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Viral causes of the acute retinal necrosis syndrome

AMERICAN JOURNAL OF OPHTHALMOLOGY 2000年第2期129卷 166-172页

作者： Ganatra, JB Chandler, D Santos, C Kuppermann, B Margolis, TP Univ Calif San Francisco Francis I Proctor Fdn Med Ctr San Francisco CA 94143 USA Univ Calif San Francisco Dept Ophthalmol San Francisco CA 94143 USA Puerto Rico Sch Med San Juan PR USA Univ Calif Irvine Dept Ophthalmol Irvine CA USA

PURPOSE: The primary goal of this study was to determine the viral cause of the acute retinal necrosis syndrome in 28 patients (30 eyes). A secondary goal was to investigate possible associations between viral cause and patient age, and viral cause and central nervous system disease. METHODS: A retrospective case series in which we reviewed the laboratory results and clinical histories of 28 patients (30 eyes) diagnosed with acute retinal necrosis syndrome, from whom vitreous or aqueous specimens were received, for diagnostic evaluation using previously described polymerase chain reaction-based assays. RESULTS: Varicella-zoster virus, herpes simplex virus, and cytomegalovirus (CMV) DNA were detected in aqueous and/or vitreous specimens from 27 of 28 patients (29 of 30 eyes with a clinical history of acute retinal necrosis syndrome). No sample was positive for DNA from more than one virus. Varicella-zoster virus DNA was detected in 13 patients (15 eyes). Median age was 57 years. Herpes simplex virus type 1 DNA was detected in seven patients (seven eyes). Median age was 47 years. Six of these patients had a history of herpes simplex virus encephalitis. Herpes simplex virus type 2 DNA was detected in six patients (six eyes). Median age was 20 years. Three of these patients had a likely history of meningitis. Cytomegalovirus DNA was detected in one patient who was immunosuppressed iatrogenically. No viral DNA was detected in one patient from whom a sample was taken after 6 weeks of acyclovir therapy. CONCLUSIONS: The data suggest that varicella-zoster virus or herpes simplex virus type 1 cause acute retinal necrosis syndrome in patients older than 25 years, whereas herpes simplex virus type 2 causes acute retinal necrosis in patients younger than 25 years. A history of central nervous system infection in a patient with acute retinal necrosis syndrome suggests that herpes simplex virus is likely to he the viral cause. (Am J Ophthalmol 2000;129:166-172, (C) 2000 by Elsevi

关键词：年龄因素眼房水/病毒学巨细胞病毒/遗传学巨细胞病毒感染/并发症 DNA 病毒/分析脑炎单纯疱疹/并发症眼感染病毒性/并发症疱疹单纯/并发症疱疹带状眼部/并发症疱疹病毒1型人/遗传学疱疹病毒2型人/遗传学疱疹病毒3型人/遗传学脑膜炎病毒性/并发症聚合酶链反应视网膜坏死综合征急性/病因学回顾性研究玻璃体/病毒学青少年成年人老年人儿童女(雌)性人类男(雄)性中年人

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Comparison of intraocular to plasma HIV-1 viral burden in patients with cytomegalovirus retinitis

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AMERICAN JOURNAL OF OPHTHALMOLOGY 1999年第2期127卷 221-223页

作者： Ciulla, TA Schnizlein-Bick, CT Danis, RP Frank, MO Wheat, LJ Indiana Univ Sch Med Dept Ophthalmol Indianapolis IN 46202 USA Indiana Univ Sch Med Dept Internal Med Div Infect Dis Indianapolis IN 46202 USA

PURPOSE: To determine the relationship between plasma and intraocular human immunodeficiency virus-1 (HIV-1) viral loads in 12 consecutive patients undergoing ganciclovir implant surgery for cytomegalovirus (CMV) retinitis. METHODS: Aqueous and vitreous specimens were assayed for HIV-1 viral load by polymerase chain reaction analysis (Roche Amplicor HIV Monitor;Roche Diagnostics Systems, Inc, Branchburg, New Jersey). RESULTS: It was possible to quantitatively assay HIV-1 burden in intraocular fluids using polymerase chain reaction analysis. In general, patients with plasma viral loads less than 250,000 copies/ml had undetectable (<200 copies/ml) HIV-1 in their aqueous and vitreous. CONCLUSIONS: It is likely that intraocular viral levels have several determinants in addition to plasma viral loads, with which they only partially correlate. (Am J Ophthalmol 1999;127:221-223. (C) 1999 by Elsevier Science Inc. All rights reserved.).

