Relationships between the clinical characteristics and copy numbers of DNA of cytomegalovirus determined by real-time PC
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ORIGINAL PAPER
Relationships between the clinical characteristics and copy numbers of DNA of cytomegalovirus determined by realtime PCR Ayano Yoshimura . Kaoru Araki-Sasaki Rho Fujiwara . Nobuo Jho . Fumi Gomi
. Noriko Toyokawa .
Received: 2 January 2020 / Accepted: 2 May 2020 Ó The Author(s) 2020
Abstract Purpose To determine whether there is a correlation between the clinicals characteristics including various types of keratic precipitates and the copy numbers of the DNA of cytomegalovirus (CMV) in eyes with CMV corneal endotheliitis. Methods We reviewed the medical charts of four cases of corneal endotheliitis that were CMV-positive. We have classified types of clinical phenomenon into four types: coin-shaped KPs, sectoral corneal edema with or without Khodadoust line-like KPs, mutton-fat KPs, and fine KPs and have graded their severity. We also determined the copy numbers of the DNA of CMV in the aqueous humor by real-time polymerase A. Yoshimura K. Araki-Sasaki (&) R. Fujiwara Japan Health Care Organization, Hoshigaoka Medical Center, Hirakata, Japan e-mail: [email protected] A. Yoshimura F. Gomi Department of Ophthalmology, Hyogo College of Medicine Hospital, Nishinomiya, Japan K. Araki-Sasaki N. Toyokawa Nagata Eye Clinic, Nara, Japan K. Araki-Sasaki R. Fujiwara Department of Ophthalmology, Kansai Medical University, 2-5-1 Shinmachi, Hirakata City, Osaka 5731010, Japan N. Jho Jho Eye Clinic, Hirakata, Japan
chain reaction before and during the treatment. We evaluated the correlation between the patterns of clinical characteristics and copy number of the DNA of CMV. Results There were clinical improvements in all eyes following topical ganciclovir in conjunction with low dose of topical steroid treatment, with or without oral valganciclovir. The clinical characteristics and the copy numbers of the DNA of CMV varied during the treatment period. The presence of coin-shaped KPs was correlated with high copy numbers (105–103 copies/ml) of the DNA of CMV. The copy numbers of the DNA of CMV with sectoral corneal edema with or without Khodadoust line-like KPs ranged from 104 to 102 copies/ml, and it was occasionally accompanied by high intraocular pressure. Mutton-fat KPs were observed inferiorly, sometimes together with coinshaped KPs and sectoral corneal edema, or solely. The copy numbers in eyes with mutton-fat KPs varied and occasionally less than the cutoff level. Fine-pigmented KPs were observed after the resolution of the endotheliitis, and no DNA of CMV was detected in the aqueous humor. Conclusions Careful observations of the clinical characteristics such as the KPs and corneal edema might be helpful in estimating the amount of the DNA of CMV in eyes with corneal endotheliitis. Keywords Keratic precipitates Corneal endotheliitis Cytomegalovirus Coin-shaped lesion Sectoral corneal edema
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Int Ophthalmol
Introduction
Methods
Corneal endotheliitis, first characterized by Khodadoust and Attarzadeh [1], is characterized by the p
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