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Journal of Microbiology: Current Research | Volume 2
November 01-02, 2018 | London, UK
7
th
European
Clinical Microbiology Congress
4
th
International Conference on
Ophthalmology and Eye Disorder
Joint Event
&
Clinical features of cytomegalovirus endotheliitis/anterior uveitis
Oya Donmez
Bayındır Hospital, Turkey
C
ytomegalovirus is a rare but, increasingly recognized cause
of corneal endotheliitis that requires strong clinical suspicion
for
diagnosis.Wereport the clinical characteristics and followup
of twelve cases of CMV endotheliitis/anterior uveitis. Six male
and six female patients were included. The mean age at the
time of diagnosis was 37.2±17.2 (15-74) years andmean follow-
up time was 40.5±24.04 (10-72) months. The mean number of
attacks were 4.7±4.5 (1-16). The time between the first attack
andCMVdiagnosiswas 17.1±11.3 (5-36)months. Diagnostic tap
was performed in 10 cases in whom quantitative PCR analysis
were positive for CMV. The focal corneal endotheliitis with
localised edema was present in 8 (66.7), diffuse iris atrophy in 7
(58.3%), cataract in 10 (83.3%), intraocular pressure rise during
acute attacks and keratic precipitates in all cases. Specular
microscopy demonstrated significantly lower endothelial cells
in affected eyes. (2288±357) compared to the fellow eyes
(3224±335). Keratic precipitates (KP) was medium-sized either
localised around the endotheliitis or at the lower two thirds
of corneal endothelium. Inferiorly localised pigmented KPs
were present in 75% of the patients. The mean IOP during the
attacks was 35.5±11.8 (15-60) mmHg and treated with medical
therapy and 2 patients required glaucoma surgery. Five patients
have visually impairing cataract and underwent surgery. All
patients were given systemic antiviral treatment (valaciclovir or
valganciclovir) and topical antiviral ophthalmic gel (ganciclovir).
Duration of systemic treatment was 10.8±8.5 months, all
patients showed favorable improvement while reinstitution
was necessary in two patients due to recurrent attacks. Focal
corneal endotheliitis with localised corneal edema, inferiorly
pigmented KP and, intraocular pressure rise during attacks
are characteristic features of CMV anterior uveitis. Early
diagnosis and treatments are crucial to reduce the number of
attacks, severity of the disease and prevent sight threatening
complications.
e:
donmezoya@hotmail.comClinical Microbiology and Eye 2018, Volume 2
DOI: 10.4066/2591-8036-C1-003