Anterior uveitis with intraocular fluid analysis positive for Rubella virus

Purpose To compare the clinical characteristics and visual prognosis of patients with anterior uveitis (AU) with intraocular fluid analysis positive for Rubella virus (RV), Herpes Simplex virus (HSV) or Varicella Zoster virus (VZV) in order to discriminate rubella virus AU from herpes virus AU. Methods Retrospective, observational study.Clinical records of 106 patients with anterior uveitis and positive Polymerase chain reaction and/ or Goldmann-Witmer coefficients for RV (n=57), HSV (n=39) and VZV (n=10) were analyzed. Demographic constitution, ophthalmological characteristics and visual prognosis were compared. Results All three types of viral AU were characterized by unilateral involvement (80-97%). RV-AU was characterized by younger age at onset and chronic course, and was typically associated with cataract at presentation. Heterochromia was present in 23% of RV-AU patients. AU associated with HSV or VZV infection occurred characteristically in older patients and frequently followed an acute course. Associated clinical features included conjunctival redness, corneal edema, history of keratitis and development of posterior synechiae. HSV-AU had more often severe AU whereas the presence of vitritis was more common in RV-AU and VZV-AU. The prevalence of documented IOP above 30mm Hg (25-50%, P=0.06) and development of glaucoma (18-30%, P=0.687) were similar in all three groups. Retinal scarring was seen in 22% of RV-AU eyes, 0% HSV-AU eyes and in 11% of VZV-AU eyes Visual prognosis was favorable for all three groups. Conclusion Our results point out clinical differences between RV-AU, HSV-AU and VZV-AU and might be especially of value to ophthalmologists who lack the possibility of intraocular fluids analysis to discriminate rubella virus AU from herpes virus AU.