Clinical investigationVaricella-Zoster Viral Antigen Identified in Iridocyclitis Patient
Introduction
Varicella-zoster virus (VZV) is known as an etiologic agent of iridocyclitis characterized by iris atrophy, mutton fat keratic precipitates, and secondary glaucoma. Zoster ophthalmicus without skin eruption is defined as zoster sine herpete.1, 2
Recent reports documented the usefulness of polymerase chain reaction (PCR) study in the diagnosis of zoster sine herpete.2, 3 However, it has not been reported that VZV antigen was identified immunohistologically in iridocyclitis due to VZV. We present the first report of detection of VZV antigen in the iris of an iridocyclitis patient.
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Case Report
Iridocyclitis and secondary glaucoma of the right eye were diagnosed in a 65-year-old woman visiting our hospital in June 1998. At initial examination, best-corrected visual acuity was 0.3 in the right eye and 1.0 in the left eye. Intraocular pressure (IOP) was 33 mm Hg in the right eye and 14 mm Hg in the left eye. Slit-lamp microscopy revealed ciliary injection, corneal epithelial edema, mutton fat keratic precipitates, flare, and cells in the anterior chamber in the right eye. The left eye
Discussion
Herpes zoster ophthalmicus is usually accompanied by a typical rash, but cases of ocular zoster with no skin eruption, ie, zoster sine herpete, have been reported.1, 2, 3, 4, 5 Cases of herpes simplex accompanying zosteriform eruptions are known as zosteriform simplex.4, 5 It is important to distinguish between herpes zoster and herpes simplex to aid in the choice of appropriate medical therapy. In this case, the vesicles that clinically simulated those caused by herpes simplex virus
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Applications of the polymerase chain reaction in clinical ophthalmology
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