The validity of clinical feature profiles for cytomegaloviral anterior segment infection
The validity of clinical feature profiles for cytomegaloviral anterior segment infection
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DOI：
10.1007/s00417-010-1510-y
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发表时间：
2011-01-01
影响因子：
2.7
通讯作者：
Hsiao, Ching-Hsi
中科院分区：
文献类型：
--
作者：
Hwang, Yih-Shiou;Shen, Chia-Rui;Hsiao, Ching-Hsi
眼前节巨细胞病毒（CMV）感染，可表现为前葡萄膜炎和角膜内皮炎，最近有报道免疫功能正常的患者。我们想评估两个假定的特征性临床特征的有效性：特征1，非单纯疱疹病毒（HSV）/水痘带状疱疹病毒（VZV）皮质类固醇-分泌物炎性高眼压综合征（IOHS），特征2，具有特定硬币状角膜沉淀物（KPs）的角膜内皮炎，在长庚的葡萄膜炎服务中心连续招募了轮廓1或轮廓2或两者都有的患者，2006年1月1日至2010年5月31日，桃园纪念医院。采用实时荧光定量聚合酶链反应（PCR）检测单纯疱疹病毒（HSV I、II）、水痘带状疱疹病毒（VZV）、巨细胞病毒（CMV）和EB病毒（Epstein-Barr virus）等疱疹病毒DNA。28例患者（男20例，女8例）29眼CMV DNA PCR阳性。资料1中19例（20只眼）CMV PCR阳性。资料2中11例患者11只眼中有10只眼CMV PCR阳性。轮廓1和轮廓2的阳性预测值分别为94.7%和90.9%。非HSV/ZVZ激素依赖性IOHS和角膜内皮炎伴特异性硬币状KPs可作为CMV眼前段眼内感染的筛查工具。
Anterior segment cytomegalovirus (CMV) infection, which can be presented as anterior uveitis and corneal endotheliitis, has recently been reported in immunocompetent patients. We would like to access the validity of two presumed characteristic clinical profiles: profile 1, non-herpes simplex virus (HSV)/varicella zoster virus (VZV) corticosteroid-recalcitrant inflammatory ocular hypertensive syndrome (IOHS), and profile 2, corneal endotheliitis with specific coin-shaped keratic precipitates (KPs), that could be helpful in identifying CMV anterior segment intraocular infection.Patients with either profile 1 or profile 2 or both were enrolled consecutively from the uveitis service in Chang Gung Memorial Hospital, Taoyuan, between January 1, 2006 and May 31, 2010. Diagnostic anterior chamber tapping was performed and followed by real-time quantitative polymerase chain reaction (PCR) to detect herpesviridae DNA including HSV I and II, VZV, CMV, and Epstein-Barr virus.Thirty-one eyes of 30 patients (21 males and nine females) were enrolled in this study. CMV DNA PCR was positive in 29 eyes of 28 patients (20 males and eight females). Nineteen of 20 eyes (19 patients) in profile 1 had positive CMV PCR. Ten of 11 eyes (11 patients) in profile 2 had positive CMV PCR. The positive predictive value of profile 1 and profile 2 was 94.7% and 90.9%, respectively. The positive predictive value of combining the two profiles was 93.3%.Non-HSV/ZVZ corticosteroid-recalcitrant IOHS and corneal endotheliitis with specific coin-shaped KPs could be used as the screening tool for CMV anterior segment intraocular infection.