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Cytomegalovirus as a Cause of Recurrent Anterior Uveitis in Immunocompetent Patients

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¹ÚÁöÇö ( Park Ji-Hyun ) - °Ç¾ç´ëÇб³ Àǰú´ëÇÐ ±è¾È°úº´¿ø ¾È°úÇб³½Ç
Á¤À縲 ( Chung Jae-Lim ) - °Ç¾ç´ëÇб³ Àǰú´ëÇÐ ±è¾È°úº´¿ø
À̼ºÈ£ ( Lee Sung-Ho ) - ·ç¹Ì¾ÆÀÌ Á¦³×ƽ½º
È«¿µÀç ( Hong Young-Jae ) - ´©³×¾È°úº´¿ø

Abstract

¸ñÀû: ¸é¿ª±â´ÉÀÌ Á¤»óÀÎ Àç¹ß¼º °í¾È¾Ð Àü¾ÈºÎ Æ÷µµ¸·¿° ȯÀÚ¿¡¼­ ºÐÀÚ»ý¹°ÇÐÀû ¹æ¹ýÀ¸·Î °¨¿°¿øÀ» ±Ô¸íÇϰíÀÚ ÇÏ¿´´Ù.
´ë»ó°ú ¹æ¹ý: Àç¹ß¼º °í¾È¾Ð Àü¾ÈºÎ Æ÷µµ¸·¿°À¸·Î Áø´Ü¹Þ¾ÒÀ¸¸ç Àü½ÅÀûÀÎ Æ÷µµ¸·¿° °Ë»ç¿¡¼­ À½¼º ¼Ò°ßÀ» º¸ÀΠȯÀÚ 20¸í 20¾ÈÀÇ Àü¹æ ¼ö ¹× ÀüÇ÷À» äÃëÇÏ¿© ´Ü¼øÆ÷Áø¹ÙÀÌ·¯½º(HSV-1), ´ë»óÆ÷Áø¹ÙÀÌ·¯½º(VZV), °Å´ë¼¼Æ÷¹ÙÀÌ·¯½º(CMV), Åå¼ÒÇöóÁ(toxoplasma) °¨¿° ¿©ºÎ¸¦ direct polymerase chain reaction (PCR)¹ýÀ¸·Î Á¶»çÇÏ¿´´Ù.

°á°ú: ´ë»ó ȯÀÚ 20¸íÀÇ Æò±Õ ³ªÀÌ´Â 41.8 ¡¾ 15.9¼¼¿´À¸¸ç ³²ÀÚ°¡ 14¸íÀ̾ú´Ù. °Å´ë¼¼Æ÷¹ÙÀÌ·¯½º´Â 7¸í(35.0%)¿¡¼­ ¾ç¼ºÀ» º¸¿´À¸¸ç ¸ðµÎ Àü¹æ¼ö¿¡¼­¸¸ °ËÃâµÇ¾ú´Ù. ´Ü¼øÆ÷Áø¹ÙÀÌ·¯½º´Â 5¸í(25.0%)¿¡¼­ ¾ç¼ºÀ» º¸¿´À¸¸ç, 2¸íÀº Àü¹æ¼ö¿¡¼­¸¸, 1¸íÀº ÀüÇ÷¿¡¼­¸¸, 2¸íÀº ¸ðµÎ¿¡¼­ °ËÃâµÇ¾ú´Ù. Åå¼ÒÇöóÁÀÇ °æ¿ì 1¸í(5%)¿¡¼­ Àü¹æ¼ö¿¡¼­¸¸ ¾ç¼ºÀ» º¸¿´´Ù.

°á·Ð: ¸é¿ª±â´ÉÀÌ Á¤»óÀΠȯÀÚÀÇ ´Ü¾È Àü¾ÈºÎ Æ÷µµ¸·¿°¿¡¼­ °Å´ë¼¼Æ÷¹ÙÀÌ·¯½º°¡ Áß¿äÇÑ °¨¿°¿øÀÇ ÇϳªÀ̹ǷΠ°Ë»ç°á°ú¿¡ µû¶ó ÀûÇÕÇÑ Ç×¹ÙÀÌ·¯½º Ä¡·á°¡ ÇÊ¿äÇÒ °ÍÀ¸·Î »ý°¢µÈ´Ù.

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 ¡¾ 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.

Ű¿öµå

Cytomegalovirus;Polymerase chain reaction;Recurrent hypertensive anterior uveitis

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