Infectious Uveitis

A number of infections cause uveitis (see table: Infectious causes of uveitis). The most common are herpes simplex virus, varicella zoster virus and cytomegalovirus (ZMV-) infections and toxoplasmosis. Different organisms affect different parts of the uvea. Infectious causes of uveitis frequency viruses or infections commonly, cytomegalovirus * Herpes simplex virus Pneumocystis jirovecii * Toxoplasmosis Varicella zoster virus Less common bartonellosis histoplasmosis disease syphilis toxocariasis tuberculosis Rarely Aspergillus Candida Cryptococcus coccidioidomycosis cysticercosis leprosy leptospirosis onchocerciasis Tropheryma whippelii * Especially in patients with AIDS. Herpes Virus The herpes simplex virus (herpes simplex virus infection (HSV)) causes anterior uveitis. The varicella-zoster virus, this is rarely the case, although the prevalence of zoster-associated anterior uveitis increases with age. Symptoms include eye pain, photophobia, and visual loss. Clinical signs include redness, conjunctival injection, and inflammation of the anterior chamber (cells and flare), frequently accompanied by inflammation of the cornea (keratitis); decreased corneal sensitivity; and a mottled or sectoral iris atrophy. Also, the intraocular pressure can be increased; increasing, by the use of, for example, applanation tonometry with a Goldmann tonometer, a pneumotonometer, an electronic Indentationstonometer, or, if these are not available, demonstrated a Schiotz tonometer. Treatment should be initiated in general by an ophthalmologist and include a topical corticosteroid and a zykloplegisch-mydriatic drug. Also acyclovir can be given (5 times 400 mg / day po for herpes simplex virus and 5 times 800 mg / day po for herpes zoster virus). In patients with ocular hypertension drops may be necessary to lower the intraocular pressure. Much less varicella zoster virus and herpes simplex viruses cause a rapidly progressive form of retinitis, known as acute retinal necrosis (ARN), which is expressed usually as confluent retinitis, occlusive retinal vasculitis and moderate to severe vitreous inflammation. A third of ARN cases are bilateral and ¾ of the eyes retinal detachment occurs. The ARN can also occur in patients with HIV / AIDS, but patients with severely weakened immune systems have a lower vitreous inflammation. A vitreous biopsy for bacterial culture and PCR analysis can help to diagnose an ARN. Treatment options include i.v. Acyclovir, i.v. Ganciclovir or foscarnet, intravitreal ganciclovir or foscarnet and oral valaciclovir or valganciclovir. Retinitis (herpes) Image courtesy of O. H. Gottfried Naumann, University Eye Hospital, Erlangen, Germany, via the Online Journal of Ophthalmology ( var model = {thumbnailUrl: ‘/-/media/manual/professional/images/retinitis_herpes_orig_high_de.jpg?la=de&thn=0&mw=350’ imageUrl: ‘/-/media/manual/professional/images/retinitis_herpes_orig_high_de.jpg?la = en & thn = 0 ‘, title:’ retinitis (herpes) ‘description:’ u003Ca id = “v37894338 ” class = “”anchor “” u003e u003c / a u003e u003cdiv class = “”para “” u003e u003cp u003eDieses photo shows an inflammation of the vitreous (indicated by the blur when viewing the retina) and necrotizing retinitis with yellowish discoloration of the retina and retinal vessels

Health Life Media Team

Leave a Reply