In-vivo confocal microscopy predicts cytomegalovirus as the cause of chronic or recurrent anterior uveitis among Chinese.

IF 2.4 3区医学 Q2 OPHTHALMOLOGY

Graefe’s Archive for Clinical and Experimental Ophthalmology Pub Date : 2024-12-01 Epub Date: 2024-07-01 DOI:10.1007/s00417-024-06561-3

Stephanie Hiu-Wai Kwok, Ka Wai Kam, Eugenie Mok, Alvin L Young

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Abstract

Purpose: To evaluate and compare endothelial features by in-vivo confocal microscopy (IVCM) in Chinese eyes with chronic or recurrent anterior uveitis (AU) with and without cytomegalovirus (CMV).

Methods: A double-masked, cross-sectional case-control study at a tertiary eye clinic.

Results: Thirty eyes of 30 subjects were analyzed. Fifteen eyes (50%) were CMV positive, while fifteen eyes were negative for herpes simplex virus, varicella zoster virus and CMV. Absence of pseudoguttata was the strongest, independent risk factor for CMV (OR 34.53, 95% CI: 1.84-648.02, p = 0.018), followed by severe iris depigmentation (OR 31.45, 1.02-965.81, p = 0.048) and low corneal endothelial cell density (ECD) (OR 14.79, 1.14-191.30, p = 0.039) on univariable regression. All three remained statistically significant after adjustment. The combination of absence of pseudoguttata and low ECD on IVCM achieved a similar predictive value as iris depigmentation examination.

Conclusion: Absence of pseudoguttata on IVCM was an independent predictor of positive CMV detection after adjusting for iris depigmentation and corneal endothelial cell density. The addition of this feature to severe iris depigmentation and low corneal ECD can increase the positive predictive value of detecting CMV. IVCM was a useful non-invasive tool to predict CMV in patients with chronic or recurrent AU.

Abstract Image

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体内共聚焦显微镜预测巨细胞病毒是中国人慢性或复发性前葡萄膜炎的病因。

目的：通过体内共聚焦显微镜（IVCM）评估和比较中国慢性或复发性前葡萄膜炎（AU）患者有无巨细胞病毒（CMV）的内皮特征：在一家三级眼科诊所进行的一项双掩蔽、横断面病例对照研究：分析了 30 名受试者的 30 只眼睛。15只眼睛（50%）CMV阳性，15只眼睛单纯疱疹病毒、水痘带状疱疹病毒和CMV阴性。在单变量回归中，无假胬肉是CMV最强的独立危险因素（OR 34.53，95% CI：1.84-648.02，p = 0.018），其次是严重的虹膜色素沉着（OR 31.45，1.02-965.81，p = 0.048）和角膜内皮细胞密度低（ECD）（OR 14.79，1.14-191.30，p = 0.039）。经调整后，三者仍具有统计学意义。IVCM上无假瞳孔和低ECD的组合具有与虹膜色素沉着检查相似的预测价值：结论：在对虹膜色素沉着和角膜内皮细胞密度进行调整后，IVCM 上无假龟头是 CMV 检测阳性的独立预测因素。在严重虹膜色素沉着和角膜内皮细胞密度低的基础上增加这一特征，可提高检测出 CMV 的阳性预测值。IVCM 是预测慢性或复发性 AU 患者中 CMV 的有用非侵入性工具。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Graefe’s Archive for Clinical and Experimental Ophthalmology 医学-眼科学

CiteScore

5.40

自引率

7.40%

发文量

398

审稿时长

3 months

期刊介绍： Graefe''s Archive for Clinical and Experimental Ophthalmology is a distinguished international journal that presents original clinical reports and clini-cally relevant experimental studies. Founded in 1854 by Albrecht von Graefe to serve as a source of useful clinical information and a stimulus for discussion, the journal has published articles by leading ophthalmologists and vision research scientists for more than a century. With peer review by an international Editorial Board and prompt English-language publication, Graefe''s Archive provides rapid dissemination of clinical and clinically related experimental information.