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Genetic analysis of varicella-zoster virus in the aqueous humor in uveitis with severe hyphema

Overview of attention for article published in BMC Infectious Diseases, June 2017
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Title
Genetic analysis of varicella-zoster virus in the aqueous humor in uveitis with severe hyphema
Published in
BMC Infectious Diseases, June 2017
DOI 10.1186/s12879-017-2518-2
Pubmed ID
Authors

Mayumi Hosogai, Yoko Nakatani, Kensuke Mimura, Shoji Kishi, Hideo Akiyama

Abstract

Genetic variations have been identified in the genome of varicella-zoster virus (VZV) strains using vesicle fluid, varicella scabs and throat swab samples. We report a rare case of VZV-associated uveitis with severe hyphema, which was immediately diagnosed by polymerase chain reaction (PCR) using the aqueous humor, in which we were able to analyze the VZV genotype for the first time. A 16-year-old Japanese boy was referred to our hospital with a 20-day history of unilateral anterior uveitis and 11-day history of hyphema. At presentation, details of the iris, the iridocorneal angle, and the fundus were not visible due to the severe hyphema. Serum anti-VZV IgG and anti-VZV IgM were elevated, and 1.61 × 10(9) copies/mL of VZV-DNA were detected by real-time PCR using the aqueous humor. As there were no eruptions on his face or body, we diagnosed zoster sine herpete and started intravenous administration of prednisolone and acyclovir. The hyphema completely disappeared 2 weeks after presentation, while sectorial iris atrophy and mild periphlebitis of the fundus became gradually apparent. Anterior inflammation and periphlebitis gradually improved and VZV-DNA in the aqueous humor was reduced to 1.02 × 10(6) copies/mL at 4 weeks after presentation. Examination by slit lamp microscope revealed no inflammation after 5 months, and VZV-DNA could no longer be detected in the aqueous humor. Serum anti-VZV IgG and anti-VZV IgM also showed a gradual decrease along with improvement in ocular inflammation. The genetic analysis of multiple open reading frames and the R5 variable repeat region in the VZV genes, using DNA extracted from the aqueous humor at presentation, showed that the isolate was a wild-type clade 2 VZV strain (prevalent in Japan and surrounding countries) with R5A allele and one SNP unique to clade 1 (both are major types in Europe and North America). VZV-associated uveitis may develop hyphema that obscures ocular inflammation, thus PCR analysis using the aqueous humor is the key investigation necessary for the diagnosis. The measurement of VZV-DNA copies by real-time PCR would be useful for evaluation of therapeutic effects. We could amplify and analyze VZV genotype using the aqueous humor including a very large number of VZV-DNA copies (1.61 × 10(9) copies/mL).

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Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 15 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 15 100%

Demographic breakdown

Readers by professional status Count As %
Researcher 3 20%
Student > Bachelor 3 20%
Unspecified 1 7%
Lecturer > Senior Lecturer 1 7%
Student > Master 1 7%
Other 1 7%
Unknown 5 33%
Readers by discipline Count As %
Medicine and Dentistry 5 33%
Unspecified 1 7%
Social Sciences 1 7%
Nursing and Health Professions 1 7%
Unknown 7 47%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 19 June 2017.
All research outputs
#20,428,633
of 22,981,247 outputs
Outputs from BMC Infectious Diseases
#6,512
of 7,716 outputs
Outputs of similar age
#275,923
of 317,090 outputs
Outputs of similar age from BMC Infectious Diseases
#146
of 174 outputs
Altmetric has tracked 22,981,247 research outputs across all sources so far. This one is in the 1st percentile – i.e., 1% of other outputs scored the same or lower than it.
So far Altmetric has tracked 7,716 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 9.8. This one is in the 1st percentile – i.e., 1% of its peers scored the same or lower than it.
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We're also able to compare this research output to 174 others from the same source and published within six weeks on either side of this one. This one is in the 1st percentile – i.e., 1% of its contemporaries scored the same or lower than it.