Department of Ophthalmology, School of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea.
Departments of Laboratory Medicine.
J Glaucoma. 2018 Dec;27(12):1151-1156. doi: 10.1097/IJG.0000000000001086.
The main purpose of this study was to evaluate herpesvirus infection in patients with corneal endotheliitis and high intraocular pressure (IOP) using multiplex polymerase chain reaction (PCR) in aqueous humor samples.
This was a retrospective, observational study of immunocompetent patients living in South Korea. Eligible subjects had typical corneal endotheliitis with an IOP≥21 mm Hg or required antiglaucoma medication. Multiplex PCR was performed using aqueous humor samples obtained at first visit to detect the DNA of 6 herpesviruses.
Forty-two eyes from 42 patients with >6 months' follow-up were analyzed. Of these, 16 were herpesvirus-positive: 3 herpes simplex virus 1, 3 varicella-zoster virus, 9 cytomegalovirus, and 1 Epstein-Barr virus. Eyes with coin-shaped or fine keratic precipitates (kps), high IOP, and a low baseline endothelial cell count were more likely to show a positive result on multiplex PCR. Univariate analysis showed that male sex (P=0.014), a previous history of uveitic glaucoma (P=0.048), and the presence of fine kps (P=0.031) were significantly associated with a positive PCR result. On multivariate analysis, male sex (P=0.010) and a previous history of uveitic glaucoma (P=0.031) showed a significant positive association.
Cytomegalovirus was the most commonly detected herpesvirus in patients with corneal endotheliitis and high IOP. A positive PCR result was seen more frequently in male individuals and patients with fine kps or a history of uveitic glaucoma.
本研究的主要目的是使用多重聚合酶链反应（PCR）评估眼内液样本中疱疹病毒感染与角膜内皮炎和高眼压（IOP）的相关性。
这是一项在韩国进行的免疫功能正常的患者的回顾性观察性研究。符合条件的受试者具有典型的角膜内皮炎，IOP≥21mmHg 或需要抗青光眼药物治疗。使用多重 PCR 检测首次就诊时获得的眼内液样本，以检测 6 种疱疹病毒的 DNA。
共分析了 42 例有 >6 个月随访的患者的 42 只眼。其中 16 只眼为疱疹病毒阳性：3 只单纯疱疹病毒 1 型，3 只水痘带状疱疹病毒，9 只巨细胞病毒和 1 只 EBV。具有 Coin 形或细小角膜后沉着物（kps）、高眼压和低基线内皮细胞计数的眼在多重 PCR 上更可能出现阳性结果。单变量分析显示，男性（P=0.014）、葡萄膜炎性青光眼既往史（P=0.048）和细小 kps 的存在（P=0.031）与 PCR 阳性结果显著相关。多变量分析显示，男性（P=0.010）和葡萄膜炎性青光眼既往史（P=0.031）与阳性 PCR 结果呈显著正相关。
巨细胞病毒是角膜内皮炎和高 IOP 患者中最常检测到的疱疹病毒。PCR 阳性结果更常见于男性个体和具有细小 kps 或葡萄膜炎性青光眼病史的患者。
