ABSTRACT
Postoperative necrotizing scleritis should be considered in cases of persistent localized postoperative inflammation following all forms of surgical trauma. We present the history, clinical findings, and follow-up data of four patients with postoperative necrotizing scleritis. The clinical records of four patients who developed scleritis following ocular surgery were retrospectively reviewed. The first step in managing necrotizing scleritis is to rule out infectious etiology. Surgically induced necrotizing scleritis is an immune-mediated condition that can coexist with concomitant infectious condition, i.e. endophthalmitis, but response to immunosuppression leads to resolution of the disease and verifies the diagnosis.
Subject(s)
Phacoemulsification , Postoperative Complications , Scleritis/etiology , Trabeculectomy , Vitrectomy , Female , Glucocorticoids/therapeutic use , Humans , Immunosuppressive Agents/therapeutic use , Lens Implantation, Intraocular , Male , Methotrexate/therapeutic use , Middle Aged , Prednisolone/therapeutic use , Retrospective Studies , Scleritis/diagnosis , Scleritis/drug therapyABSTRACT
PURPOSE: To determine the presence of herpesvirus DNA in the aqueous humor (AH) of patients with serpiginous choroiditis using polymerase chain reaction (PCR). METHODS: AH from nine patients previously diagnosed with serpiginous choroiditis were investigated for herpes simplex virus (HSV), varicella zoster virus (VZV), and cytomegalovirus (CMV) by conventional virological methods and PCR. The PCR-positive DNA was gel-purified, extracted, and sequenced using a dye-based Applied Biosystems procedure. The sequences were processed through the National Cancer Institute's BLAST inquiry for species identification. RESULTS: Culture and cytological examination of AH from all nine patients were negative for HSV, VZV, and CMV. Five were positive for VZV, one was positive for HSV, and three were wholly negative using PCR. Subsequent DNA sequencing of the positive samples authenticated the presence of VZV and HSV DNA in the respective patients. CONCLUSION: VZV and HSV DNA were detected in a subset of patients with serpiginous choroiditis, suggesting that these viruses may function in the pathogenesis of this disease.
