Kawaguchi Tatsushi, Sugita Sunao, Shimizu Norio, Mochizuki Manabu
Department of Ophthalmology & Visual Science, Tokyo Medical and Dental University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan.
Int Ophthalmol. 2007 Dec;27(6):383-6. doi: 10.1007/s10792-007-9090-5. Epub 2007 May 24.
A case report of recurrent unilateral granulomatous iridocyclitis with ocular hypertension without retinitis caused by cytomegalovirus (CMV) in an immunocompetent patient.
Aqueous humor was analysed by multiplex PCR to detect viral DNA, and real-time PCR was used to evaluate virus copies before and after anti-virus treatments. Inflammation of the anterior chamber was evaluated by a laser flare photometry.
Genomic DNA of CMV - but not of other herpes viruses - was detected in the aqueous humor. Quantitative real-time PCR revealed 2.3 x 10(5) copies/ml of CMV DNA from the specimen. Oral valganciclovir was added to the ongoing treatment, which consisted of topical corticosteroid, timolol and latanoprost as well as systemic acetazolamide, resulting in the reduction of aqueous flare correlated with the reduction of virus copies in aqueous humor.
In this case of CMV-related iridocyclitis in an immunocompetent patient, specific additional anti-viral therapy was effective in controlling inflammation of anterior chamber but, as is so often the case, it was unable to control intraocular pressure. We show that inflammatory activity correlated well with the number of virus copies in the aqueous humor.
一名免疫功能正常的患者出现复发性单侧肉芽肿性虹膜睫状体炎伴高眼压且无视网膜炎症，由巨细胞病毒（CMV）引起的病例报告。
通过多重聚合酶链反应（PCR）分析房水以检测病毒DNA，并使用实时PCR评估抗病毒治疗前后的病毒拷贝数。通过激光散射光度法评估前房炎症。
在房水中检测到CMV的基因组DNA，但未检测到其他疱疹病毒的基因组DNA。定量实时PCR显示标本中CMV DNA为2.3×10⁵拷贝/毫升。在正在进行的治疗（包括局部使用皮质类固醇、噻吗洛尔和拉坦前列素以及全身使用乙酰唑胺）中加入口服缬更昔洛韦，导致房水闪光减少，这与房水中病毒拷贝数的减少相关。
在这名免疫功能正常的患者发生的与CMV相关的虹膜睫状体炎病例中，特定的额外抗病毒治疗有效地控制了前房炎症，但通常情况下，它无法控制眼压。我们表明炎症活动与房水中病毒拷贝数密切相关。
