Virus-associated anterior uveitis and secondary glaucoma
Purpose
Compare clinical characteristics and analyze glaucoma development/surgery requirements in patients with different virus-associated anterior uveitis (VAU).
Methods
Study of 270 patients with VAU confirmed by positive Goldmann-Witmer-coefficients(GWC) for cytomegalovirus(CMV), herpes simplex virus(HSV), varicella-zoster virus(VZV), rubella virus(RV), & multiple-viruses(MV).Demographic constitution, clinical findings, glaucoma development, and surgeries were recorded.
Results
GWC analysis showed positive results for CMV(21%), HSV(29%), VZV(17%), RV(29%), and MV(5%). CMV and RV AU occur predominantly in younger/male patients, while VZV and HSV AU appeared in elderly/females. Unilateral involvement was typical for almost all viruses(76-98%), but 24% of VZV also showed bilateral manifestation. Course of disease was mainly acute for CMV(96%), while chronic disease was observed in RV(84%) and in HSV(68%). Differences like iris synechia, vitreous haze, and macular edema were noted. In total, 19% showed glaucomatous damage and 10% needed glaucoma surgery. Minimal-invasive glaucoma surgery resulted in a reliable IOP reduction in short-term period. In 37% first surgical intervention failed, and a follow-up surgery was required.
Conclusion
Different virus entities show common clinical findings. To establish an appropriate treatment, it is important to confirm the diagnosis by GWC. Otherwise, development of secondary glaucoma as a serious complication of uveitis is inevitable. It is crucial to choose distinctive therapeutic approaches like appropriate surgical interventions to avoid vision-threatening complications.
Conflict of interest
No
Author 1
Last name
POHLMANN
Initials of first name(s)
D
Department
Ophthalmology, Charité
City
Berlin
Country
Germany
Author 2
Last name
Pahlitzsch
Initials of first name(s)
M
Department
Charité
City
Berlin
Country
Germany
Author 3
Last name
Winterhalter
Initials of first name(s)
S
Department
Charité
City
Berlin
Country
Germany
Author 4
Last name
Pleyer
Initials of first name(s)
U
Department
Charité
City
Berlin
Country
Germany
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