Polymerase chain reaction test for diagnosis of infectious uveitis
Abstract Background To study the clinical utility of broad-range real-time Polymerase Chain Reaction (PCR) assay in patients suspected for infectious uveitis and to analyze the clinical relevance. Methods Medical records of patients with uveitis were assessed in whom PCR analysis of intraocular flui...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2023-04-01
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| Series: | International Journal of Retina and Vitreous |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s40942-023-00465-w |
| _version_ | 1827966176217530368 |
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| author | Sahba Fekri Ehsan Barzanouni Shahram Samiee Masoud Soheilian |
| author_facet | Sahba Fekri Ehsan Barzanouni Shahram Samiee Masoud Soheilian |
| author_sort | Sahba Fekri |
| collection | DOAJ |
| description | Abstract Background To study the clinical utility of broad-range real-time Polymerase Chain Reaction (PCR) assay in patients suspected for infectious uveitis and to analyze the clinical relevance. Methods Medical records of patients with uveitis were assessed in whom PCR analysis of intraocular fluids was performed between January 2018 and February 2021. Intraocular samples were investigated for cytomegalovirus (CMV), Epstein-Barr virus (EBV), varicella zoster virus (VZV), herpes simplex viruses type 1 and 2 (HSV1,2), human T-lymphotropic virus type 1 (HTLV-1), Toxoplasma gondii and also for bacterial 16 S and fungal 18 S/28S ribosomal DNA (rDNA). Results Aqueous paracentesis and vitreous sampling was done for 151 (81.2%) and 35 (18.8%) patients, respectively. Most of the patients had panuveitis (61.3%). PCR results were positive in 69 out of 186 patients (37%) according to the following order: CMV (18 cases), VZV (18 cases), fungal 18s/28s rDNA (17 cases), HSV (9 cases), bacterial 16s rDNA (3 cases), HTLV-1 (2 cases), and Toxoplasma gondii (2 cases). PCR positivity rate was 5.8% in patients with undifferentiated panuveitis. EBV was not detected at all. Initial treatment was changed in 38 patients (20%) based on PCR results. The overall sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of PCR test for aqueous samples was 82%, 91%, 96%, and 87%, respectively. No significant adverse effect related to sampling was reported. Conclusion PCR analysis of intraocular fluids in patients with suspected infectious uveitis plays an important role in confirming diagnosis or changing treatment with good predictive value. However, routine PCR test in patients with undifferentiated panuveitis in order to rule out possible underlying infectious etiology had low benefit. |
| first_indexed | 2024-04-09T17:45:51Z |
| format | Article |
| id | doaj.art-3bfacd86e90d440580cdf9090a5742f6 |
| institution | Directory Open Access Journal |
| issn | 2056-9920 |
| language | English |
| last_indexed | 2024-04-09T17:45:51Z |
| publishDate | 2023-04-01 |
| publisher | BMC |
| record_format | Article |
| series | International Journal of Retina and Vitreous |
| spelling | doaj.art-3bfacd86e90d440580cdf9090a5742f62023-04-16T11:21:18ZengBMCInternational Journal of Retina and Vitreous2056-99202023-04-01911710.1186/s40942-023-00465-wPolymerase chain reaction test for diagnosis of infectious uveitisSahba Fekri0Ehsan Barzanouni1Shahram Samiee2Masoud Soheilian3Department of Ophthalmology, Labbafinejad Medical Center, Shahid Beheshti University of Medical SciencesDepartment of Ophthalmology, Labbafinejad Medical Center, Shahid Beheshti University of Medical SciencesBlood Transfusion Research Center, High Institute for Research & Education in Transfusion MedicineDepartment of Ophthalmology, Labbafinejad Medical Center, Shahid Beheshti University of Medical SciencesAbstract Background To study the clinical utility of broad-range real-time Polymerase Chain Reaction (PCR) assay in patients suspected for infectious uveitis and to analyze the clinical relevance. Methods Medical records of patients with uveitis were assessed in whom PCR analysis of intraocular fluids was performed between January 2018 and February 2021. Intraocular samples were investigated for cytomegalovirus (CMV), Epstein-Barr virus (EBV), varicella zoster virus (VZV), herpes simplex viruses type 1 and 2 (HSV1,2), human T-lymphotropic virus type 1 (HTLV-1), Toxoplasma gondii and also for bacterial 16 S and fungal 18 S/28S ribosomal DNA (rDNA). Results Aqueous paracentesis and vitreous sampling was done for 151 (81.2%) and 35 (18.8%) patients, respectively. Most of the patients had panuveitis (61.3%). PCR results were positive in 69 out of 186 patients (37%) according to the following order: CMV (18 cases), VZV (18 cases), fungal 18s/28s rDNA (17 cases), HSV (9 cases), bacterial 16s rDNA (3 cases), HTLV-1 (2 cases), and Toxoplasma gondii (2 cases). PCR positivity rate was 5.8% in patients with undifferentiated panuveitis. EBV was not detected at all. Initial treatment was changed in 38 patients (20%) based on PCR results. The overall sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of PCR test for aqueous samples was 82%, 91%, 96%, and 87%, respectively. No significant adverse effect related to sampling was reported. Conclusion PCR analysis of intraocular fluids in patients with suspected infectious uveitis plays an important role in confirming diagnosis or changing treatment with good predictive value. However, routine PCR test in patients with undifferentiated panuveitis in order to rule out possible underlying infectious etiology had low benefit.https://doi.org/10.1186/s40942-023-00465-wInfectious UveitisOcular samplingPolymerase chain reaction (PCR)Uveitis |
| spellingShingle | Sahba Fekri Ehsan Barzanouni Shahram Samiee Masoud Soheilian Polymerase chain reaction test for diagnosis of infectious uveitis International Journal of Retina and Vitreous Infectious Uveitis Ocular sampling Polymerase chain reaction (PCR) Uveitis |
| title | Polymerase chain reaction test for diagnosis of infectious uveitis |
| title_full | Polymerase chain reaction test for diagnosis of infectious uveitis |
| title_fullStr | Polymerase chain reaction test for diagnosis of infectious uveitis |
| title_full_unstemmed | Polymerase chain reaction test for diagnosis of infectious uveitis |
| title_short | Polymerase chain reaction test for diagnosis of infectious uveitis |
| title_sort | polymerase chain reaction test for diagnosis of infectious uveitis |
| topic | Infectious Uveitis Ocular sampling Polymerase chain reaction (PCR) Uveitis |
| url | https://doi.org/10.1186/s40942-023-00465-w |
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