Liu Hui, Guo Suo, Liu Yaning, Su Guannan, Yang Peizeng
Ophthalmology Medical Center, The First Affiliate Hospital of Chongqing Medical University, Chongqing Key Laboratory for the Prevention and Treatment of Major Blinding Diseases, Chongqing, People's Republic of China.
Hebei Medical University Clinical Medicine Postdoctoral Research Station (The Second Hospital), People's Republic of China.
Transl Vis Sci Technol. 2025 Apr 1;14(4):2. doi: 10.1167/tvst.14.4.2.
To identify the subtypes among patients clinically diagnosed as herpetic anterior uveitis (HAU) and characterize their clinical features and visual prognosis.
Three hundred and seventeen patients were clinically diagnosed as HAU in our department. Aqueous humor (AqH) and serum were collected from 43 of 317 HAU patients during eye surgery. Pathogens were identified using droplet digital polymerase chain reaction and the Goldmann-Witmer coefficient. The AqH levels of 10 inflammatory cytokines were measured. The demographics, clinical features, treatment, and visual prognosis of the subtypes of HAU identified by AqH analysis were analysed.
DNA for herpes simplex virus (HSV), varicella-zoster virus (VZV), and cytomegalovirus (CMV) were identified in 13,18 and 12 eyes, respectively. The AqH levels of interleukin-13, interferon-γ, and tumor necrosis factor-α were significantly higher in VZV-AU as compared with HSV-AU and CMV-AU (all P < 0.05). In general, all these three subtypes of HAU had clinical features in common, including mutton-fat keratic precipitates usually toned with pigmentation, iris atrophy, elevated intraocular pressure (IOP), and posterior synechia with pupil pulling appearance unlike that caused by other uveitis. A much higher IOP and poor visual acuity at first visit were more commonly observed in VZV-AU and CMV-AU as compared with HSV-AU (both P < 0.05). A poor visual prognosis was noted in VZV-AU as compared with HSV-AU and CMV-AU (P = 0.010).
Our study identified three subtypes of HAU and characterized their clinical features. VZV-AU is frequently associated with much higher IOP and a poor visual prognosis.
We addressed the similarity and difference regarding clinical features and visual prognosis among three subtypes of HAU and also found droplet digital polymerase chain reaction is a sensitive technique for identifying its subtypes throughout the disease course.
识别临床诊断为疱疹性前葡萄膜炎（HAU）的患者中的亚型，并描述其临床特征和视力预后。
在我们科室，317例患者被临床诊断为HAU。在眼科手术期间，从317例HAU患者中的43例收集房水（AqH）和血清。使用液滴数字聚合酶链反应和戈德曼-维特默系数鉴定病原体。测量10种炎性细胞因子的房水水平。分析通过房水分析确定的HAU亚型的人口统计学、临床特征、治疗和视力预后。
分别在13只、18只和12只眼中鉴定出单纯疱疹病毒（HSV）、水痘-带状疱疹病毒（VZV）和巨细胞病毒（CMV）的DNA。与HSV-AU和CMV-AU相比，VZV-AU中白细胞介素-13、干扰素-γ和肿瘤坏死因子-α的房水水平显著更高（均P<0.05）。一般来说，这三种HAU亚型都有共同的临床特征，包括通常伴有色素沉着的羊脂状角膜后沉着物、虹膜萎缩、眼压（IOP）升高以及与其他葡萄膜炎不同的伴有瞳孔牵拉外观的虹膜后粘连。与HSV-AU相比，VZV-AU和CMV-AU在首次就诊时更常观察到更高的眼压和较差的视力（均P<0.05）。与HSV-AU和CMV-AU相比记录到VZV-AU的视力预后较差（P=0.010）。
我们的研究鉴定出HAU的三种亚型并描述了其临床特征。VZV-AU常与更高的眼压和较差的视力预后相关。
我们阐述了HAU三种亚型在临床特征和视力预后方面的异同，还发现液滴数字聚合酶链反应是在整个病程中识别其亚型的敏感技术。
