Yamamoto S, Pavan-Langston D, Kinoshita S, Nishida K, Shimomura Y, Tano Y
Department of Ophthalmology, Harvard Medical School, Boston, USA.
Br J Ophthalmol. 1996 May;80(5):465-8. doi: 10.1136/bjo.80.5.465.
Herpesviruses are involved in the pathogenesis of many ocular diseases including keratitis, iridocyclitis, and acute retinal necrosis syndrome. The rapid and accurate diagnosis of herpetic infections has become increasingly important with the rising incidence of immunosuppressive diseases. The purpose of this study was to evaluate the use of the polymerase chain reaction (PCR) to detect herpesvirus DNA in uveitis patients.
Aqueous samples were aspirated from 11 patients with active uveitis of suspected viral origin. Using PCR, masked samples were assayed for herpes simplex virus (HSV), varicella zoster virus (VZV), and cytomegalovirus (CMV) to assist in supporting the clinical diagnosis of viral aetiology. Masked controls included 10 aqueous humour specimens from normal patients undergoing cataract surgery and specimens from seven patients diagnosed with active non-viral uveitis--Behçet's disease, sarcoidosis, Fuchs' heterochromic iridocyclitis, or Harada's disease.
Ten of 11 cases clinically diagnosed as being of possible viral aetiology yielded aqueous PCR positive for a herpesvirus. Eight patients were PCR positive for amplified HSV DNA, of whom two had acute retinal necrosis, one had corneal endotheliitis, and five had recurrent iridocyclitis. VZV DNA was detected in one case of iridocyclitis, and CMV DNA in one case of chorioretinitis. Successful therapy was based on the PCR results. Ten normal aqueous specimens and the seven uveitis samples from cases not suspected of a viral aetiology were PCR negative for HSV, VZV, and CMV.
These results demonstrate that detecting herpesvirus DNA in the aqueous humour is useful to support a clinical diagnosis of viral uveitis.
疱疹病毒参与多种眼部疾病的发病机制，包括角膜炎、虹膜睫状体炎和急性视网膜坏死综合征。随着免疫抑制性疾病发病率的上升，快速准确地诊断疱疹感染变得越来越重要。本研究的目的是评估使用聚合酶链反应（PCR）检测葡萄膜炎患者疱疹病毒DNA的情况。
从11例疑似病毒源性活动性葡萄膜炎患者中抽取房水样本。使用PCR对盲法样本检测单纯疱疹病毒（HSV）、水痘带状疱疹病毒（VZV）和巨细胞病毒（CMV），以辅助支持病毒病因的临床诊断。盲法对照包括10例接受白内障手术的正常患者的房水标本以及7例诊断为活动性非病毒性葡萄膜炎（白塞病、结节病、富克斯异色性虹膜睫状体炎或原田病）患者的标本。
11例临床诊断为可能病毒病因的病例中，有10例房水PCR检测疱疹病毒呈阳性。8例患者HSV DNA扩增PCR呈阳性，其中2例患有急性视网膜坏死，1例患有角膜内皮炎，5例患有复发性虹膜睫状体炎。在1例虹膜睫状体炎病例中检测到VZV DNA，在1例脉络膜视网膜炎病例中检测到CMV DNA。基于PCR结果进行了成功的治疗。10例正常房水标本以及7例未怀疑病毒病因的葡萄膜炎样本HSV、VZV和CMV的PCR检测均为阴性。
这些结果表明，检测房水中的疱疹病毒DNA有助于支持病毒性葡萄膜炎的临床诊断。
