Frequency of dendritiform inflammatory cells in the cornea in herpetic anterior uveitis without clinical keratitis and Fuchs uveitis

Journal of Ophthalmic Inflammation and Infection - Tập 4 - Trang 1-6 - 2014
Alexandra B Knoll1, Andreea S Postole1, Gerd U Auffarth1, Friederike Mackensen1
1Interdisciplinary Uveitis Center, Department of Ophthalmology, University Hospital Heidelberg, Heidelberg, Germany

Tóm tắt

Herpetic anterior uveitis is a frequent cause of infectious uveitis. A definite diagnosis is obtained by anterior chamber puncture and polymerase chain reaction, an invasive procedure. We hypothesized that patients with herpetic anterior uveitis have a certain pattern of inflammatory cells in their cornea that distinguishes herpetic anterior uveitis from other uveitis types. This study is a prospective, controlled, observational study. Ten patients are with active herpetic anterior uveitis and 14 patients are with Fuchs uveitis syndrome. Patients were imaged with the Heidelberg Retina Tomograph with the Rostock Cornea Module attachment. Three images of the subepithelial area of the cornea were evaluated for dendritiform inflammatory cells. Means were calculated and used for analysis. The contralateral unaffected eyes and numbers published in the literature served as controls. The number of dendritiform inflammatory cells in herpetic anterior uveitis was compared to that in the Fuchs uveitis syndrome. Of the eyes of patients with herpetic anterior uveitis, 80% had an average of 98.0±10.8 cells/mm2 (mean±standard error of the mean (SEM), n=10) in their affected eyes and 60.4±26.4 cells/mm2, (n=6) in 30% of their fellow eyes. Patients with Fuchs uveitis syndrome had moderately elevated dendritiform inflammatory cells (47.0±9.7 cells/mm2, n=14) in 96.4% of their affected eyes and normal numbers (23.0±7.3 cells/mm2, n=13) in 46.4% of their fellow eyes. The difference between the four groups was significant (p=0.0004). Patients with herpetic anterior uveitis had significantly higher levels of dendritiform inflammatory cells in their subepithelial cornea than patients with Fuchs uveitis syndrome, which can be detected by in vivo confocal microscopy. The clinically unaffected eyes of herpetic anterior uveitis patients showed a co-response regarding dendritiform inflammatory cell elevation. We conclude that high numbers of dendritiform inflammatory cells in the cornea of uveitis patients may support the clinical diagnosis of herpetic anterior uveitis.

Tài liệu tham khảo

Jakob E, Reuland MS, Mackensen F, Harsch N, Fleckenstein M, Lorenz HM, Max R, Becker MD: Uveitis subtypes in a german interdisciplinary uveitis center–analysis of 1916 patients. J Rheumatol 2009,36(1):127–36.

Rodriguez A, Calonge M, Pedroza-Seres M, Akova YA, Messmer EM, D'Amico DJ, Foster CS: Referral patterns of uveitis in a tertiary eye care center. Arch Ophthalmol 1996,114(5):593–599. 10.1001/archopht.1996.01100130585016

Wensing B, Relvas LM, Caspers LE, Valentincic NV, Stunf S, de Groot-Mijnes JD, Rothova A: Comparison of rubella virus- and herpes virus-associated anterior uveitis: clinical manifestations and visual prognosis. Ophthalmology 2011,118(10):1905–1910. 10.1016/j.ophtha.2011.03.033

Jap A, Chee SP: Viral anterior uveitis. Curr Opin Ophthalmol 2011,22(6):483–488. 10.1097/ICU.0b013e32834be021

Rosenberg ME, Tervo TM, Muller LJ, Moilanen JA, Vesaluoma MH: In vivo confocal microscopy after herpes keratitis. Cornea 2002,21(3):265–269. 10.1097/00003226-200204000-00006

Mastropasqua L, Nubile M, Lanzini M, Carpineto P, Ciancaglini M, Pannellini T, Di Nicola M, Dua HS: Epithelial dendritic cell distribution in normal and inflamed human cornea: in vivo confocal microscopy study. Am J Ophthalmol 2006,142(5):736–744. 10.1016/j.ajo.2006.06.057

