Skip to main content

Advertisement

SpringerLink
Log in

Intraocular antibody synthesis against rubella virus and other microorganisms in Fuchs' heterochromic cyclitis

  • Inflammatory Disorders
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Introduction

Fuchs' heterochromic cyclitis (FHC) is a common intraocular disease of uncertain etiology that has recently been related to rubella virus (RV) infection.

Methods

We investigated the synthesis of RV-specific IgG using aqueous humor and serum samples from 63 consecutive patients with FHC. In addition, intraocular immunoglobulin G production against herpes simplex virus (HSV), varicella zoster virus (VZV), cytomegalovirus (CMV) and toxoplasma gondii was determined. In 20 patients, the detection of RV RNA was additionally performed by RT-PCR on the E1 gene. Forty-six patients with HSV- and VZV-associated uveitis, HLA B-27 positive anterior uveitis, and Posner–Schlossman syndrome served as controls.

Results

Specific intraocular antibody synthesis against RV was confirmed in all 63 FHC patients, whereas none of the 46 controls was positive for RV IgG. Interestingly, in 11 patients with positive RV IgG synthesis, additional HSV (eight), VZV (one) and CMV (two) specific antibodies could be detected. Only twice was viral RNA detectable by PCR in a patient with FHC.

Conclusions

In this largest reported series of FHC patients, we detected a strong association between FHC and intraocular antibody synthesis against rubella virus. Furthermore, in 11 patients, it was possible to confirm an additional intraocular antibody synthesis, in particular HSV. PCR-positive results in the aqueous humor were exclusively obtained for RV. In contrast to other studies, the RV genome could only be identified in two patients (10%).

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Aggarwal RK, Luck J, Coster DJ (1994) Horner's syndrome and Fuchs' heterochromic uveitis. Br J Ophthalmol 78:949

    Article  CAS  PubMed  Google Scholar 

  2. Barequet IS, Li Q, Wang Y, O'Brien TP, Hooks JJ, Stark WJ (2000) Herpes simplex virus DNA identification from aqueous fluid in Fuchs' heterochromic iridocyclitis. Am J Ophthalmol 129:672–673

    Article  CAS  PubMed  Google Scholar 

  3. Becker MD, Zierhut M (2005) Das Fuchs’sche Uveitis Syndrom. Ophthalmologe 102:733–744

    Article  CAS  PubMed  Google Scholar 

  4. Bednarova J, Stourac P, Adam P (2005) Relevance of immunological variables in neuroborreliosis and multiple sclerosis. Acta Neurol Scand 112:97–102

    Article  CAS  PubMed  Google Scholar 

  5. Birnbaum AD, Tessler HH, Schultz KL, Farber MD, Gao W, Lin P, Oh F, Goldstein DA (2007) Epidemiologic relationship between Fuchs' heterochromic iridocyclitis and the United States rubella vaccination program. Am J Ophthalmol 144:424–428

    Article  PubMed  Google Scholar 

  6. Bonfioli AA, Curi AL, Orefice F (2005) Fuchs' heterochromic cyclitis. Semin Ophthalmol 20:143–146

    Article  PubMed  Google Scholar 

  7. Bosma TJ, Corbett RM, O’Shea S, Banatvala JE, Best JN (1995) PCR for detection of rubella virus RNA in clinical samples. J Clin Microbiol 33:1075–1079

    CAS  PubMed  Google Scholar 

  8. Chee SP, Bacsal K, Jap A, Se-Thoe SY, Cheng CL, Tan BH (2008) Clinical features of cytomegalovirus anterior uveitis in immunocompetent patients. Am J Ophthalmol 145:834–840

    Article  PubMed  Google Scholar 

  9. Fuchs E (1906) Über Komplikationen der Heterochromie. Z Augenheilkd 15:191–212

    Google Scholar 

  10. Felgenhauer K (1982) Differentiation of the humoral immune response in inflammatory diseases of the central nervous system. J Neurol 228:223–247

