两家欧洲转诊中心的巨细胞病毒性前葡萄膜炎的诊断。
Diagnosis of Cytomegalovirus Anterior Uveitis in Two European Referral Centers.
机构信息
a Department of Ophthalmology , CHU Saint-Pierre, Université Libre de Bruxelles (ULB) , Brussels , Belgium.
b Department of Ophthalmology , CHU Brugmann, Université Libre de Bruxelles (ULB) , Brussels , Belgium.
出版信息
Ocul Immunol Inflamm. 2018;26(1):116-121. doi: 10.1080/09273948.2017.1411952.
PURPOSE
To evaluate diagnostic methods and clinical signs of CMV anterior uveitis (AU), a rarely described entity in Europe.
METHODS
We included patients with clinical characteristics of CMV AU and positive PCR and/or Goldmann-Witmer coefficient (GWc) for CMV.
RESULTS
We report 21 patients with unilateral uveitis (100%) and signs of Posner-Schlossman syndrome (PSS) (n = 20, 95.2%), Fuchs uveitis syndrome (FUS) (n = 1, 4.7%), and endotheliitis (n = 4, 19,04%). PCR was positive in 15/21 (71.4%) and GWc in 8/9 patients (88.9%) in aqueous for CMV. GWc was the only positive test in 6/9 patients (66,6%). When PCR alone was performed (without GWc) in the first tap, repeated aqueous taps were needed, twice in five cases and thrice in one case.
CONCLUSION
Combining PCR and GWc were very helpful to confirm the clinical diagnosis of CMV AU. In case of very high clinical suspicion and negative results, repeated tap seems to be recommended.
目的
评估巨细胞病毒（CMV）前葡萄膜炎（AU）的诊断方法和临床体征，CMV AU 在欧洲是一种罕见的疾病。
方法
我们纳入了具有 CMV AU 临床特征且 CMV 的 PCR 和/或 Goldmann-Witmer 系数（GWc）阳性的患者。
结果
我们报告了 21 例单侧葡萄膜炎（100%）患者，表现为 Posner-Schlossman 综合征（PSS）（n=20，95.2%）、Fuchs 葡萄膜炎综合征（FUS）（n=1，4.7%）和内皮炎（n=4，19.04%）。15/21（71.4%）例患者的房水中 CMV-PCR 阳性，9/9（88.9%）例患者的 GWc 阳性。GWc 是 6/9（66.6%）例患者唯一的阳性检查。在首次房水穿刺时单独进行 PCR（不进行 GWc）时，需要重复进行房水穿刺，5 例患者重复 2 次，1 例患者重复 3 次。
结论
PCR 和 GWc 的联合使用对确诊 CMV AU 的临床诊断非常有帮助。在高度怀疑但结果为阴性的情况下，似乎推荐重复进行房水穿刺。
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