Zhivov A, Stave J, Vollmar B, Guthoff R: In vivo confocal microscopic evaluation of langerhans cell density and distribution in the corneal epithelium of healthy volunteers and contact lens wearers. Cornea 2007,26(1):47–54. 10.1097/ICO.0b013e31802e3b55

Niederer RL, McGhee CN: Clinical in vivo confocal microscopy of the human cornea in health and disease. Prog Retin Eye Res 2010,29(1):30–58. 10.1016/j.preteyeres.2009.11.001

Mocan MC, Irkec M, Mikropoulos DG, Bozkurt B, Orhan M, Konstas AG: In vivo confocal microscopic evaluation of the inflammatory response in non-epithelial herpes simplex keratitis. Curr Eye Res 2012,37(12):1099–106. 10.3109/02713683.2012.707270

Mackensen FXJ, Chua C: In vivo laser confocal microscopy of keratic precipitates is a useful tool in differencing specific uveitis diagnosis as well As active from inactive uveitis . ARVO Meeting Abstracts 2009,50(5):1525.

Van der Lelij A, Ooijman FM, Kijlstra A, Rothova A: Anterior uveitis with sectoral iris atrophy in the absence of keratitis: a distinct clinical entity among herpetic eye diseases. Ophthalmology 2000,107(6):1164–70. 10.1016/S0161-6420(00)00115-9

Khan BF, Pavan-Langston D: Clinical manifestations and treatment modalities in herpes simplex virus of the ocular anterior segment. Int Ophthalmol Clin 2004,44(3):103–133. 10.1097/00004397-200404430-00012

Becker MD, Zierhut M: Fuchs uveitis syndrome--heterochromia is no “conditio sine qua non”. Ophthalmologe 2005,102(7):733–742. quiz 743–4 10.1007/s00347-005-1237-z

Hamrah P, Liu Y, Zhang Q, Dana MR: The corneal stroma is endowed with a significant number of resident dendritic cells. Invest Ophthalmol Vis Sci 2003,44(2):581–9. 10.1167/iovs.02-0838

Hau SC, Dart JK, Vesaluoma M, Parmar DN, Claerhout I, Bibi K, Larkin DF: Diagnostic accuracy of microbial keratitis with in vivo scanning laser confocal microscopy. Br J Ophthalmol 2010,94(8):982–7. 10.1136/bjo.2009.175083

Kanavi MR, Javadi M, Yazdani S, Mirdehghanm S: Sensitivity and specificity of confocal scan in the diagnosis of infectious keratitis. Cornea 2007,26(7):782–6. 10.1097/ICO.0b013e318064582d

Choudhury A, Pakalnis VA, Bowers WE: Function and cell surface phenotype of dendritic cells from rat cornea. Invest Ophthalmol Vis Sci 1995,36(13):2602–2613.

Mayer WJ, Mackert MJ, Kranebitter N, Messmer EM, Gruterich M, Kampik A, Kook D: Distribution of antigen presenting cells in the human cornea: correlation of in vivo confocal microscopy and immunohistochemistry in different pathologic entities. Curr Eye Res 2012,37(11):1012–8. 10.3109/02713683.2012.696172

Hamrah P, Liu Y, Zhang Q, Dana MR: Alterations in corneal stromal dendritic cell phenotype and distribution in inflammation. Arch Ophthalmol 2003,121(8):1132–40. 10.1001/archopht.121.8.1132

Yamagami S, Yokoo S, Usui T, Yamagami H, Amano S, Ebihara N: Distinct populations of dendritic cells in the normal human donor corneal epithelium. Invest Ophthalmol Vis Sci 2005,46(12):4489–94. 10.1167/iovs.05-0054

Asbell PA, Kamenar T: The response of Langerhans cells in the cornea to herpetic keratitis. Curr Eye Res 1987,6(1):179–82. 10.3109/02713688709020087

Frank GM, Buela KA, Maker DM, Harvey SA, Hendricks RL: Early responding dendritic cells direct the local NK response to control herpes simplex virus 1 infection within the cornea. J Immunol 2012,188(3):1350–9. 10.4049/jimmunol.1101968

