International Ophthalmology

, Volume 34, Issue 5, pp 1123–1129 | Cite as

Posner-Schlossman syndrome associated with cytomegalovirus infection: a case series from a non-endemic area

  • Alireza Hedayatfar
  • Soon-Phaik Chee
Case Report


To describe clinical features, laboratory findings, course of disease and response to treatment in four patients diagnosed with Posner-Schlossman syndrome (PSS) who had evidence of cytomegalovirus (CMV) infection in their aqueous humour. Review of four consecutive CMV positive PSS patients seen at the Noor Eye Hospital. CMV was diagnosed by polymerase chain reaction analysis of their aqueous. All four patients were immunocompetent males. Mean age of onset was 44.5 years (range, 32–63 years). Maximum intraocular pressure ranged from 36 to 48 mmHg. Mild to moderate anterior chamber reaction, lack of posterior synechiae and posterior segment involvement were consistent features in all the patients. Three patients had diffuse iris atrophy. One patient with a stromal immune ring at presentation developed features of Fuch’s heterochromic iridocyclitis (FHI) later in his course of disease. Heterochromia was also observed in another patient. All patients had a positive titre of IgG but not IgM against CMV, and none had concomitant CMV antigenemia. One patient who had recalcitrant uveitis and glaucoma and another patient who was suffering from frequent attacks and showed evidence of significant endothelial cell loss received anti-CMV therapy. In our population, PSS may be associated with CMV infection and may develop clinical features similar to FHI. Anti-CMV therapy should be reserved for cases with recalcitrant course or secondary complications.


Aqueous humour Cytomegalovirus Diagnostic tests/investigation Inflammation Posner-Schlossman syndrome 



This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

Conflict of interests

The authors declare that they have no competing interests.


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Copyright information

© Springer Science+Business Media Dordrecht 2014

Authors and Affiliations

  1. 1.Noor Ophthalmic Research CenterNoor Eye HospitalTehranIran
  2. 2.Rassoul Akram HospitalIran University of Medical SciencesTehranIran
  3. 3.Singapore National Eye CentreSingaporeSingapore
  4. 4.National University of SingaporeSingaporeSingapore
  5. 5.Singapore Eye Research InstituteSingaporeSingapore

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