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A significant association of viral loads with corneal endothelial cell damage in cytomegalovirus anterior uveitis
  1. Masaru Miyanaga1,
  2. Sunao Sugita1,
  3. Norio Shimizu2,
  4. Tomohiro Morio3,
  5. Kazunori Miyata4,
  6. Kazuichi Maruyama5,
  7. Shigeru Kinoshita5,
  8. Manabu Mochizuki1,*
  1. 1 Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University Graduate School, Japan;
  2. 2 Department of Virology, Medical Research Institute, Tokyo Medical and Dental University, Japan;
  3. 3 Center for Cell Therapy, Tokyo Medical and Dental University Graduate School, Japan;
  4. 4 Miyata Ete Hospital, Japan;
  5. 5 Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
  1. To whom correspondence should be addressed. E-mail: m.manabu.oph{at}


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.

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