Quentin CD, Reiber H: Fuchs heterochromic cyclitis: rubella virus antibodies and genome in aqueous humor. American Journal of Ophthalmology 2004, 138: 46–54. 10.1016/j.ajo.2004.02.055

de Groot-Mijnes JD, de Visser L, Rothova A, Schuller M, van Loon AM, Weersink AJ: Rubella virus is associated with fuchs heterochromic iridocyclitis. American Journal of Ophthalmology 2006,141(1):212–214. 10.1016/j.ajo.2005.07.078

Hamrah P, Cruzat A, Dastjerdi MH, Pruss H, Zheng L, Shahatit BM, Bayhan HA, Dana R, Pavan-Langston D: Unilateral herpes zoster ophthalmicus results in bilateral corneal nerve alteration: an in vivo confocal microscopy study. Ophthalmology 2013,120(1):40–7. 10.1016/j.ophtha.2012.07.036

Garweg JG, Halberstadt M: The pathogenesis of herpetic keratitis. Klin Monbl Augenheilkd 2002,219(7):477–86. 10.1055/s-2002-33587

Toma HS, Murina AT, Areaux RG Jr, Neumann DM, Bhattacharjee PS, Foster TP, Kaufman HE, Hill JM: Ocular HSV-1 latency, reactivation and recurrent disease. Semin Ophthalmol 2008,23(4):249–73. 10.1080/08820530802111085

Hill JM, Gebhardt BM, Wen R, Bouterie AM, Thompson HW, O’Callaghan RJ, Halford WP, Kaufman HE: Quantitation of herpes simplex virus type 1 DNA and latency-associated transcripts in rabbit trigeminal ganglia demonstrates a stable reservoir of viral nucleic acids during latency. J Virol 1996,70(5):3137–41.

Baringer JR, Swoveland P: Recovery of herpes-simplex virus from human trigeminal ganglions. N Engl J Med 1973,288(13):648–50. 10.1056/NEJM197303292881303

Bustos DE, Atherton SS: Detection of herpes simplex virus type 1 in human ciliary ganglia. Invest Ophthalmol Vis Sci 2002,43(7):2244–9.

Cantin EM, Chen J, McNeill J, Willey DE, Openshaw H: Detection of herpes simplex virus DNA sequences in corneal transplant recipients by polymerase chain reaction assays. Curr Eye Res 1991,10(Suppl):15–21. 10.3109/02713689109020353

Kennedy DP, Clement C, Arceneaux RL, Bhattacharjee PS, Huq TS, Hill JM: Ocular herpes simplex virus type 1: is the cornea a reservoir for viral latency or a fast pit stop? Cornea 2011,30(3):251–9. 10.1097/ICO.0b013e3181ef241d

Jager MJ, Bradley D, Atherton S, Streilein JW: Presence of Langerhans cells in the central cornea linked to the development of ocular herpes in mice. Exp Eye Res 1992,54(6):835–41. 10.1016/0014-4835(92)90146-J

McLeish W, Rubsamen P, Atherton SS, Streilein JW: Immunobiology of Langerhans cells on the ocular surface. II. Role of central corneal Langerhans cells in stromal keratitis following experimental HSV-1 infection in mice. Reg Immunol 1989,2(4):236–43.

Takase H, Kubono R, Terada Y, Imai A, Fukuda S, Tomita M, Miyanaga M, Kamoi K, Sugita S, Miyata K, Mochizuki M: Comparison of the ocular characteristics of anterior uveitis caused by herpes simplex virus, varicella-zoster virus, and cytomegalovirus. Jpn J Ophthalmol 2014,58(6):473–82. 10.1007/s10384-014-0340-6

Hamrah P, Cruzat A, Dastjerdi MH, Zheng L, Shahatit BM, Bayhan HA, Dana R, Pavan-Langston D: Corneal sensation and subbasal nerve alterations in patients with herpes simplex keratitis: an in vivo confocal microscopy study. Ophthalmology 2010,117(10):1930–6. 10.1016/j.ophtha.2010.07.010

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Journal of Ophthalmic Inflammation and Infection

Tập 4

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