Manandhar Anu, Margolis Todd P, Khanal Bhaiya
Tilganga Institute of Ophthalmology.
Nepal J Ophthalmol. 2018 Jan;10(19):23-31. doi: 10.3126/nepjoph.v10i1.21684.
The cause of Seasonal hyperacute panuveitis (SHAPU) also known as seasonal endophthalmitis is not yet confirmed. So far, bacteria have been isolated from the vitreous of three cases, VZV from the aqueous of one case and anellovirus from the vitreous of 30 cases of SHAPU. Its connection with moth is still assumed but not proven yet.
To study the clinical and microbiological features of SHAPU. To find out indirect evidence of it connection with moths.
Prospective longitudinal study of all the cases of SHAPU observed at Tilganga Institute of Ophthalmology in 2009 and 2010. A detailed ocular examination was performed on each case and vitreous fluid was removed from almost all cases for microbiological study.
66 cases of SHAPU were identified. Most were children. Twenty-three percent reported a recent history of white moth contact. Fine brown hairs, were present in 5 eyes. Bacteria were isolated from the vitreous of 9 eyes, PCR testing of the vitreous of all 48 cases showed no evidence of HSV, VZV or CMV DNA. Twenty of 34 cases (58.8%) who presented within 7 days of onset of symptoms had a final visual acuity ≥ 6/60 whereas 4/25 cases (16.0%) who presented after 7 days had final visual acuity ≥ 6/60 (p=0.001).
Herpes group of virus is the less likely cause of SHAPU. Bacteria are found in more cases. Early presentation is associated with a better visual outcome. Role of moth in its pathogenesis is still suspected.
季节性超急性全葡萄膜炎（SHAPU）又称季节性眼内炎，其病因尚未明确。到目前为止，已从3例患者的玻璃体液中分离出细菌，从1例患者的房水中分离出水痘带状疱疹病毒（VZV），并从30例SHAPU患者的玻璃体液中分离出细小病毒。虽然仍推测其与飞蛾有关，但尚未得到证实。
研究SHAPU的临床和微生物学特征。找出其与飞蛾相关的间接证据。
对2009年和2010年在蒂尔甘加眼科研究所观察到的所有SHAPU病例进行前瞻性纵向研究。对每个病例进行详细的眼部检查，几乎所有病例均抽取玻璃体液进行微生物学研究。
共确诊66例SHAPU患者。大多数为儿童。23%的患者报告近期有接触白蛾的病史。5只眼中发现有细小棕色毛发。9只眼的玻璃体液中分离出细菌，对所有48例患者的玻璃体液进行PCR检测，未发现单纯疱疹病毒（HSV）、水痘带状疱疹病毒（VZV）或巨细胞病毒（CMV）DNA的证据。症状发作7天内就诊的34例患者中有20例（58.8%）最终视力≥6/60，而症状发作7天后就诊的25例患者中有4例（16.0%）最终视力≥6/60（p=0.001）。
疱疹病毒组不太可能是SHAPU的病因。更多病例中发现有细菌。早期就诊与较好的视力预后相关。飞蛾在其发病机制中的作用仍受到怀疑。
