Klin Monbl Augenheilkd 2021; 238(04): 448-453
DOI: 10.1055/a-1425-4809
Der interessante Fall

Cytomegalovirus Anterior Uveitis from the Perspective of the Common Practitioner: Missed Diagnosis Can Be at the Origin of Severe Functional Loss – A Scenario to Be Avoided

Zytomegalovirus-anteriore Uveitis aus der Sicht des Allgemeinaugenarztes: Eine verpasste Diagnose kann Ursprung eines schweren funktionellen Verlustes sein – ein zu vermeidendes Szenario
Retinal and Inflammatory Eye Diseases, Centre for Ophthalmic Specialized Care (COS), Clinic Montchoisi Teaching Centre, Lausanne, Switzerland
,
Carl Peter Herbort Jr
Retinal and Inflammatory Eye Diseases, Centre for Ophthalmic Specialized Care (COS), Clinic Montchoisi Teaching Centre, Lausanne, Switzerland
› Author Affiliations

Introduction

In everyday clinical practice, among anterior uveitis cases induced by the herpes family of viruses, cytomegalovirus (CMV) anterior uveitis is relatively rare and is therefore often diagnosed with a substantial delay. Herpes anterior uveitis is a clinical diagnosis, and the three main causative agents, herpes simplex virus (HSV), varicella-zoster virus (VZV), and CMV, produce a similar clinical picture with subtle variations [1], [2]. The vast majority of herpetic uveitis seen by the practitioner is due to HSV or VZV when compared to CMV. This proportion is also reflected in studies performed on the identification of the viral agent in the aqueous humour, when we exclude Asian studies where CMV is more prevalent [3], [4]. In common practice, polymerase chain reaction (PCR) investigations are very rarely done, as the clinical picture of herpes anterior uveitis is quite characteristic, and the diagnosis is made relatively easily. In the presence of a unilateral, sometimes hypertensive, granulomatous uveitis with a moderate number of keratic precipitates (KPs) and possibly atrophy of iris sectors, the practitioner identifies a herpetic uveitis and applies the classical treatment of systemic valacyclovir or similar together with topical corticosteroid drops.



Publication History

Received: 04 September 2020

Accepted: 07 March 2021

Publication Date:
30 April 2021 (online)

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