The Mpox virus (MPXV) is the causative agent of human Mpox disease – a debilitating rash illness similar to smallpox. Although Clade I MPXV has remained endemic to West and Central Africa, Clade II MPXV has been responsible for many outbreaks worldwide. The most recent outbreak in 2022 resulted from the rapid spread of a new clade of MPXV, classified into Clade IIb – a distinct lineage from the previously circulating viral strains. The rapid spread and increased severity of Mpox disease by the Clade IIb strain have raised the serious public health imperative of better understanding the host and viral determinants during MPXV infection. In addition to typical skin rashes, including in the periorbital area, MPXV causes moderate to severe ophthalmic manifestations – most commonly, ocular surface complications (e.g., keratitis, conjunctivitis, blepharitis). While ocular manifestations of Clade I Mpox within the Congo basin have been well-reported, global incidence trends of ocular Mpox cases by Clade IIb are still emerging. Given the demonstrated ability of all MPXV strains to auto-inoculate ocular tissue, alongside the enhanced transmissibility of the Clade IIb virus, there is an urgent need to elucidate the mechanisms by which MPXV causes ocular anomalies. In this review, we discuss the viral and genomic structures of MPXV, the epidemiology, and pathology of systemic and ocular Mpox, as well as potential prophylactic and therapeutic interventions.

中文翻译：

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猴痘病毒及其眼表表现


猴痘病毒 （MPXV） 是人类猴痘病的病原体，猴痘病是一种类似于天花的使人衰弱的皮疹疾病。尽管 I 型 MPXV 分支在西非和中非仍然流行，但 II 型 MPXV 型是全球许多疫情的原因。2022 年最近的一次疫情是由于 MPXV 的一个新分支迅速传播造成的，该分支被归类为 IIb 分支——与以前流行的病毒株不同的谱系。分支 IIb 菌株对 Mpox 病的迅速传播和严重程度增加，提出了在 MPXV 感染期间更好地了解宿主和病毒决定因素的严重公共卫生必要性。除了典型的皮疹（包括眶周区域）外，MPXV 还会引起中度至重度眼科表现——最常见的是眼表并发症（例如角膜炎、结膜炎、睑缘炎）。虽然刚果盆地内 I 型猴痘分支的眼部表现已得到充分报道，但 IIb 型分支的眼部猴痘病例的全球发病率趋势仍在显现。鉴于所有 MPXV 菌株都已证明能够自动接种眼组织，以及 Clade IIb 病毒的传播性增强，迫切需要阐明 MPXV 导致眼部异常的机制。在这篇综述中，我们讨论了 MPXV 的病毒和基因组结构、全身性和眼部 Mpox 的流行病学和病理学，以及潜在的预防和治疗干预措施。