Clinical Manifestations and Molecular Biologic Diagnosis of Herpetic Glaucoma

ABSTRACT

PURPOSE: We attempted to detect the herpes virus using a polymerase chain reaction (PCR) technique from the aqueous humor of patients who were suspected of having herpetic uveitis. METHODS: We obtained aqueous humor from four patients who suffered from elevated intraocular pressure and uveitis but did not respond to steroid and intraocular pressure depressants. We employed the PCR technique for to detect herpes-virus specific DNA. Patients were treated with oral and topical acyclovir. RESULTS: Uveitis of varying severity and progressive iris atrophy was observed in all patients. Varicella zoster virus (VZV) specific DNA was detected in two of four patients. Two patients showed a favorable course but the other two patients showed an unfavorable course due to advanced peripheral anterior synechia and corneal decompensation. CONCLUSIONS: Diagnosis of herpetic uveitis was difficult because it was not usually accompanied by dendritic corneal lesions. Herpetic uveitis should be considered whenever anterior uveitis and elevated intraocular pressure accompanies the characteristic iris atrophy. PCR was very useful in detecting the virus DNA in the aqueous humor to enable rapid diagnosis and adequate treatment.