From: Human Herpesvirus-6 corneal Endotheliitis after intravitreal injection of Ranibizumab
Author, year [reference umber] | Age (years) | Gender | Eye | DM | Other associated diseases | Ocular disease and complications | HHV-6 detection | Variant | Treatment | Clinical outcomes | |
---|---|---|---|---|---|---|---|---|---|---|---|
aqueous humor | blood | ||||||||||
Wiersbitzky, 1993 [18] | 11 | F | OS | – | None | Chronic iridocyclitis | NA | Anti-HHV-6 ab |  | NA | NA |
Oberacher-Velten, 2005 [19] | 31 | M | OU | + | – | Optic neuropathy, unilateral tonic pupil | NA | Positive HHV-6 titers |  | Foscarnet, methylprednisolone | Optic nerve atrophy. Reaction of the pupil became normal. VA improved to 20/25 OD and 20/20 OS |
Takizawa, 2006 [20] | 1 | F | OS | – | – | Central retinal vein occlusion by optic disc vasculitis | NA | + HHV-6 DNA by PCR |  | Intravenous methylprednisolone | Optic disc atrophy, fundus atrophy. Unmeasurable VA |
Moschettini, 2006 [21] | 23 | F | OU | – | None | Recurrent anterior optic neuritis and granulomatous iridocyclitis | NA | + (also in CSF) by PCR | HHV-6B | Intravenous and oral glucocorticoids, Ganciclovir | Patient had optic neuritis 4 times. After last relapse, patient was successfully treated with ganciclovir. |
Méchaï, 2007 [22] | 59 | F | OU | – | HIV | Retrobulbar optic neuritis and meningoencephalitis | NA | + (also in CSF) by PCR | HHV-6B | Foscarnet and ganciclovir, then changed to cidofovir and long-term valganciclovir | By 12 months, the optic neuritis had almost resolved fully. VA was 20/20 (OU). |
Sugita, 2007 [5] | 75 | M | OD | NA | Anti-Toxocara canis IgG in serum, aqueous humor, and vitreous | Severe panuveitis | + (in also vitreous) by PCR | + by PCR, Positive HHV-6 titer | HHV-6A | Diagnostic vitrectomy, valganciclovir, systemic corticosteroids | Resolution of vitreous opacities, disc swelling, and retinal exudates. HHV-6A DNA levels decreased in aqueous humor. |
Maslin, 2007 [6] | 81 | M | OU | + | AML (in remission after chemotherapy) | Acute uveitis, disc edema Meningitis | + by PCR | + (in CSF) by PCR, Positive HHV-6 titer | HHV-6A | Foscarnet, ganciclovir | Disc edema was totally regressed. VA improved to the previous level of 20/40 (OD) and 20/32 (OS). HHV-6 was negative in aqueous humor and cerebrospinal fluid on day 45. |
Cohen, 2010 [7] | NA | NA | NA | NA | Case 1; CMV retinitis | Case 1: Ocular inflammation | + (in vitreous) by PCR Of 101 samples, Case 1 was positive for HHV-6A and CMV | NA | Case 1: HHV-6A | NA | NA |
 | NA | NA | NA | NA | Case 2; none | Case 2: Ocular inflammation | + (in vitreous) by PCR | NA | Case 2: HHV-6B | NA | NA |
Groot-mijines, 2010 [23] | 42 | M | OD | – | – | Uveitis with heterochromia | + (in vitreous) by PCR | NA |  | Diagnostic vitrectomy | Patient regained full VA |
Glâtre F, 2010 [24] | 47 | F | Unilateral | – | RA, TB, Toxicoplasmic co-infection | panuveitis | + by PCR | NA |  | Ganciclovir for HHV-6, and pyrimethamine and sulfadiazine for Toxicoplasma | NA |
Ogata, 2011 [25] | 63 | M | OS | – | none | Uveitis with optic neuritis | +by PCR | Positive HHV-6 titer |  | Systemic corticosteroids, aspirin | VA improved to 10/20 |
Okuno T, 2011 [26] | N/A | N/A | NA | NA | HSV-1 was detected in 4 cases | Corneal ulcer in 6 cases and keratouveitis in 3 cases | +(in smear samples from corneal ulcer or keratouveitis) by PCR | NA | Â | Acyclovir | NA |
Sugita 2012 [8] | 64 | F | OS | NA | HSV-1 | Corneal endotheliitis | +by PCR | N/A | HHV-6B | Valganciclovir | NA |
70 | M | OS | NA | bacteria (+) | Endophthalmitis, retinal necrosis | + (in vitreous) by PCR | N/A | HHV-6B | Vitrectomy, antibiotics | NA | |
74 | F | OD | NA | P. acnes | Postoperative endotheliitis | +(in vitreous) by PCR | N/A | HHV-6B | Vitrectomy, valganciclovir | NA | |
79 | F | OS | NA | bacteria (+) | Postoperative endotheliitis | +(in vitreous) by PCR | N/A | HHV-6B | Vitrectomy, steroids, antibiotics | NA | |
71 | F | OS | NA | CMV | Necrotic retinitis | +(in vitreous) by PCR | N/A | HHV-6A | Valganciclovir | NA | |
24 | F | OS | NA | none | uveitis | +by PCR | N/A | HHV-6B | none | NA | |
22 | M | OD | NA | bacteria (+) | keratitis | +(in cornea) by PCR | N/A | HHV-6B | Antibiotics | NA | |
Yokogawa, 2013 [27] | 67 | M | OD | – | RA CMV | Corneal endotheliitis | + (Both HHV-6 and CMV) by PCR | NA |  | Valganciclovir, topical 0.5% ganciclovir 0.1% betamethasone | Corneal endotheliitis resolved VA improved to 20/25 |
Malamos, 2013 [28] | 64 | M | OU | – | HIV | Posterior uveitis | + (in vitreous) by PCR | + Positive HHV-6 titer |  | Diagnostic vitrectomy, valganciclovir | Complete remission of inflammation |
Bajric, 2014 [29] | 59 | M | OU | – | Multiple myeloma | Panuveitis, encephalitis | Negative by PCR | + (in CSF) by PCR | + by PCR | Ganciclovir, foscarnet, intravitreal foscarnet | Encephalitis resolved. VA improved to 20/20 (OD) and 20/30 (OS) with complete resolution of retinal hemorrhages and no evidence of active uveitis. |
Papageorgious, 2014 [9] | 22 | M | OU | – | EBV | Acute retinal necrosis, fourth nerve palsy, encephalitis | Not performed | + (in CSF) by PCR | HHV-6A | Acyclovir, valacyclovir, methylprednisolone | VA improved to 20/20 (OU). There was no residual visual field defect, and binocular diplopia improved. |
Current report, 2018 | 63 | M | OS | + | Fahr’s disease, bullous pemphigoid | Corneal endotheliitis | + by PCR | + by PCR | HHV-6A | Oral valganciclovir, topical ganciclovir | VA improved to 20/80, the same level before the episode of corneal endotheliitis. |