RESUMEN
PURPOSE: To clarify the prevalence of secondary glaucoma (SG) and its speed of progression in patients with herpes simplex virus (HSV)-anterior uveitis (AU), varicella zoster virus (VZV)-AU, and cytomegalovirus (CMV)-AU. METHODS: In total, 170 patients with herpetic AU were enrolled in this retrospective observational case series. Patients with visual field (VF) defects and glaucomatous disc abnormalities were diagnosed with SG. Moreover, the speed of SG progression was defined as decreasing mean deviation (MD) values per year. SG prevalence and annual MD-value decrease were compared among the three types of herpetic AU. RESULTS: SG prevalence was 16%, 9%, and 72% in patients with HSV-AU, VZV-AU, and CMV-AU, respectively. Patients with CMV-AU had the highest SG prevalence (odds ratio = 3.15; 95% confidence interval = 1.15-8.65; P < 0.05). Furthermore, the annual MD-value change was significantly higher in SG caused by CMV-AU than in that caused by HSV/VZV-AU (-2.6 ± 2.4 dB/year and -0.45 ± 0.54 dB/year, respectively; P < 0.05). CONCLUSIONS: Our results demonstrated that patients with CMV-AU may have a higher risk and faster speed of progression of SG than patients with HSV/VZV-AU. Therefore, clinicians should monitor glaucoma onset and VF-defect progression in patients with CMV-AU.
Asunto(s)
Humor Acuoso/virología , ADN Viral/análisis , Infecciones Virales del Ojo/complicaciones , Glaucoma/complicaciones , Herpes Zóster Oftálmico/complicaciones , Escotoma/etiología , Uveítis Anterior/complicaciones , Progresión de la Enfermedad , Infecciones Virales del Ojo/diagnóstico , Infecciones Virales del Ojo/virología , Femenino , Estudios de Seguimiento , Glaucoma/diagnóstico , Glaucoma/fisiopatología , Herpes Zóster Oftálmico/diagnóstico , Herpes Zóster Oftálmico/virología , Herpesvirus Humano 3/genética , Humanos , Presión Intraocular , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Escotoma/diagnóstico , Escotoma/fisiopatología , Simplexvirus/genética , Uveítis Anterior/diagnóstico , Uveítis Anterior/virologíaAsunto(s)
Síndrome Uveomeningoencefálico/complicaciones , Preescolar , Glucocorticoides/uso terapéutico , Humanos , Hiperemia/diagnóstico , Hiperemia/tratamiento farmacológico , Hiperemia/etiología , Infusiones Intravenosas , Masculino , Metilprednisolona/uso terapéutico , Desprendimiento de Retina/diagnóstico , Desprendimiento de Retina/tratamiento farmacológico , Desprendimiento de Retina/etiología , Tomografía de Coherencia Óptica , Uveítis Anterior/diagnóstico , Uveítis Anterior/tratamiento farmacológico , Uveítis Anterior/etiología , Síndrome Uveomeningoencefálico/diagnóstico , Síndrome Uveomeningoencefálico/tratamiento farmacológico , Agudeza VisualRESUMEN
OBJECTIVE: Exposure to particulate matter less than 2.5 µm in diameter (PM2.5) is associated with asthma and respiratory symptoms, but little is known about the influence of PM2.5 on allergic conjunctivitis. The purpose of this study was to examine the association of PM2.5 with outpatient attendance for allergic conjunctivitis. METHODS: We conducted a time-series analysis of the association between outpatient attendance for allergic conjunctivitis and PM2.5 levels from May to July (non-pollen season) and from August to October (the autumnal pollen season) in 2012. Air pollution data (including the levels of PM2.5, oxidants, nitric oxide, nitrogen dioxide, nitrogen oxide, carbon monoxide, methane, non-methane hydrocarbons, and total hydrocarbons) and data on the daily weather conditions (temperature, wind speed, and humidity) were collected at a centrally located monitoring station in Tokyo. We calculated weekly average values for the daily number of outpatient visits, as well as the air pollution and weather data, and used the weekly average values for analysis. RESULTS: There was a significant association between the number of outpatient visits for allergic conjunctivitis and the PM2.5 level (r=0.62, p=0.0177) from May to July, while no correlation was found between the number of outpatient visits and any variable assessed from August to November. Multivariate analysis also showed that PM2.5 was a significant predictor of the number of outpatient visits from May to July (odds ratio=9.05, p=0.0463), while there were no significant predictors of the number of outpatient visits from August to October. From May to July, PM2.5 showed a negative correlation with humidity (r=-0.53, p=0.0499). CONCLUSIONS: These findings suggest a possible role of PM2.5 in the development of allergic conjunctivitis during the non-pollen season. This association between PM2.5 and allergic conjunctivitis may have broad public health implications in relation to allergic diseases.