Abstract
BackgroundPolymerase chain reaction (PCR) analysis is an important tool in the diagnosis of infectious uveitis. A retrospective, interventional study of PCR analysis of ocular fluid in suspected infectious uveitis cases between January 2014 to July 2016 was done. Nested, real-time and broad range PCR was performed for detection of the genome of Mycobacterium tuberculosis, herpes virus family, Chikungunya virus, Toxoplasma gondii, fungus, eubacterium and propionibacterium acne.ResultsTotal of 100 cases included, mean age was 39.2 ± 15.4 years. Uveitis was unilateral in 82% and granulomatous in 40%. Mean visual acuity at the initial visit and final visit was 0.73 logMar and 0.63 logMar respectively. PCR analysis confirmed the clinical diagnosis in 70.1% patients. The sensitivity, specificity, positive predictive value and negative predictive value of PCR analysis was 90.2%, 93.9%, 93.9% and 90.2% respectively. The quantitative value of real-time M. tb. Positive PCR ranged from 32c/ml to 2722 c/ml.ConclusionsPCR assay is an accurate technique with high sensitivity and specificity to diagnose the DNA genome in infectious uveitis.
Highlights
Polymerase chain reaction (PCR) analysis is an important tool in the diagnosis of infectious uveitis
We investigated the diagnostic utility of real-time and nested polymerase chain reaction (PCR) samples obtained from the ocular fluid in clinically suspected infectious uveitis
A retrospective, interventional study of PCR analysis of ocular fluid in suspected infectious uveitis cases was conducted in January 2014 to July 2016 at Sankara Nethralaya, a tertiary level referral eye center of South India
Summary
Polymerase chain reaction (PCR) analysis is an important tool in the diagnosis of infectious uveitis. A retrospective, interventional study of PCR analysis of ocular fluid in suspected infectious uveitis cases between January 2014 to July 2016 was done. The polymerase chain reaction (PCR) analysis of ocular fluid samples allows early, accurate, and rapid detection of small quantities of DNA or RNA from potential pathogens infecting the uveal tract and is a sensitive and specific method to detect microbial DNA in ocular samples from immunocompetent and immunocompromised patients with uveitis [2–7]. Patients with uveitis of infectious and non-infectious etiologies often share similar clinical signs and symptoms at presentation, representing diagnostic challenges, especially when serology is unable to establish the diagnosis [8]. We investigated the diagnostic utility of real-time and nested PCR samples obtained from the ocular fluid in clinically suspected infectious uveitis. Specificity and, predictive values of PCR to detect the etiological agent from aqueous and vitreous humors and compared with the diagnostic hypothesis
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