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High prevalence of herpes simplex virus type 2 in acute retinal necrosis syndrome associated with herpes simplex virus in Japan

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AMERICAN JOURNAL OF OPHTHALMOLOGY 2000年第3期129卷 404-405页

作者： Itoh, N Matsumura, N Ogi, A Nishide, T Imai, Y Kanai, H Ohno, S Yokohama City Univ Sch Med Dept Ophthalmol Kanazawa Ku Yokohama Kanagawa 236 Japan

PURPOSE: To determine the type of herpes simplex virus in acute retinal necrosis syndrome associated with herpes simplex virus. METHODS: Herpes simplex virus type 1, herpes simplex virus type 2, varicella-zoster virus, Epstein-Barr virus, and cytomegalovirus were examined by polymerase chain reaction in intraocular specimens from 16 patients with acute retinal necrosis syndrome. Anti-herpes simplex virus type 1 and anti-herpes simplex virus type 2 type-specific antibodies in serum from the patients were detected by enzyme immunoassay. RESULTS: Of 16 patients with acute retinal necrosis syndrome, seven were polymerase chain reaction positive for herpes simplex virus type 2 and nine were positive for varicella-zoster virus, Anti-herpes simplex virus type 2 antibody was positive and antiherpes simplex virus type 1 antibody was negative in the sera of the seven patients with herpes simplex virus type 2 DNA-positive acute retinal necrosis syndrome. In contrast, anti-herpes simplex virus type 2 antibody was absent in all nine varicella-zoster virus DNA-positive acute retinal necrosis syndrome patients. CONCLUSION: Herpes simplex virus type 2 has been demonstrated to be the major causative agent in acute retinal necrosis syndrome associated with herpes simplex virus by molecular biological and serological methods. Negative preexisting anti-herpes simplex virus type 1 antibody may play an important role in acute retinal necrosis syndrome associated with herpes simplex virus type 2. (C) 2000 by Elsevier Science Inc. All rights reserved.

关键词：抗体病毒/分析眼房水/病毒学巨细胞病毒/遗传学巨细胞病毒/免疫学巨细胞病毒/分离和提纯 DNA 病毒/分析酶联免疫吸附测定眼感染病毒性/流行病学眼感染病毒性/病毒学疱疹生殖器/流行病学疱疹生殖器/病毒学疱疹病毒1型人/遗传学疱疹病毒1型人/免疫学疱疹病毒1型人/分离和提纯疱疹病毒2型人/遗传学疱疹病毒2型人/分离和提纯疱疹病毒3型人/遗传学疱疹病毒3型人/免疫学疱疹病毒3型人/分离和提纯疱疹病毒4型人/遗传学疱疹病毒4型人/免疫学疱疹病毒4型人/分离和提纯日本/流行病学聚合酶链反应患病率视网膜坏死综合征急性/流行病学视网膜坏死综合征急性/病毒学玻璃体/病毒学青少年成年人老年人女(雌)性人类男(雄)性中年人

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Herpes simplex virus DNA identification from aqueous fluid in Fuchs heterochromic iridocyclitis

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AMERICAN JOURNAL OF OPHTHALMOLOGY 2000年第5期129卷 672-673页

作者： Barequet, IS Li, Q Wang, Y O'Brien, TP Hooks, JJ Stark, WJ Johns Hopkins Sch Med Wilmer Eye Inst Baltimore MD USA NEI NIH Bethesda MD 20892 USA

