면역기능이 정상인 재발성 전안부 포도막염환자에서 거대세포바이러스의 임상적 중요성 = Cytomegalovirus as a Cause of Recurrent Anterior Uveitis in Immunocompetent Patients

다국어 초록 (Multilingual Abstract)

Purpose: This study aimed to identify various infectious causes in unilateral recurrent hypertensive anterior uveitis in immunocompetent individuals. Methods: Twenty eyes of 20 patients diagnosed with recurrent hypertensive anterior uveitis, who had negative systemic uveitis lab results, were enrolled. Polymerase chain reaction (PCR) was performed in the aqueous humor and peripheral blood specimens to detect the following infectious agents: cytomegalovirus (CMV), herpes simplex virus-1 (HSV-1), varicella zoster virus (VZV), toxoplasma. Results: The mean age of 20 patients was 41.8 ± 15.9 year (19-77 year), and 14 (70%) patients were male. CMV was positive in 7 eyes (35%) and was detected only in aqueous humor. HSV-1 was positive in 5 (25%) eyes; only in aqueous humor in 2 eyes, only in blood in 1 eye, and in both specimens in 2 eyes. Only 1 (5%) eye was positive for toxoplasma in the aqueous humor. Conclusions: This study demonstrated that CMV might be another major infectious cause in recurrent hypertensive anterior uveitis in immunocompetent patients. If CMV is detected, it might be reasonable to add appropriate antiviral agents, rather than treating only with immunosuppresive and hypotensive drugs. J Korean Ophthalmol Soc 2010;51(9):1245-1249

참고문헌 (Reference)

1 Hurtado A, "Single tube nested PCR for the detection of Toxoplasma gondii in fetal tissues from naturally aborted ewes" 102 : 17-27, 2001

2 Murphy J, "Reliability of real-time reverse-transcription PCR in clinical diagnostics: gold standard or substandard?" 9 : 187-197, 2009

3 이성호, "Rapid ABO Genotyping Using Whole Blood without DNA Purification" 대한진단검사의학회 29 (29): 231-237, 2009

4 Winston DJ, "Randomized controlled trial of oral ganciclovir versus oral acyclovir after induction with intravenous ganciclovir for long-term prophylaxis of cytomegalovirus disease in cytomegalovirus-seropositive liver transplant recipients" 75 : 229-233, 2003

5 Chou Q, "Prevention of pre-PCR mis-priming and primer dimerization improves low-copynumber amplifications" 11 : 1717-1723, 1992

6 Griffais R, "K-tuple frequency in the human genome and polymerase chain reaction" 19 : 3887-3891, 1991

7 Hwang YS, "Intravitreal loading injection of ganciclovir with or without adjunctive oral valganciclovir for cytomegalovirus anterior uveitis" 248 : 263-269, 2010

8 Anduze-Faris BM, "Induction and maintenance therapy of cytomegalovirus central nervous system infection in HIV-infected patients" 14 : 517-524, 2000

9 Mietz H, "Ganciclovir for the treatment of anterior uveitis" 238 : 905-909, 2000

10 De Schryver I, "Diagnosis and treatment of cytomegalovirus iridocyclitis without retinal necrosis" 90 : 852-855, 2006

11 Henderly DE, "Cytomegalovirus retinitis and response to therapy with ganciclovir" 94 : 425-434, 1987

12 Teoh SB, "Cytomegalovirus in aetiology of Posner-Schlossman syndrome: evidence from quantitative polymerase chain reaction" 19 : 1338-1340, 2005

13 Koizumi N, "Cytomegalovirus as an etiologic factor in corneal endotheliitis" 115 : 292-297, 2008

14 Markomichelakis NN, "Cytomegalovirus as a cause of anterior uveitis with sectoral iris atrophy" 109 : 879-882, 2002

15 Van Boxtel LA, "Cytomegalovirus as a cause of anterior uveitis in immunocompetent patients" 114 : 1358-1362, 2007

16 Chee SP, "Clinical Features of Cytomegalovirus Anterior Uveitis in Immunocompetent Patients" 145 : 834-840, 2008

17 Yang YG, "A novel buffer system, AnyDirect, can improve polymerase chain reaction from whole blood without DNA isolation" 380 : 112-117, 2007