    Article  CAS  PubMed  Google Scholar 

  11. Ganesh SK, Sharma S, Narayana KM, Biswas J (2004) Fuchs' heterochromic iridocyclitis following bilateral ocular toxoplasmosis. Ocul Immunol Inflamm 12:75–77

    Article  PubMed  Google Scholar 

  12. van Gelder RN (2008) Idiopathic no more: clues to the pathogenesis of Fuchs' heterochromic iridocyclitis and glaucomatocyclitic crisis. Am J Ophthalmol 145:769–771

    Article  PubMed  Google Scholar 

  13. Gordon L (2004) Fuchs' heterochromic cyclitis: new clues regarding pathogenesis. Am J Ophthalmol 138:133–134

    Article  PubMed  Google Scholar 

  14. de Groot-Mijnes JD, de Visser L, Rothova A, Schuller M, van Loon AM, Weersink AJ (2006) Rubella virus is associated with Fuchs' heterochromic iridocyclitis. Am J Ophthalmol 141:212–214

    Article  PubMed  Google Scholar 

  15. Hartmann C, Felgenhauer K, Hanssen C (1983) Filtration und lokale Synthese von Proteinen im Kammerwasser und Liquor cerebrospinalis. Fortschr Ophthalmol 80:103–107

    CAS  PubMed  Google Scholar 

  16. La Hey E, Baarsma GS (1993) Contralateral active ocular toxoplasmosis in Fuchs' heterochromic cyclitis. Br J Ophthalmol 77:455–456

    Article  PubMed  Google Scholar 

  17. Jarius S, Eichhorn P, Jacobi C, Wildemann B, Wick M, Voltz R (2009) The intrathecal, polyspecific antiviral immune response: specific for MS or a general marker of CNS autoimmunity? J Neurol Sci 280:98–100

    Article  CAS  PubMed  Google Scholar 

  18. Jones NP (1991) Glaucoma in Fuchs' heterochromic uveitis: aetiology, management and outcome. Eye 5:662–667

    PubMed  Google Scholar 

  19. Jones NP (1993) Fuchs' heterochromic uveitis: an update. Surv Ophthalmol 37:253–272

    Article  CAS  PubMed  Google Scholar 

  20. Van der Lelij A, Rothova A (1997) Diagnostic anterior chamber paracentesis in uveitis: a safe procedure? Br J Ophthalmol 81:976–979

    Article  PubMed  Google Scholar 

  21. Labalette P, Caillau D, Grutzmacher C, Dessaint JP, Labalette M (2002) Highly focused clonal composition of CD8(+) CD28(neg) T cells in aqueous humor of Fuchs' heterochromic cyclitis. Exp Eye Res 75:317–325

    CAS  PubMed  Google Scholar 

  22. Liekfeld A, Schweig F, Jaeckel C, Wernecke KD, Hartmann C, Pleyer U (2000) Intraocular antibody production in intraocular inflammation. Graefes Arch Clin Exp Ophthalmol 238:222–227

    Article  CAS  PubMed  Google Scholar 

  23. Liekfeld A, Jaeckel C, Pleyer U, Robert PY, Hartmann C (2001) Kammerwasseranalyse bei Keratoplastikpatienten mit Keratitiden. Erste Resultate. Ophthalmologe 98:456–459

    Article  CAS  PubMed  Google Scholar 

  24. Luxton RW, Zeman A, Holzel H, Harvey P, Wilson J, Kocen R, Morgan-Hughes J, Miller DH, Compston A, Thompson EJ (1995) Affinity of antigen-specific IgG distinguishes multiple sclerosis from encephalitis. J Neurol Sci 132:11–19

    Article  CAS  PubMed  Google Scholar 

  25. Mets MB, Chhabra MS (2008) Eye manifestations of intrauterine infections and their impact on childhood blindness. Surv Ophthalmol 53:95–111

    Article  PubMed  Google Scholar 

  26. Mohamed Q, Zamir E (2005) Update on Fuchs' uveitis syndrome. Curr Opin Ophthalmol 16:356–363

    Article  PubMed  Google Scholar 

  27. Murray PI, Hoekzema R, van Haren MA, Luyendijk L, Kijlstra A (1990) Aqueous humor analysis in Fuchs' heterochromic cyclitis. Curr Eye Res 9:53–57

