Identification of Torque Teno Virus in Culture-Negative Endophthalmitis by Representational Deep DNA Sequencing

Lee, Aaron; Akileswaran, Lakshmi; Tibbetts, Michael D.; Garg, Sunir J.; Gelder, Russell N. Van

doi:10.1016/j.ophtha.2014.09.001

Cited by 98 publications

(65 citation statements)

References 43 publications

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“…Lastly, recent work showing high rates of torque teno virus in culture-negative endophthalmitis has blurred the previously sharp distinction between infectious and “sterile” endophthalmitis altogether. 18 …”

Section: Discussionmentioning

confidence: 99%

The Association between Intravitreal Steroids and Post-Injection Endophthalmitis Rates

VanderBeek

Bonaffini

2015

Ophthalmology

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Objective To determine if there is a difference in the risk of endophthalmitis after an intravitreal steroid injection compared to an anti-vascular endothelial growth factor agent (anti-VEGF) injection Design Retrospective cohort study Participants 75,249 beneficiaries in a large national US medical claims database representing 406,380 intravitreal injections Methods Data were searched for all intravitreal injections (CPT 67028) performed between 2003 and 2012. Cohorts were created based on injections using anti-VEGF agents (bevacizumab, ranibizumab, aflibercept and pegaptanib) and intraocular steroids (triamcinolone and dexamethasone). Endophthalmitis was defined as having a new endophthalmitis diagnosis (ICD9 360.0×) and either a “tap-and-inject” procedure (CPT67015, 67025), a vitrectomy (67036) or an intravitreal antibiotic injection on the same day, between 1 and 14 days post-injection. Exclusion occurred for any history of endophthalmitis, <6 months in the plan or <1 month follow up. The main outcome measure was the odds of endophthalmitis using logistic regression while controlling for injection-associated diagnosis, age, race and gender. Results 387,714 anti-VEGF injections and 18,666 steroid intravitreal injections were performed and were followed by 73 (rate=0.019% or 1/5283 anti-VEGF injections) and 24 (rate= 0.13% or 1/778 steroid injections) cases of endophthalmitis respectively. After controlling for diagnosis, age, race and gender, the odds ratio for endophthalmitis occurring was 6.92 (95% CI: 3.54–13.52, p<0.001) times higher post-steroid injection compared to anti-VEGF injections. Conclusions The rate of endophthalmitis post-intravitreal steroid injection in a national cohort was 0.13% (1/778 injections). This rate conferred a significantly increased odds ratio of 6.92 for endophthalmitis compared to anti-VEGF agents.

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Section: Discussionmentioning

confidence: 99%

The Association between Intravitreal Steroids and Post-Injection Endophthalmitis Rates

VanderBeek

Bonaffini

2015

Ophthalmology

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“…A few studies have used BRiSK to detect organisms de novo [36, 37]. We performed a pilot study with 21 consecutive vitreous samples from post-procedural, presumed infectious endophthalmitis and 7 vitreous samples from routine vitrectomy cases without inflammation were compared with culture, 16S PCR, and BRiSK [36].…”

Section: Massive Parallel Sequencingmentioning

confidence: 99%

“…We performed a pilot study with 21 consecutive vitreous samples from post-procedural, presumed infectious endophthalmitis and 7 vitreous samples from routine vitrectomy cases without inflammation were compared with culture, 16S PCR, and BRiSK [36]. Fourteen of the 21 endophthalmitis samples were found to be bacterial culture-positive.…”

Section: Massive Parallel Sequencingmentioning

confidence: 99%

Emerging techniques for pathogen discovery in endophthalmitis

Hong

Lee

Gelder

2015

Current Opinion in Ophthalmology

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Purpose of review Despite the inability to detect certain organisms and relatively low yield, microbial culture is the current gold standard for the diagnosis of most intraocular infections. Research on alternative molecular diagnostic methods has produced an array of strategies that augment and improve pathogen detection. This review summarizes the most recent literature on this topic. Recent findings The yield of traditional microbial culture has not improved since the Endophthalmitis Vitrectomy Study results were published 20 years ago. Advances in polymerase chain reaction (PCR) methods have enabled quantification of pathogen load and screening for multiple organisms at once. More recently, deep sequencing techniques allow highly sensitive detection of any DNA-based life form in a specimen. This offers the promise of not only improved detection of traditional organisms but can also identify organisms not previously associated with endophthalmitis. Summary Molecular diagnostic methods enhance the results of microbial culture and may become the new standard in the diagnosis of intraocular infections.

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“…For example, one study revealed that fungi and viruses make‐up less than 2% of the microbial reads from conjunctival swabs . In another study, DNA analysis showed that 65% of healthy subjects were positive for torque teno virus, which has also been linked to culture‐negative cases of endophthalmitis . Other viruses have also been found at the ocular surface of asymptomatic subjects, suggesting that niches for viruses may exist at the ocular surface .…”

Section: The Ocular Microbiome‐myth or Fact?mentioning

confidence: 99%

Visions of Eye Commensals: The Known and the Unknown About How the Microbiome Affects Eye Disease

Leger

Caspi

2018

BioEssays

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Until recently, the ocular surface is thought by many to be sterile and devoid of living microbes. It is now becoming clear that this may not be the case. Recent and sophisticated PCR analyses have shown that microbial DNA-based “signatures” are present within various ethnic, geographic, and contact lens wearing communities. Furthermore, using a mouse model of ocular surface disease, we have shown that the microbe, Corynebacterium mastitidis (C. mast), can stably colonize the ocular mucosa and that a causal relationship exists between ocular C. mast colonization and beneficial local immunity. While this constitutes proof-of-concept that a bona fide ocular microbiome that tunes immunity can exist at the ocular surface, there remain numerous unanswered questions to be addressed before microbiome-modulating therapies may be successfully developed. Here, the authors will briefly outline what is currently known about the local ocular microbiome as well as microbiomes associated with other sites, and how those sites may play a role in ocular surface immunity. Understanding how commensal microbes affect the ocular surface immune homeostasis has the potential revolutionize how we think about treating ocular surface disease.

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Identification of Torque Teno Virus in Culture-Negative Endophthalmitis by Representational Deep DNA Sequencing

Cited by 98 publications

References 43 publications

The Association between Intravitreal Steroids and Post-Injection Endophthalmitis Rates

The Association between Intravitreal Steroids and Post-Injection Endophthalmitis Rates

Emerging techniques for pathogen discovery in endophthalmitis

Visions of Eye Commensals: The Known and the Unknown About How the Microbiome Affects Eye Disease

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