Clinical Features and Diagnosis of Anterior Segment Inflammation Related to Cytomegalovirus in Immunocompetent African, Asian, and Caucasian Patients

Ocul Immunol Inflamm. 2021 Jan 2;29(1):160-168. doi: 10.1080/09273948.2019.1662059. Epub 2019 Oct 23.

Abstract

Objective: To report the clinical features and treatment outcomes in immunocompetent patients with anterior segment inflammation (ASI) related to human cytomegalovirus (HCMV) depending on their ethnic origin.Material and Methods: Multicenter retrospective study of 38 patients with at least one test, either HCMV-positive PCR or GWc.Results: Features of Posner-Schlossman syndrome were observed in 50% of the eyes, Fuchs heterochromic iridocyclitis in 13% of the eyes, chronic nonspecific anterior uveitis in 21% of the eyes, and corneal endotheliitis in 18% of the eyes. PCR and GWc were positive for HCMV in 50% and 96.2% of the eyes, respectively. Glaucoma was diagnosed in 50% of eyes. Treatment was oral valganciclovir in about half of the patients. Other treatments were intravenous ganciclovir and/or ganciclovir topical ointment and/or intravitreal ganciclovir.Conclusions: No obvious association of specific clinical features with individual ethnicity could be identified. We found a high rate of glaucoma in all ethnic groups. There was a delay in diagnosis and specific treatment of HCMV in most patients.

Keywords: Fuchs heterochromic iridocyclitis; Goldmann-Witmer coefficient; HCMV; Posner-Schlossman syndrome; endotheliitis; polymerase chain reaction; uveitis.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antiviral Agents / therapeutic use
  • Aqueous Humor / virology
  • Asian People*
  • Black People*
  • Black or African American
  • Child
  • Cytomegalovirus / genetics
  • Cytomegalovirus Infections / diagnosis*
  • Cytomegalovirus Infections / ethnology
  • Cytomegalovirus Infections / immunology
  • DNA, Viral / analysis
  • Eye Infections, Viral / diagnosis*
  • Eye Infections, Viral / ethnology
  • Eye Infections, Viral / immunology
  • Female
  • Follow-Up Studies
  • France / epidemiology
  • Ganciclovir / therapeutic use
  • Humans
  • Immunocompromised Host*
  • Incidence
  • Male
  • Middle Aged
  • Retrospective Studies
  • United States / epidemiology
  • Uveitis, Anterior / diagnosis*
  • Uveitis, Anterior / ethnology
  • Uveitis, Anterior / immunology
  • Valganciclovir / therapeutic use
  • White People*
  • Young Adult

Substances

  • Antiviral Agents
  • DNA, Viral
  • Valganciclovir
  • Ganciclovir