    Article  PubMed  Google Scholar 

  28. Murray PI (1994–1995) Fuchs' heterochromic cyclitis: an immunological disease or an immunological response? Int Ophthalmol 18:313–314

    Article  Google Scholar 

  29. Quentin CD, Reiber H (2004) Fuchs' heterochromic cyclitis: rubella virus antibodies and genome in aqueous humor. Am J Ophthalmol 138:46–54

    Article  PubMed  Google Scholar 

  30. Robert PY, Liekfeld A, Ranger-Rogez S, Jaeckel C, Pleyer U, Adenis JP, Hartmann C (2003) Ajustement du traitment antiviral après greffe du cornée par mesure de la production d’anticorps dans l’humeur aqueuse. J Fr Ophtalmol 26:350–354

    PubMed  Google Scholar 

  31. Robert PY, Liekfeld A, Metzner S, Ranger-Rogez S, Adenis JP, Denis F, Hartmann C, Pleyer U (2006) Specific antibody production in herpes keratitis: intraocular inflammation and corneal neovascularisation as predicting factors. Graefes Arch Clin Exp Ophthalmol 244:210–215

    Article  PubMed  Google Scholar 

  32. Rothova A, de Boer JH, Ten Dam-van Loon NH, Postma G, de Visser L, Zuurveen SJ, Schuller M, Weersink AJ, van Loon AM, de Groot-Mijnes JD (2008) Usefulness of aqueous humor analysis for the diagnosis of posterior uveitis. Ophthalmology 115:306–311

    Article  PubMed  Google Scholar 

  33. Rothova A (2007) The riddle of Fuchs' heterochromic uveitis. Am J Ophthalmol 144:447–448

    Article  PubMed  Google Scholar 

  34. Schwab IR (1991) The epidemiologic association of Fuchs' heterochromic iridocyclitis and ocular toxoplasmosis. Am J Ophthalmol 15(111):356–362

    Google Scholar 

  35. Teyssot N, Cassoux N, Lehoang P, Bodaghi B (2005) Fuchs' heterochromic cyclitis and ocular toxocariasis. Am J Ophthalmol 139:915–916

    Article  PubMed  Google Scholar 

  36. Torun N, Liekfeld A, Hartmann C, Metzner S, Pleyer U (2002) Okuläre Toxoplasmose-Antikörper in Kammerwasser und Serum. Ophthalmologe 99:109–112

    Article  CAS  PubMed  Google Scholar 

  37. de Visser L, Braakenburg A, Rothova A, de Boer JH (2008) Rubella virus-associated uveitis: clinical manifestations and visual prognosis. Am J Ophthalmol 146:292–297

    Article  PubMed  Google Scholar 

  38. Yamamoto S, Pavan-Langston D, Kinoshita S, Nishida K, Shimomura Y, Tano Y (1996) Detecting herpesvirus DNA in uveitis using the polymerase chain reaction. Br J Ophthalmol 80:465–468

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Augenklinik Charité—Universitätsmedizin Berlin (CVK) Germany, Augustenburger Platz 1, 13353, Berlin, Germany

    Peter C. Ruokonen, Sylvia Metzner, Aylin Ücer, Necip Torun & Uwe Pleyer

  2. Institut für Medizinische Virologie Charité—Universitätsmedizin Berlin (CCM) Germany, Berlin, Germany

    Jörg Hofmann

Authors
  1. Peter C. Ruokonen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sylvia Metzner
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Aylin Ücer
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Necip Torun
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jörg Hofmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Uwe Pleyer
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Peter C. Ruokonen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ruokonen, P.C., Metzner, S., Ücer, A. et al. Intraocular antibody synthesis against rubella virus and other microorganisms in Fuchs' heterochromic cyclitis. Graefes Arch Clin Exp Ophthalmol 248, 565–571 (2010). https://doi.org/10.1007/s00417-009-1239-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00417-009-1239-7

Keywords

Search

Navigation