Epstein-Barr Virus and Ocular Inflammation

Wenkel H.,
Friedrich-Alexander-Universität, Augenklinik (Erlangen)

Purpose: There is still a debate whether Epstein-Barr virus (EBV) can be responsible for ocular inflammation. We reviewed the clinical data of 8 patients with different patterns of ocular inflammation with serological evidence of acute EBV-infection.
Patients: There were 7 female and 1 male patients with an age range from 15 to 63 years (median 41 years). Four patients presented retinal vasculitis; two unilateral and two bilateral. There was a unilateral anterior and a posterior scleritis in one patient, respectively. A multifocal retinochoroiditis and an anterior ischemic opticneuropathy were also seen in one patient, respectively. Three patients reported a typical systemic EBV-infection 3 weeks to 3 years before onset of ocular changes. One patient had a history of EBV-infection of her mother some weeks prior to presentation.
Results: Serologically there were signs of acute reactivation of EBV-infection in 6 patients, an acute EBV-infection in one patient and the suspicion of an EBV-reactivation in one patient. In three patients the systemic presence of active EBV was confirmed by detection of EBV-DNA using polymerase chain reaction in peripheral blood. In two patients discontinuation of antiviral treatment resulted in recurrence of ocular disease.
Conclusions: Even though serological findings of EBV reactivation may be coincidental due to the high rate of seropositivity for EBV, the presence of EBV-DNA and the history of a recent systemic EBV infection may indicate a potential role of EBV in different ocular inflammations.

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