Infectious Uveitis in Immunocompromised Patients and the Diagnostic Value of Polymerase Chain Reaction and Goldmann-Witmer Coefficient in Aqueous Analysis

Westeneng, Arnaud C.; Rothová, Aniki; Boer, Joke H. de; Groot-Mijnes, Jolanda D.F. de

doi:10.1016/j.ajo.2007.06.034

Cited by 112 publications

(87 citation statements)

References 26 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…An American study reported that Toxoplasma gondii was involved in the pathogenesis of FHUS. [22][23][24][25][26] In our study, none of the six FHUS patients had typical chorioretinal lesions, but the number of FHUS cases is small. In Europe, Rubella virus infection was frequently linked to FHUS, whereas in Asia CMV has been reported as a frequent causal agent of FHUS.…”

Section: Discussionmentioning

confidence: 91%

Viral causes of unexplained anterior uveitis in Thailand

Kongyai

Sirirungsi

Pathanapitoon

et al. 2012

Eye

View full text Add to dashboard Cite

Aims To assess the possible role of virus infection in patients with unexplained anterior uveitis (AU). Methods Intraocular fluid and plasma samples of 30 HIV-negative AU patients who were unresponsive or poorly responsive to topical steroid therapy were analyzed for nucleic acid of cytomegalovirus (CMV), herpes simplex virus (HSV), and varicella zoster virus (VZV) by realtime polymerase chain reaction (PCR) and for intraocular antibodies against these viruses by Goldmann-Witmer coefficient (GWC) analysis. Of these 30 cases, 21 were tested for rubella virus by GWC analysis, 16 of which also had PCR assessment of aqueous for rubella virus. Results Viral uveitis determined by either real-time PCR and/or GWC was documented in 20 out of 30 patients (67%). Of 30 paired samples tested by both methods for HSV, CMV, and VZV, 15 showed positive results (CMV (10), HSV (4), and VZV (1)). Real-time PCR was positive in 8/15 (53%), whereas GWC was positive in 10/15 (67%). Out of 10 CMV-positive patients, four had endotheliitis, two had Posner-Schlossman syndrome, and one Fuchs heterochromic uveitis syndrome (FHUS). Five out of 21 (24%) samples tested by GWC for Rubella virus were positive, three of which exhibited clinical features of FHUS. Conclusions Our results indicate that CMV is a major cause of AU in Thailand and show that FHUS can be caused by both CMV and Rubella virus.

show abstract

Section: Discussionmentioning

confidence: 91%

Viral causes of unexplained anterior uveitis in Thailand

Kongyai

Sirirungsi

Pathanapitoon

et al. 2012

Eye

View full text Add to dashboard Cite

show abstract

“…Moreover, T. gondii was the most frequently detected pathogen. In 2007, Westeneng and collaborators also showed T. gondii infection as the most frequently detected (18) . CMV infections were mostly detected in plasma samples and in one case it was detected in plasma and blood.…”

Section: Discussionmentioning

confidence: 99%

Real-time PCR in infectious uveitis as an alternative diagnosis

Santos¹,

Commodaro²,

Souza³

et al. 2011

Arq. Bras. Oftalmol.

View full text Add to dashboard Cite

Purpose: Uveitis is a major visual impairment disease affecting parts or the entire uveal tract and occasionally the sclera, the cornea or the optic nerve. The disease is a major cause of ocular morbidity and blindness in immunocompetent and immunocompromised patients. In this work we analyzed the sensitivity and specificity of realtime PCR to detect the etiological agent from blood, plasma, vitreous and aqueous humor and compared with the diagnostic hypothesis. Methods: Twenty-seven patients (13 male) were studied and Real-time PCR method was used for the detection of herpes simplex virus 1 (HSV-1), herpes simplex virus 2 (HSV-2), varicella zoster virus (VZV), cytomegalovirus (CMV), Mycobacterium tuberculosis (TB) and Toxoplasma gondii (Toxo) in the aqueous humor as well as in the vitreous, blood and plasma. Results: Our results showed the presence of Toxo, CMV, VZV or HSV-2 in 19.2% of aqueous humor samples, and in 30% of vitreous humor samples. In plasma and blood samples, only CMV was detected (11.1% and 3.7%, respectively). Conclusion: Real-time PCR was able to detect and to confirm diagnostic hypothesis in uveitis. Our data also confirms that vitreous humor is the best source for molecular diagnosis of infectious uveitis but indicates aqueous humor samples that are easier to obtain may also be appropriate to be tested by Real-time PCR. Keywords

show abstract

“…However, in case of ocular toxoplasmosis, GWC analysis has contributed to its diagnosis considerably more than PCR in immunosuppressed patients. 11 Due to the atypical clinical presentations, an initial noncontributory vitreous biopsy report, a poor response to therapy, and a high clinical suspicion of toxoplasmosis in an immunocompromised eye, we resorted to more invasive tests, such as retinal or subretinal biopsy. In our cases, the long period of inadequate treatment before definite cytological examination might have contributed to the diagnostic yield of these tests.…”

Section: Discussionmentioning

confidence: 99%