PURPOSE: To report the presence of herpes simplex virus DNA in the aqueous humor of an eye with Fuchs heterochromic iridocyclitis. METHODS: In an eye with a clinical diagnosis of Fuchs heterochromic iridocyclitis, samples of aqueous humor and anterior capsule of the lens were obtained during cataract surgery. Polymerase chain reaction was per formed on the samples to detect the presence of viral DNA including herpes simplex virus, varicella-zoster virus, and cytomegalovirus. Serologic analysis was also performed for antiviral immunoglobulins, RESULTS: Herpes simplex virus DNA was identified in the aqueous humor but not in the anterior capsule, Serum immunoglobulin G was positive for herpes simplex virus, varicella-zoster virus, and cytomegalovirus, CONCLUSIONS: The presence of herpes simplex virus DNA in the aqueous humor of an eye with Fuchs heterochromic iridocyclitis suggests that herpes simplex virus infection may play a role in the pathogenesis of Fuchs heterochromic iridocyclitis. (C) 2000 by Elsevier Science Inc, All rights reserved.

关键词：抗体病毒/血液眼房水/病毒学印迹法 DNA DNA 病毒/分析眼感染病毒性/免疫学眼感染病毒性/病毒学疱疹单纯/免疫学疱疹单纯/病毒学疱疹病毒1型人/遗传学疱疹病毒1型人/免疫学疱疹病毒1型人/分离和提纯免疫球蛋白G/分析虹膜睫状体炎/免疫学虹膜睫状体炎/病毒学成年人人类男(雄)性

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Anterior uveitis with sectoral iris atrophy in the absence of keratitis - A distinct clinical entity among herpetic eye diseases

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OPHTHALMOLOGY 2000年第6期107卷 1164-1170页

作者： Van der Lelij, A Ooijman, FM Kijlstra, A Rothova, A Netherlands Ophthalm Res Inst Dept Ophthalmoimmunol Amsterdam Netherlands

Objective: To determine the cause and describe the clinical features of unilateral anterior uveitis with sectoral atrophy of the iris in the absence of associated keratitis, Design: Retrospective, observational case series. Participants: Thirty-one patients with unilateral anterior uveitis with sectoral iris atrophy and without (previous) keratitis. Methods: The patients were selected from our database of 592 patients with anterior uveitis, Main Outcome Measures: We reviewed the clinical data on the 31 patients and the results of diagnostic anterior chamber fluid analysis for 24 of the 31 patients. Specifically, production of local antibodies against herpes simplex virus (HSV) and varicella tester virus (VZV) was determined and the polymerase chain reaction was performed to demonstrate the DNA of HSV, VZV, and cytomegalovirus (CMV) in the aqueous samples. Results: Main clinical characteristics of anterior uveitis with iris atrophy included unilateral involvement with a prolonged course and recurrent exacerbations in all cases. Elevated intraocular pressure during intraocular inflammation occurred in 90% of patients (28 of 31). Visual outcome was favorable because 29 of 31 patients (94%) retained a visual acuity of 20/32 or more. The causal agent was identified as HSV in 83% (20 of 24) and VZV in 13% (3 of 24) and was inconclusive in one case. The patients with HSV uveitis were younger than those with VZV uveitis (mean age at onset 34 and 65 years, respectively;P = 0.0056), Conclusions: Unilateral anterior uveitis with sectoral atrophy of the iris without associated (previous) keratitis is a distinct entity among herpetic eye diseases. Recurrent unilateral anterior uveitis with iris atrophy and/or elevated intraocular pressure has most likely been caused by HSV, Ophthalmology 2000;107:1164-1170 (C) 2000 by the American Academy of Ophthalmology.

关键词：发病年龄抗体病毒/分析眼房水/病毒学萎缩 DNA 病毒/分析眼感染病毒性/并发症眼感染病毒性/病毒学单纯疱疹/并发症单纯疱疹/病毒学眼部带状疱疹/并发症眼部带状疱疹/病毒学疱疹病毒1型人/遗传学疱疹病毒1型人/免疫学疱疹病毒3型人/遗传学疱疹病毒3型人/免疫学眼内压虹膜/病理学聚合酶链反应回顾性研究葡萄膜炎前/诊断葡萄膜炎前/病因学青少年成年人老年人儿童女(雌)性人类男(雄)性中年人

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