Epstein-Barr Virus and the Eye.

Epstein-Barr Virus (EBV), also known as Human HerpesVirus-4 (HHV-4), is a -type herpesvirus with a global infection prevalence of over 95%.[1],[2] Infection, which occurs nasopharyngeally via either aerosol or direct contact, tends to be asymptomatic in children, but may be associated with the development of infectious mononucleous (IM) in 50% or more of adolescents and young adults. Such observations, together with the fact that a molecular resemblance exists between several EBV proteins and selected self-antigens, has led some experts to propose that EBV reactivation followed by bystander leukocyte activation with epitope spreading and/or molecular mimicry between EBV and self-proteins might contribute to the pathogenesis of autoimmune disease in some patients. Several studies[23] [31] have assessed intraocular levels of EBV DNA and/or anti-EBV antibodies in patients with uveitis, providing evidence for the presence of EBV in up to 10% of eyes with active inflammation. A similar case of purported bilateral EBV-associated scleritis complicated by perforation in a 71-year-old Japanese woman with elevated serum anti-EBV antibody titers has been reported.[54] The authors suggested that the serologic and PCR-based test results, together with the slow therapeutic response to combined corticosteroids and an anti-viral agent, supported the causal association with EBV. [Extracted from the article]