Department of Ophthalmology, Bicêtre Hospital, 26930Assistance Publique - Hôpitaux de Paris, Paris-Saclay University, France.
Department of Ophthalmology, Bicêtre Hospital, 26930Assistance Publique - Hôpitaux de Paris, Paris-Saclay University, & U1184, IMVA-HB, CEA, France.
Eur J Ophthalmol. 2022 Nov;32(6):3489-3497. doi: 10.1177/11206721221087562. Epub 2022 Mar 14.
AIMS / BACKGROUND: Rubella virus-associated uveitis (RVAU) classically presents with the clinical features of Fuchs uveitis syndrome (FUS). We report a series RVAU, and discuss the relevance of available diagnostic strategies, and how vaccination could potentially prevent disease.
We retrospectively included patients with RV-positive aqueous humor (AH) with RT-PCR and/or intraocular RV-IgG production, between January 2014 and December 2019. RV-IgG titers from AH and serum were compared with other virus-specific IgG titers (VZV and/or CMV and/or HSV-1), to determine the derived Goldmann-Witmer coefficient (GWC'). Clinical findings at presentation and during follow-up are reported, as well as the anti-RV vaccination status.
All 13 included patients demonstrated intraocular synthesis of RV-IgG (median GWC': 9.5; 3.2-100). RV-RNA was detected in one patient while PCR results were negative for other HSV1, VZV and CMV. The mean delay in diagnosis was 13 ± 12.6 years, with an initial presentation of FUS in only 3 patients (23%). Only four patients had been vaccinated, but all after the recommended age.
As RVAU is a pleiomorphic entity, virological analysis (RV RT-PCR and GWC') of aqueous humor is essential to improve the diagnosis and management of this entity. Improper vaccination against RV appears to be implicated in RVAU.
目的/背景：风疹病毒相关性葡萄膜炎（RVAU）通常表现为 Fuchs 葡萄膜炎综合征（FUS）的临床特征。我们报告了一系列 RVAU，并讨论了现有的诊断策略的相关性，以及疫苗接种如何可能预防疾病。
我们回顾性纳入了 2014 年 1 月至 2019 年 12 月期间，通过 RT-PCR 和/或眼内风疹病毒 IgG 产生阳性的 RV 阳性房水的患者。比较 AH 和血清中的 RV-IgG 滴度与其他病毒特异性 IgG 滴度（VZV 和/或 CMV 和/或 HSV-1），以确定衍生的 Goldmann-Witmer 系数（GWC'）。报告了就诊时和随访期间的临床发现，以及抗 RV 疫苗接种状况。
所有 13 例纳入患者均表现为眼内合成 RV-IgG（中位数 GWC'：9.5；3.2-100）。1 例患者检测到 RV-RNA，而 PCR 结果对其他 HSV1、VZV 和 CMV 均为阴性。平均诊断延迟为 13±12.6 年，仅 3 例（23%）患者最初表现为 FUS。只有 4 例患者接种过疫苗，但均在推荐年龄之后。
由于 RVAU 是一种多态性实体，房水的病毒学分析（RV RT-PCR 和 GWC'）对于改善该实体的诊断和管理至关重要。对 RV 的不当疫苗接种似乎与 RVAU 有关。
