Polymerase chain reaction in viral anterior uveitis with secondary glaucoma: Analysis of 28 eyes from a tertiary eye care center in South India.

IF 1.2 Q4 OPHTHALMOLOGY

Taiwan Journal of Ophthalmology Pub Date : 2025-05-21 eCollection Date: 2025-04-01 DOI:10.4103/tjo.TJO-D-24-00089

Bhavini Johri, Dhanurekha Lakshmipathy, Jyotirmay Biswas

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引用次数: 0

Abstract

Purpose: To study the role of polymerase chain reaction (PCR) in viral anterior uveitis with secondary glaucoma.

Materials and methods: This was a retrospective cohort study in which aqueous humor from 28 eyes of 23 patients with viral uveitis and secondary glaucoma from 2008 to 2024 was sent for real-time/nested PCR. The clinical features of the patients were analyzed (P < 0.05 statistically significant).

Results: The median age at uveitis onset was 45 years. Secondary open-angle glaucoma was found in 23 out of 28 eyes, 82.1%. The median intraocular pressure (IOP) reduced significantly from baseline, 18.5 to 14 mmHg at the final visit (P = 0.01). Maximum IOP was 60 mmHg. PCR was positive in 57.1% of eyes, mostly for varicella-zoster virus (32.1%), followed by Cytomegalovirus (CMV) (17.8%) and herpes simplex virus (10.7%). Valacyclovir was used to treat 50% of eyes. CMV was treated with valganciclovir (10.7% eyes). Antiglaucoma and anti-inflammatory medications were reduced significantly from initiation (P < 0.001).

Conclusion: PCR enables timely and accurate detection of virus causing anterior uveitis and helps salvage vision in secondary glaucoma with appropriate antiviral therapy.

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病毒前葡萄膜炎伴继发性青光眼的聚合酶链反应：印度南部一家三级眼科保健中心28只眼的分析。

目的：探讨聚合酶链反应（PCR）在病毒性葡萄膜前炎合并继发性青光眼中的作用。材料和方法：这是一项回顾性队列研究，对2008年至2024年期间23例病毒性葡萄膜炎和继发性青光眼患者的28只眼的房水进行实时/巢式PCR检测。分析两组患者的临床特征（P < 0.05，有统计学意义）。结果：葡萄膜炎发病的中位年龄为45岁。继发性开角型青光眼23眼，占82.1%。中位眼压（IOP）较基线（18.5至14 mmHg）显著降低（P = 0.01）。最大眼压为60 mmHg。PCR阳性57.1%，以水痘-带状疱疹病毒为主（32.1%），其次为巨细胞病毒（CMV）（17.8%）和单纯疱疹病毒（10.7%）。使用伐昔洛韦治疗50%的眼睛。缬更昔洛韦治疗巨细胞病毒（10.7%）。抗青光眼和抗炎药物治疗从开始就显著减少（P < 0.001）。结论：PCR能及时、准确地检测出引起前葡萄膜炎的病毒，对继发性青光眼患者进行适当的抗病毒治疗有助于恢复视力。

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