The Value of Routine Polymerase Chain Reaction Analysis of Intraocular Fluid Specimens in the Diagnosis of Infectious Posterior Uveitis
Objective. To assess the value of routine polymerase chain reaction (PCR) analysis on intraocular fluid from patients presenting with a first episode of suspected active infectious posterior uveitis in a population with a high prevalence of human immunodeficiency virus infection. Design. Retrospecti...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | The Scientific World Journal |
| Online Access: | http://dx.doi.org/10.1155/2013/545149 |
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| author | Marius A. Scheepers Karin A. Lecuona Graeme Rogers Catey Bunce Craig Corcoran Michel Michaelides |
| author_facet | Marius A. Scheepers Karin A. Lecuona Graeme Rogers Catey Bunce Craig Corcoran Michel Michaelides |
| author_sort | Marius A. Scheepers |
| collection | DOAJ |
| description | Objective. To assess the value of routine polymerase chain reaction (PCR) analysis on intraocular fluid from patients presenting with a first episode of suspected active infectious posterior uveitis in a population with a high prevalence of human immunodeficiency virus infection. Design. Retrospective, interventional case series. Participants. 159 consecutive patients presenting at a tertiary care hospital over a five-year period. Methods. PCR analysis was performed for cytomegalovirus, varicella zoster virus, herpes simplex virus types 1 and 2, Toxoplasma gondii, and Mycobacterium tuberculosis. Results. PCR analysis confirmed the initial clinical diagnosis in 55 patients (35%) and altered the initial clinical diagnosis in 36 patients (23%). The clinical diagnosis prior to PCR testing was nonspecific (uncertain) in 51 patients (32%), with PCR providing a definitive final diagnosis in 20 of these patients (39%); necrotizing herpetic retinopathy and ocular toxoplasmosis were particularly difficult to diagnose correctly without the use of PCR analysis. Conclusion. The clinical phenotype alone was unreliable in diagnosing the underlying infectious cause in a quarter of patients in this study. Since the outcome of incorrectly treated infective uveitis can be blinding, PCR analysis of ocular fluids is recommended early in the disease even in resource poor settings. |
| format | Article |
| id | doaj-art-d367302dc6484406abfd1d66d80340b6 |
| institution | Kabale University |
| issn | 1537-744X |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | The Scientific World Journal |
| spelling | doaj-art-d367302dc6484406abfd1d66d80340b62025-02-03T05:45:55ZengWileyThe Scientific World Journal1537-744X2013-01-01201310.1155/2013/545149545149The Value of Routine Polymerase Chain Reaction Analysis of Intraocular Fluid Specimens in the Diagnosis of Infectious Posterior UveitisMarius A. Scheepers0Karin A. Lecuona1Graeme Rogers2Catey Bunce3Craig Corcoran4Michel Michaelides5Groote Schuur Hospital, Ophthalmology Department, Cape Town, South AfricaGroote Schuur Hospital, Ophthalmology Department, Cape Town, South AfricaGroote Schuur Hospital, Ophthalmology Department, Cape Town, South AfricaMoorfields Eye Hospital, London, UKGroote Schuur Hospital, Ophthalmology Department, Cape Town, South AfricaMoorfields Eye Hospital, London, UKObjective. To assess the value of routine polymerase chain reaction (PCR) analysis on intraocular fluid from patients presenting with a first episode of suspected active infectious posterior uveitis in a population with a high prevalence of human immunodeficiency virus infection. Design. Retrospective, interventional case series. Participants. 159 consecutive patients presenting at a tertiary care hospital over a five-year period. Methods. PCR analysis was performed for cytomegalovirus, varicella zoster virus, herpes simplex virus types 1 and 2, Toxoplasma gondii, and Mycobacterium tuberculosis. Results. PCR analysis confirmed the initial clinical diagnosis in 55 patients (35%) and altered the initial clinical diagnosis in 36 patients (23%). The clinical diagnosis prior to PCR testing was nonspecific (uncertain) in 51 patients (32%), with PCR providing a definitive final diagnosis in 20 of these patients (39%); necrotizing herpetic retinopathy and ocular toxoplasmosis were particularly difficult to diagnose correctly without the use of PCR analysis. Conclusion. The clinical phenotype alone was unreliable in diagnosing the underlying infectious cause in a quarter of patients in this study. Since the outcome of incorrectly treated infective uveitis can be blinding, PCR analysis of ocular fluids is recommended early in the disease even in resource poor settings.http://dx.doi.org/10.1155/2013/545149 |
| spellingShingle | Marius A. Scheepers Karin A. Lecuona Graeme Rogers Catey Bunce Craig Corcoran Michel Michaelides The Value of Routine Polymerase Chain Reaction Analysis of Intraocular Fluid Specimens in the Diagnosis of Infectious Posterior Uveitis The Scientific World Journal |
| title | The Value of Routine Polymerase Chain Reaction Analysis of Intraocular Fluid Specimens in the Diagnosis of Infectious Posterior Uveitis |
| title_full | The Value of Routine Polymerase Chain Reaction Analysis of Intraocular Fluid Specimens in the Diagnosis of Infectious Posterior Uveitis |
| title_fullStr | The Value of Routine Polymerase Chain Reaction Analysis of Intraocular Fluid Specimens in the Diagnosis of Infectious Posterior Uveitis |
| title_full_unstemmed | The Value of Routine Polymerase Chain Reaction Analysis of Intraocular Fluid Specimens in the Diagnosis of Infectious Posterior Uveitis |
| title_short | The Value of Routine Polymerase Chain Reaction Analysis of Intraocular Fluid Specimens in the Diagnosis of Infectious Posterior Uveitis |
| title_sort | value of routine polymerase chain reaction analysis of intraocular fluid specimens in the diagnosis of infectious posterior uveitis |
| url | http://dx.doi.org/10.1155/2013/545149 |
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