RESUMEN
This retrospective study was designed to estimate the cumulative incidence of glaucoma in viral uveitis. Seventy-six consecutive patients with viral stromal keratouveitis were divided into two groups according to the etiologic agents herpes simplex virus (HSV) keratouveitis (n = 58) and herpes zoster virus (HZV) keratouveitis (n = 18). The groups were evaluated for the incidence and prognosis of ocular hypertension. Etiologic agents were determined with the help of clinical observation supported by the polymerase chain reaction (PCR) of aqueous humor. All patients received oral acyclovir therapy for at least six months and topical prednisolone in tapered doses. There was no significant difference in the recurrences of HSV and varicella zoster virus (VZV) keratouveitis between groups (P = 0.431). The total incidence of secondary glaucoma was 13.1%. Most of the patients responded to antiviral and antiglaucomatous therapy. Trabeculectomy with mitomycin C was performed in only two patients. Secondary glaucoma can be regarded as a frequent complication of viral uveitis. As it has a good prognosis, surgical intervention is rarely required.
Asunto(s)
Glaucoma/epidemiología , Glaucoma/fisiopatología , Herpesvirus Humano 3 , Simplexvirus , Uveítis Anterior/complicaciones , Aciclovir/administración & dosificación , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Antiinflamatorios/administración & dosificación , Antivirales/administración & dosificación , Femenino , Glaucoma/etiología , Humanos , Incidencia , Presión Intraocular , Masculino , Persona de Mediana Edad , Prednisolona/administración & dosificación , Prednisolona/análogos & derivados , Pronóstico , Estudios Retrospectivos , Uveítis Anterior/tratamiento farmacológico , Uveítis Anterior/virologíaRESUMEN
OBJECTIVE: To report the ocular findings associated with brucellosis. DESIGN: Cohort study. PARTICIPANTS: One hundred thirty-two patients with the diagnosis of brucellosis. METHODS: Ocular manifestations of 132 patients with brucellosis admitted to the Uveitis-Behçet Service of Ophthalmology Department at the Ankara Education and Research Hospital in Turkey between May 1992 and May 2006 were evaluated prospectively. The diagnosis of brucellosis was based on clinical signs, Brucella agglutination tests, and blood cultures. RESULTS: Ocular involvement was detected in 21% of brucellosis patients. The most frequent manifestations were anterior uveitis (41%) and choroiditis (32%), followed by panuveitis (9%), papilledema (9%), and retinal hemorrhages (9%). Forty-one percent of these patients were in the acute stage and 59% were in the chronic stage of brucellosis. Interestingly, all the patients with anterior uveitis were in the acute stage and all the other patients with choroiditis, papilledema, and retinal hemorrhages were in the chronic stage. All patients responded well to systemic antibiotic treatment along with topical or systemic corticosteroid treatment. No recurrence of ocular manifestations was detected during the follow-up period, after completion of a 2-month systemic antibiotic treatment. CONCLUSIONS: Because ocular involvement of brucellosis is frequent in endemic regions, detailed ophthalmic examination of all patients with brucellosis should be done routinely. Ocular brucellosis should be considered in the differential diagnosis of all forms of uveitis or choroiditis in endemic regions, and these patients should undergo serologic screening for brucellosis.