Title | Association of Ocular Inflammation and Rubella Virus Persistence. |
Publication Type | Journal Article |
Year of Publication | 2019 |
Authors | Gonzales JA, Hinterwirth A, Shantha J, Wang K, Zhong L, Cummings SL, Qian Y, Wilson MR, Acharya NR, Doan T |
Journal | JAMA Ophthalmol |
Volume | 137 |
Issue | 4 |
Pagination | 435-438 |
Date Published | 2019 04 01 |
ISSN | 2168-6173 |
Keywords | Adult, Eye Infections, Viral, Humans, Male, Middle Aged, Rubella, Uveitis |
Abstract | Importance: Metagenomic deep sequencing (MDS) demonstrates that persistent and active rubella virus (RV) infection is associated with Fuchs heterochromic iridocyclitis (FHI). Objective: To assess the utility of MDS in identifying RV infection in patients with uveitis. Design, Setting, and Participants: This case series assessed 6 patients diagnosed by MDS with RV-associated uveitis at a tertiary uveitis referral center in the United States. Exposures: Prior RV infection. Main Outcomes and Measures: Clinical examination findings, slitlamp photography, corneal confocal imaging, and infectious pathogen genome obtained from RNA sequencing. Results: Six white men (age range, 36-61 years) were diagnosed with RV-associated uveitis by MDS. Three patients exhibited iris heterochromia associated with their uveitis in classic FHI fashion. The other 3 patients had less classic FHI features and exhibited anterior vitritis. Three patients had in vivo corneal confocal microscopy, with 2 demonstrating stellate keratic precipitates in addition to endothelial infiltration, spotlike holes, and enlarged intercellular boundaries. Of these 3 patients, 1 patient exhibited polymorphism and polymegathism of the endothelial cells. Conclusions and Relevance: These findings suggest that persistent RV infection is associated with recurrent or chronic anterior or anterior-intermediate uveitis as well as corneal endothelial cell damage. Ophthalmologists should consider RV infection as a potential cause of hypertensive anterior and intermediate uveitis. |
DOI | 10.1001/jamaophthalmol.2018.6185 |
Alternate Journal | JAMA Ophthalmol |
PubMed ID | 30589932 |
PubMed Central ID | PMC6439711 |
Grant List | K08 EY026986 / EY / NEI NIH HHS / United States K12 HD085850 / HD / NICHD NIH HHS / United States |