Intérêt de la recherche du cytomégalovirus par polymerase chain reaction dans le syndrome de Posner-Schlossman

Abstract

To investigate the possible association between cytomegalovirus (CMV) infection and Posner-Schlossman syndrome using PCR. To evaluate the clinical effect of valganciclovir treatment. Patients with anterior uveitis associated with suspected Posner-Schlossman syndrome had their aqueous humor prospectively analyzed for viral deoxyribonucleic acid by HXFL4 gene detection using quantitative real-time PCR. Seven patients (two females and five males from 15 to 56 years old) with clinical signs of Posner-Schlossman syndrome (anterior nongranulomatous hypertensive uveitis with anterior chamber cells, central keratic precipitates, anisocoria, without iris atrophy) were tested. Examinations of the aqueous humor by polymerase chain reaction demonstrated CMV-DNA in five patients and were negative for other herpes viruses in all patients. Two patients were treated with oral antiviral therapy (valganciclovir). Relapses occurred in all cases after cessation of therapy. Aqueous humor analysis by PCR is useful in differentiating between CMV and other herpes viruses and in making a positive etiological diagnosis in anterior hypertensive uveitis. Valganciclovir may be effective in treating CMV anterior uveitis, but its exact role should be determined in larger studies with a longer follow-up. Cytomegalovirus detection in aqueous humor using polymerase chain reaction is useful in the management of patients with Posner-Schlossman syndrome.