Clinical Manifestations and Molecular Biologic Diagnosis of Herpetic Glaucoma.

Kim, Mi Rang; Sohn, Sae Woon; Kee, Changwon

Original Article

Journal of the Korean Ophthalmological Society 2006;47(1):105-111.
Published online January 31, 2006.

Clinical Manifestations and Molecular Biologic Diagnosis of Herpetic Glaucoma.

Mi Rang Kim, Sae Woon Sohn, Changwon Kee

Department of Ophthalmology, Samsung Medical Center School of Medicine, Sungkyunkwan University, Seoul, Korea. cwkee@smc.samsung.co.kr

헤르페스성 녹내장의 임상양상과 분자생물학적 진단

김미랑,손세운,기창원

Department of Ophthalmology, Samsung Medical Center School of Medicine, Sungkyunkwan University, Seoul, Korea

Correspondence: Mi Rang Kim, M.D.

Abstract

PURPOSE
We attempted to detect the herpes virus using a polymerase chain reaction (PCR) technique from the aqueous humor of patients who were suspected of having herpetic uveitis. METHODS: We obtained aqueous humor from four patients who suffered from elevated intraocular pressure and uveitis but did not respond to steroid and intraocular pressure depressants. We employed the PCR technique for to detect herpes-virus specific DNA. Patients were treated with oral and topical acyclovir. RESULTS: Uveitis of varying severity and progressive iris atrophy was observed in all patients. Varicella zoster virus (VZV) specific DNA was detected in two of four patients. Two patients showed a favorable course but the other two patients showed an unfavorable course due to advanced peripheral anterior synechia and corneal decompensation. CONCLUSIONS: Diagnosis of herpetic uveitis was difficult because it was not usually accompanied by dendritic corneal lesions. Herpetic uveitis should be considered whenever anterior uveitis and elevated intraocular pressure accompanies the characteristic iris atrophy. PCR was very useful in detecting the virus DNA in the aqueous humor to enable rapid diagnosis and adequate treatment.

Key Words: Herpetic glaucoma;Herpetic uveitis;Herpes virus;Polymerase chain reaction;Varicella zoster virus