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Association of Ocular Inflammation and Rubella Virus Persistence

John A Gonzales1,2, Armin Hinterwirth1, Jessica Shantha3

  • 1Francis I. Proctor Foundation, University of California, San Francisco.

JAMA Ophthalmology
|December 28, 2018
PubMed
Abstract

Insights

Persistent rubella virus (RV) infection is linked to uveitis and corneal damage. Metagenomic deep sequencing (MDS) aids in diagnosing RV-associated uveitis, prompting consideration of RV in hypertensive anterior and intermediate uveitis cases.

Area of Science:

  • Ophthalmology
  • Virology
  • Genomics

Background:

  • Fuchs heterochromic iridocyclitis (FHI) is a form of uveitis.
  • The role of rubella virus (RV) in persistent uveitis is not fully understood.
  • Metagenomic deep sequencing (MDS) offers a potential tool for identifying infectious agents in ocular inflammation.

Purpose of the Study:

  • To evaluate the effectiveness of MDS in detecting RV infection in patients presenting with uveitis.
  • To investigate the association between RV infection and specific clinical manifestations of uveitis.

Main Methods:

  • A case series of 6 patients diagnosed with RV-associated uveitis using MDS.
  • Clinical examinations, slitlamp photography, and corneal confocal microscopy were performed.
  • RNA sequencing was utilized to obtain pathogen genomes.

Main Results:

  • MDS identified RV infection in all 6 patients with uveitis.
  • Three patients had classic FHI features, while others presented with anterior vitritis.
  • Corneal confocal microscopy revealed endothelial infiltration and damage in some patients.

Conclusions:

  • Persistent RV infection is associated with chronic or recurrent anterior/intermediate uveitis.
  • RV infection can lead to corneal endothelial cell damage.
  • Ophthalmologists should consider RV as a potential cause of hypertensive uveitis.

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