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Clinical science
A significant association of viral loads with corneal endothelial cell damage in cytomegalovirus anterior uveitis
  1. Masaru Miyanaga1,2,
  2. Sunao Sugita1,
  3. Norio Shimizu3,
  4. Tomohiro Morio4,
  5. Kazunori Miyata2,
  6. Kazuichi Maruyama5,
  7. Shigeru Kinoshita5,
  8. Manabu Mochizuki1
  1. 1Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Tokyo, Japan
  2. 2Miyata Eye Hospital, Miyakonojo, Japan
  3. 3Department of Virology, Medical Research Institute, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Tokyo, Japan
  4. 4Center for Cell Therapy, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, Tokyo, Japan
  5. 5Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan
  1. Correspondence to Manabu Mochizuki, Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University Graduate School of Medical and Dental Sciences, 1-5-45 Yushima, Bunkyo-ku, Tokyo 113-8519, Japan; m.manabu.oph{at}tmd.ac.jp

Abstract

Aim 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.

Conclusion There is a significant correlation between the CMV viral load and corneal endothelial cell loss in both CMV-associated iridocyclitis and corneal endotheliitis.

  • Aqueous humour
  • cornea
  • corneal endotheliitis
  • cytomegalovirus
  • genetics
  • infection
  • inflammation iridocyclitis
  • polymerase chain reaction

https://doi.org/10.1136/bjo.2008.156422

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    Footnotes

    • Competing interests None.

    • Ethics approval This study was conducted with the approval of the Institutional Ethics Committee of Tokyo Medical and Dental University.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.