Cytomegalovirus

Abstract Cytomegalovirus‐associated anterior uveitis is a recently described entity. Based on the PCR‐analysis of the aqueous humor, the diagnosis may be confirmed in patients with unilateral hypertensive anterior uveitis with mild iris atrophy but without posterior synechiae. Two different subtypes of the disease have been reported so far. It has been shown that more than 50% of cases of Posner‐Schlossman syndrome are CMV‐induced. The type and distribution of keratic precipitates are major clinical elements for the diagnosis of the infection. Interestingly, retinitis has never been described in this group of patients and none of them is immunosuppressed. In Europe, the association of FUuchs heterochromic cyclitis and CMV has not been confirmed. Rarely, PCR tools are insufficient and local antibody production may help diagnostic confirmation. The most important issue remains the therapeutic management of these patients. Specific anti‐CMV drugs have been proposed but the route of administration, the dosages and the duration of therapy remain controversial. Topical anti‐CMV drugs are promising but rarely efficient as an induction regimen. Systemic valganciclovir is highly efficient and proposed for at least 2 months with a close follow‐up to detect any further relapse.