PDF(Pubmed)
Abstract：
Hypertensive anterior uveitis poses diagnostic challenges owing to its multiple potential etiologies. Cytomegalovirus (CMV) infection is an under-recognized cause that exhibits diverse clinical presentations. This case report focuses on the intricate diagnostic challenge encountered in a 66-year-old immunocompetent patient with CMV-induced hypertensive anterior uveitis. The patient\'s history, encompassing angle closure glaucoma and topiramate use, contributed to the hypertensive crisis. Initial management included intraocular pressure (IOP)-lowering medication, topiramate discontinuation, and bilateral phacoemulsification, successfully normalizing IOP. However, a subsequent recurrence prompted a detailed investigation. The identification of keratic precipitates and a synechial closed angle led to aqueous humor sampling and polymerase chain reaction (PCR) testing, unveiling the presence of CMV-DNA. Treatment led to a favorable response, resolving ocular inflammation and effectively controlling IOP. This case underscores the complexity of diagnosing and managing CMV-induced hypertensive anterior uveitis, emphasizing the critical role of a comprehensive approach in achieving successful outcomes.
摘要：
高血压前葡萄膜炎因其多种潜在病因而面临诊断挑战。巨细胞病毒（CMV）感染是一种未被认识到的原因，表现出多种临床表现。此病例报告着重于一名66岁的CMV诱导的高血压前葡萄膜炎免疫功能正常的患者所遇到的复杂的诊断挑战。病人的病史,包括闭角型青光眼和托吡酯的使用，导致了高血压危机。初始管理包括降低眼压（IOP）的药物，托吡酯停药,双侧白内障超声乳化术,成功正常化IOP。然而,随后的复发促使我们进行了详细的调查。确定角质沉淀物和粘连封闭角导致房水采样和聚合酶链反应（PCR）测试，揭示CMV-DNA的存在。治疗导致了良好的反应，解决眼部炎症，有效控制眼压。该病例强调了诊断和治疗CMV诱发的高血压前葡萄膜炎的复杂性。强调全面方法在取得成功成果方面的关键作用。
