DNA of cytomegalovirus detected by PCR in aqueous of patient with corneal endotheliitis after penetrating keratoplasty
DNA of cytomegalovirus detected by PCR in aqueous of patient with corneal endotheliitis after penetrating keratoplasty
复制标题
DOI：
10.1097/ico.0b013e31802d82fa
复制
发表时间：
2007-04-01
期刊：
影响因子：
2.8
通讯作者：
Ohashi, Yuichi
中科院分区：
文献类型：
--
作者：
Suzuki, Takashi;Hara, Yuko;Ohashi, Yuichi
目的：角膜内皮炎通常导致严重的内皮功能障碍，可由单纯疱疹病毒（HSV）、水痘带状疱疹病毒（VZV）和其他病毒（如腮腺炎病毒）引起。我们报告一例角膜内皮炎所造成的巨细胞病毒（CMV），开发后穿透keratoplasty.Methods：一个完整的眼科检查进行角膜内皮炎的患者，开发后穿透性角膜移植术。为了确定内皮炎的原因，聚合酶链反应（PCR）被用来扩增的HSV VZV，CMV的样本中的aqueum.Results：裂隙灯生物显微镜显示中度基质水肿在颞上部的移植角膜沿着与角膜沉淀物（KPs）排列在一个硬币状的图案。用类固醇和阿昔洛韦反复治疗只是暂时成功。PCR检测到的DNA的CMV的水样，和治疗切换到局部和全身应用更昔洛韦。这导致了KPs的消失和解决的间质水肿在2 weeks.Conclusions：从PCR结果和良好的反应更昔洛韦，角膜内皮炎是最有可能引起的巨细胞病毒在这种情况下。
Purpose: Corneal endotheliitis often leads to severe endothelial dysfunction and can be caused by herpes simplex virus (HSV), varicella zoster virus (VZV), and other viruses (eg, the mumps virus). We report a case of corneal endotheliitis caused by cytomegalovirus (CMV) that developed after a penetrating keratoplasty.Methods: A complete ophthalmologic examination was performed on a patient with corneal endotheliitis that developed after a penetrating keratoplasty. To determine the cause of the endotheliitis, polymerase chain reaction (PCR) was used to amplify the DNA of HSV VZV, and CMV in samples of the aqueous humor.Results: Slit-lamp biomicroscopy showed a moderate stromal edema in the upper temporal part of the transplanted cornea along with keratic precipitates (KPs) arranged in a coin-shaped pattern. Repeated treatments with steroids and acyclovir were only temporarily successful. PCR detected the DNA of CMV in an aqueous sample, and the treatment was switched to topical and systemic application of ganciclovir. This resulted in the disappearance of the KPs and resolution of the stromal edema within 2 weeks.Conclusions: From the PCR results and the favorable response to ganciclovir, the corneal endotheliitis was most likely caused by cytomegalovirus in this case.