Bilateral Herpes Simplex Uveitis: Review of the Literature and Own Reports
Bilateral Herpes Simplex Uveitis: Review of the Literature and Own Reports
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DOI：
10.3109/09273948.2016.1142572
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发表时间：
2017-08-01
影响因子：
3.3
通讯作者：
Foster, C. Stephen
中科院分区：
文献类型：
--
作者：
de-la-Torre, Alejandra;Valdes-Camacho, Juanita;Foster, C. Stephen
目的：单纯疱疹相关性葡萄膜炎通常被认为是一种单侧眼病，很少包括在鉴别诊断时，只要有双边参与。我们报告了三例双侧疱疹性前葡萄膜炎。方法：我们评估了三名患者的临床表现，双侧葡萄膜炎提示病毒origin.Results：我们发现高眼压，细胞在前房，麻痹性瞳孔散大，虹膜萎缩与透照缺陷，和变量前玻璃体细胞。根据临床研究结果，支持疱疹特异性抗体滴度和房水PCR结果在其中两个，他们被诊断为双边前疱疹性葡萄膜炎。结论：我们的患者最初被误诊为非感染性葡萄膜炎，并与免疫调节药物治疗，这可能有利于双边感染的扩展。虽然不常见，但当患者双眼均表现为高血压性葡萄膜炎时，应始终考虑双眼疱疹性葡萄膜炎的鉴别诊断。
Purpose: Herpes simplex-associated uveitis is usually considered a unilateral eye disease, and rarely included in the differential diagnosis whenever there is bilateral involvement. We report three cases of bilateral herpetic anterior uveitis.Methods: We evaluated three patients who presented with clinical manifestations of bilateral uveitis suggestive of viral origin.Results: We found intraocular hypertension, cells in the anterior chamber, paralytic mydriasis, iris atrophy with transillumination defects, and variable anterior vitreous cellularity. According to the clinical findings, supported with herpes-specific antibody titers and aqueous humor PCR results in two of them, they were diagnosed with bilateral anterior herpetic uveitis.Conclusions: Our patients were initially misdiagnosed as having non-infectious uveitis and were treated with immunomodulatory medications, which could have favored the extension of infection bilaterally. Although uncommon, bilateral herpetic uveitis should always be considered in the differential diagnoses, when patients present with hypertensive uveitis in both eyes.