Skip to main content

Advertisement

Log in

Clinical features and prognosis of herpetic anterior uveitis: a retrospective study of 111 cases

  • Original Paper
  • Published:
International Ophthalmology Aims and scope Submit manuscript

Abstract

To describe the clinical features and outcomes in patients with herpetic anterior uveitis. We reviewed the records of 111 patients with a clinical diagnosis of herpetic anterior uveitis seen at the Department of Ophthalmology, Istanbul Faculty of Medicine, from January 1996 to December 2006. Demographic and clinical features, recurrence rate, and visual outcome were analyzed. Fifty patients were male, 61 were female. Mean age at presentation was 39.2 ± 16.5 (6–74) years. Three atopic patients had bilateral involvement. Twelve patients had active or a past episode of herpes zoster ophthalmicus. Ocular findings were granulamatous anterior uveitis (93%), active keratitis or corneal scars (57%), elevated intraocular pressure (51%), iris atrophy (48%), distorted pupil (25%), and posterior synechiae (26%). Secondary glaucoma developed in two patients. None of the patients had posterior segment complications. The recurrence rate was 0.45/person-year. Topical corticosteroids and oral antiviral therapy were administered to all patients during active episodes. Long-term prophylactic oral acyclovir was used in 13%. Final visual acuity was worse than 0.5 in 17% of the involved eyes and was due to corneal scarring or cataract formation. Patients with iridocyclitis only had no permanent visual loss. Herpetic anterior uveitis is a recurrent granulomatous disease commonly associated with corneal involvement, iris atrophy, and transient intraocular pressure rise. Visual prognosis is good, especially in patients who have only anterior uveitis without corneal disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Rathinam SR, Namperumalsamy P (2007) Global variation and pattern changes in epidemiology of uveitis. Indian J Ophthalmol 55:173–183

    Article  CAS  PubMed  Google Scholar 

  2. Chee SP, Bacsal K, Jap A et al (2008) Clinical features of cytomegalovirus anterior uveitis in immunocompetent patients. Am J Ophthalmol 145:834–840

    Article  PubMed  Google Scholar 

  3. Nakamura M, Tanabe M, Yamada Y, Azumi A (2000) Zoster sine herpete with bilateral ocular involvement. Am J Ophthalmol 129:809–810

    Article  CAS  PubMed  Google Scholar 

  4. Van der Lelij A, Ooijman FM, Kijlstra A, Rothova A (2000) Anterior uveitis with sectoral iris atrophy in the absence of keratitis. A distinct clinical entity among herpetic eye diseases. Ophthalmology 107:1164–1170

    Article  PubMed  Google Scholar 

  5. Markomichelakis NN, Canakis C, Zafirakis P et al (2002) Cytomegalovirus as a cause of anterior uveitis with sectoral iris atrophy. Ophthalmology 109:879–882

    Article  PubMed  Google Scholar 

  6. de Schryver I, Rozenberg F, Cassoux N et al (2006) Diagnosis and treatment of cytomegalovirus iridocyclitis without retinal necrosis. Br J Ophthalmol 90:852–855

    Article  PubMed  Google Scholar 

  7. Usui M, Usui N, Goto H et al (1993) Polymerase chain reaction for diagnosis of herpetic intraocular inflammation. Ocul Immunol Inflamm 1:105–112

    Article  Google Scholar 

  8. Yamamoto S, Pavan-Langston D, Kinoshita S et al (1996) Detecting herpesvirus DNA in uveitis using the polymerase chain reaction. Br J Ophthalmol 80:465–468

    Article  CAS  PubMed  Google Scholar 

  9. Green LK, Pavan-Langston D (2006) Herpes simplex ocular inflammatory disease. Int Ophthalmol Clin 46:27–37

    Article  PubMed  Google Scholar 

  10. Khan BF, Pavan-Langston D (2004) Clinical manifestations and treatment modalities in herpes simplex virus of the ocular anterior segment. Int Ophthalmol Clin 44:103–133

    Article  PubMed  Google Scholar 

  11. Kazokoglu H, Onal S, Tugal-Tutkun I et al (2008) Demographic and clinical features of uveitis in tertiary centers in Turkey. Ophthalmic Epidemiol 15:285–293

    Article  PubMed  Google Scholar 

  12. Siverio CD, Imai Y, Cunningham ET (2002) Diagnosis and management of herpetic anterior uveitis. Int Ophthalmol Clin 42:43–48

    Google Scholar 

  13. Barequet IS, Li Q, Wang Y et al (2000) Herpes simplex virus DNA identification from aqueous fluid in Fuchs heterochromic iridocyclitis. Am J Ophthalmol 129:672–673

    Article  CAS  PubMed  Google Scholar 

  14. Quentin CD, Reiber H (2004) Fuchs heterochromic cylitis: rubella virus antibodies and genome in aqueous humor. Am J Ophthalmol 138:45–54

    Article  Google Scholar 

  15. de Groot-Mijnes JD, de Visser L, Rothova A et al (2006) Rubella virus is associated with Fuchs heterochromic iridocyclitis. Am J Ophthalmol 141:212–214

    Article  PubMed  Google Scholar 

  16. Yamamoto S, Pavan-Langston D, Tada R et al (1995) Possible role of herpes simplex virus in the origin of Posner–Schlossman syndrome. Am J Ophthalmol 119:796–798

    CAS  PubMed  Google Scholar 

  17. Tugal-Tutkun I, Araz B, Taskapili M et al (2009) Bilateral acute depigmentation of the iris: report of 26 new cases and four-year follow-up of two patients. Ophthalmology 116:1552–1557

    Article  PubMed  Google Scholar 

  18. Tugal-Tutkun I, Güney-Tefekli E, Kamaci-Duman F, Corum I (2009) A cross-sectional and longitudinal study of Fuchs uveitis syndrome in Turkish patients. Am J Ophthalmol 148:510–515

    Article  PubMed  Google Scholar 

  19. Van Boxtel LAA, van der Lelij A, van der Meer J, Los LI (2007) Cytomegalovirus as a cause of anterior uveitis in immunocompetent patients. Ophthalmology 114:1358–1362

    Article  PubMed  Google Scholar 

  20. Miserocchi E, Waheed NK, Dios E et al (2002) Visual outcome in herpes simplex virus and varicella zoster virus uveitis. A clinical evaluation and comparison. Ophthalmology 109:1532–1537

    Article  PubMed  Google Scholar 

  21. Herpetic Eye Disease Study Group (1998) Acyclovir for the prevention of recurrent herpes simplex virus eye disease. N Engl J Med 339:300–306

    Article  Google Scholar 

  22. Uchoa UB, Rezende RA, Carrasco MA et al (2003) Long-term acyclovir use to prevent recurrent ocular herpes simplex virus infection. Arch Ophthalmol 121:1702–1704

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ilknur Tugal-Tutkun.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tugal-Tutkun, I., Ötük-Yasar, B. & Altinkurt, E. Clinical features and prognosis of herpetic anterior uveitis: a retrospective study of 111 cases. Int Ophthalmol 30, 559–565 (2010). https://doi.org/10.1007/s10792-010-9394-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10792-010-9394-8

Keywords

Navigation