytomegalovirus / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000821:virology; D004279:DNA, Viral / Q000032:analysis; D015828:Eye Infections, Viral / Q000821:virology*; D005260:Female; D006801:Humans; D015863:Iridocyclitis / Q000821:virology*; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods; D019562:Viral Load
D004279:DNA, Viral