Aims: To investigate the correlation between the clinical manifestation and the cytomegalovirus (CMV) viral load in the aqueous humor of patients with CMV anterior uveitis.
Methods: A total of 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 manifestation was 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 (IOP) and mutton fat keratic precipitates with pigmentation. Stromal edema 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 humor of all 11 patients. A significant association was found between the corneal endothelial cell loss intensity and CMV viral load in the aqueous humor.
Conclusion: There is a significant correlation between the CMV viral load and corneal endothelial cell loss in both CMV-associated iridocyclitis and corneal endotheliitis.