Department of Ophthalmology, University of Tokyo Graduate School of Medicine, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
Department of Ophthalmology, Cancer Institute Hospital, 3-8-31 Ariake, Koto-ku, Tokyo, 135-8550, Japan.
Graefes Arch Clin Exp Ophthalmol. 2020 Mar;258(3):639-645. doi: 10.1007/s00417-019-04559-w. Epub 2019 Dec 12.
To clarify the prevalence of secondary glaucoma (SG) and its speed of progression in patients with herpes simplex virus (HSV)-anterior uveitis (AU), varicella zoster virus (VZV)-AU, and cytomegalovirus (CMV)-AU.
In total, 170 patients with herpetic AU were enrolled in this retrospective observational case series. Patients with visual field (VF) defects and glaucomatous disc abnormalities were diagnosed with SG. Moreover, the speed of SG progression was defined as decreasing mean deviation (MD) values per year. SG prevalence and annual MD-value decrease were compared among the three types of herpetic AU.
SG prevalence was 16%, 9%, and 72% in patients with HSV-AU, VZV-AU, and CMV-AU, respectively. Patients with CMV-AU had the highest SG prevalence (odds ratio = 3.15; 95% confidence interval = 1.15-8.65; P < 0.05). Furthermore, the annual MD-value change was significantly higher in SG caused by CMV-AU than in that caused by HSV/VZV-AU (-2.6 ± 2.4 dB/year and -0.45 ± 0.54 dB/year, respectively; P < 0.05).
Our results demonstrated that patients with CMV-AU may have a higher risk and faster speed of progression of SG than patients with HSV/VZV-AU. Therefore, clinicians should monitor glaucoma onset and VF-defect progression in patients with CMV-AU.
阐明单纯疱疹病毒（HSV）-前葡萄膜炎（AU）、水痘带状疱疹病毒（VZV）-AU 和巨细胞病毒（CMV）-AU 患者继发青光眼（SG）的患病率及其进展速度。
本回顾性观察性病例系列研究共纳入 170 例单纯疱疹性 AU 患者。存在视野（VF）缺损和青光眼性视盘异常的患者被诊断为 SG。此外，SG 进展速度定义为每年平均偏差（MD）值的下降。比较了三种类型单纯疱疹性 AU 患者之间的 SG 患病率和每年 MD 值下降。
HSV-AU、VZV-AU 和 CMV-AU 患者的 SG 患病率分别为 16%、9%和 72%。CMV-AU 患者的 SG 患病率最高（比值比 = 3.15；95%置信区间 = 1.15-8.65；P < 0.05）。此外，CMV-AU 引起的 SG 每年 MD 值变化明显高于 HSV/VZV-AU 引起的 SG（-2.6 ± 2.4 dB/年和-0.45 ± 0.54 dB/年；P < 0.05）。
我们的研究结果表明，CMV-AU 患者 SG 的发生风险更高，进展速度更快。因此，临床医生应监测 CMV-AU 患者的青光眼发作和 VF 缺损进展。
