title: Clinical features and management of cytomegalovirus corneal endotheliitis: analysis of 106 cases from the Japan corneal endotheliitis study.
abstract: OBJECTIVE
  The purpose of this study is to elucidate the clinical manifestations and the current treatment status of cytomegalovirus (CMV) endotheliitis via a large case series obtained from a national survey conducted in Japan.
  
  
  METHODS
  The Japan Corneal Endotheliitis Study Group proposed diagnostic criteria for CMV endotheliitis based on a viral examination by PCR of aqueous humour, in combination with clinical manifestations. A national survey was then retrospectively conducted among 1160 members of the Japan Cornea Society. The study reviewed the patient profiles, clinical manifestations, and treatment modalities of individuals who met the diagnostic criteria for CMV endotheliitis.
  
  
  RESULTS
  The study included 109 eyes of 106 patients. Mean patient age was 66.9±10.9 years (85 males (80.2%), 21 females (19.8%)). Patients were commonly diagnosed with anterior uveitis and ocular hypertension prior to confirmation of CMV endotheliitis. Coin-shaped lesions were observed in 70.6%, and linear keratic precipitates in 8.3% of the patients, respectively. 95% of cases were treated with anti-CMV drugs.
  
  
  CONCLUSIONS
  CMV endotheliitis is most common in middle-aged and elderly men. CMV endotheliitis should be suspected when patients present with corneal endotheliitis involving coin-shaped lesions accompanied by anterior uveitis and ocular hypertension.
authors: Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan Department of Biomedical Engineering, Faculty of Life and Medical Sciences, Doshisha University, Kyotanabe, Japan.
authors: Noriko
authors: N
authors: Koizumi
authors: Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors: Tsutomu
authors: T
authors: Inatomi
authors: Department of Ophthalmology, Ehime University School of Medicine, Ehime, Japan.
authors: Takashi
authors: T
authors: Suzuki
authors: Department of Ophthalmology, Ehime University School of Medicine, Ehime, Japan.
authors: Atsushi
authors: A
authors: Shiraishi
authors: Department of Ophthalmology, Ehime University School of Medicine, Ehime, Japan.
authors: Yuichi
authors: Y
authors: Ohashi
authors: Division of Ophthalmology and Visual Science, Faculty of Medicine, Tottori University, Tottori, Japan.
authors: Michiko
authors: M
authors: Kandori
authors: Division of Ophthalmology and Visual Science, Faculty of Medicine, Tottori University, Tottori, Japan.
authors: Dai
authors: D
authors: Miyazaki
authors: Division of Ophthalmology and Visual Science, Faculty of Medicine, Tottori University, Tottori, Japan.
authors: Yoshitsugu
authors: Y
authors: Inoue
authors: Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan.
authors: Takeshi
authors: T
authors: Soma
authors: Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan.
authors: Kohji
authors: K
authors: Nishida
authors: Department of Ophthalmology and Vision Science, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan.
authors: Hiroshi
authors: H
authors: Takase
authors: Department of Ophthalmology and Vision Science, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan.
authors: Sunao
authors: S
authors: Sugita
authors: Department of Ophthalmology and Vision Science, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan.
authors: Manabu
authors: M
authors: Mochizuki
authors: Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
authors: Shigeru
authors: S
authors: Kinoshita
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000627:therapeutic use; D001082:Aqueous Humor / Q000821:virology; D002452:Cell Count; D003587:Cytomegalovirus / Q000235:genetics / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000188:drug therapy; D004279:DNA, Viral / Q000235:genetics; D004728:Endothelium, Corneal / Q000473:pathology* / Q000821:virology; D015828:Eye Infections, Viral / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D015774:Ganciclovir / Q000031:analogs & derivatives / Q000627:therapeutic use; D006801:Humans; D007429:Intraocular Pressure; D007564:Japan; D007634:Keratitis / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000175:diagnosis; D016133:Polymerase Chain Reaction; D017678:Sex Distribution; D014606:Uveitis, Anterior / Q000175:diagnosis; D000077562:Valganciclovir; D014792:Visual Acuity
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D000077562:Valganciclovir; D015774:Ganciclovir
keywords: Cornea; Infection