Current aspects on the management of viral uveitis in immunocompetent individuals

Figures & data

Table 1 The comparison of the epidemiology, clinical features, complications, and clinical course among the three herpes viruses

	HSV	VZV	CMV acute	CMV chronic
Age	30–50 years	50–70 years	20–50 years	40–70 years
Sex	Equal	Equal	Males (65%)	Males (80%)
Race	All	All	Predominantly Asian	Predominantly Asian
Laterality	Bilateral in 18% of eyes	Unilateral	Unilateral	Predominantly unilateral
Skin involvement	± crops of vesicles	± va dermatome blisters	None	None
Cornea	Scars 12%–33% Corneal involvement 57%–61%	Scars 2.5%–9% Corneal involvement 58%	± nodular endothelial lesions 26%	± nodular endothelial lesions 60%, immune ring
Corneal sensation	Reduced	Reduced	Normal	Normal
KP	Granulomatous or nongranulomatous	Granulomatous or nongranulomatous	Granulomatous	Fine, stellate, diffuse ± pigmented
AC cells	Moderate	Moderate	Few	Moderate
AC flare	Moderate	Moderate	Minimal	Minimal
Pupil shape	May be irregular	May be irregular	Normal	Normal
Posterior synechiae	May be present 25%–38%	May be present 0%–40%	Absent	Absent
Iris atrophy	Sector or spiral 25%–46%	Sector, circular 25%–88%	Patchy or diffuse, rarely sector 43%	Diffuse or patchy 60%
IOP	Elevated 38%–90%	Elevated 40%–75%	Elevated 100%	Elevated 69%
Vitritis	43%	83%	0%	9%
Glaucoma	Present in 18%–54%	Present in 30%–40%	23%	36%
Cataract	Present in 28%–35%	Present in 27%–30%	23%	75%
Recurrence	In 15%–65%	In 13%–51%	100%	NA

Abbreviations: HSV, herpes simplex virus; VZV, varicella-zoster virus; CMV, cytomegalovirus; va, cranial nerve V1; KP, keratic precipitate; AC, anterior chamber; IOP, intraocular pressure.

Figure 1 Treatment approach to herpetic anterior uveitis.

Abbreviations: PCR, polymerase chain reaction; HSV, herpes simplex virus; VZV, varicella-zoster virus; CMV, cytomegalovirus; NSAIDs, nonsteroidal anti-inflammatory drugs.

Figure 2 Treatment approach if HSV is nonresponsive to oral (valacyclovir) ACV treatment.

Abbreviations: HSV, herpes simplex virus; ACV, acyclovir.