Serologic and polymerase chain reaction analysis of intraocular fluids in the diagnosis of infectious uveitis

J H de Boer; C Verhagen; M Bruinenberg; A Rothova; P T de Jong; G S Baarsma; A Van der Lelij; F M Ooyman; J G Bollemeijer; P J Derhaag; A Kijlstra

doi:10.1016/s0002-9394(14)70631-2

Serologic and polymerase chain reaction analysis of intraocular fluids in the diagnosis of infectious uveitis

J H de Boer, C Verhagen, M Bruinenberg, A Rothova, P T de Jong, G S Baarsma, A Van der Lelij, F M Ooyman, J G Bollemeijer, P J Derhaag, A Kijlstra

Medical retina and Uveitis

Research output: Contribution to journal › Article › Research › peer-review

Abstract

PURPOSE: Infectious uveitis entities are usually rapidly progressive blinding diseases that can be prevented by prompt administration of specific antimicrobial therapy. With the aim of improving early diagnosis in patients with infectious uveitis, intraocular fluid samples from patients with sight-threatening posterior uveitis were investigated to determine the causative agent.

METHODS: Thirty-eight patients with acquired immunodeficiency syndrome (AIDS) and retinitis, eight immunosuppressed patients with retinitis, 16 immunocompetent patients with acute retinal necrosis, and 22 immunocompetent patients with toxoplasmic retinochoroiditis were analyzed by polymerase chain reaction for the presence of herpesviruses and Toxoplasma gondii DNA and for local antibody production against these microorganisms.

RESULTS: In patients with AIDS and retinitis, polymerase chain reaction was positive for cytomegalovirus DNA in 21 (91%) of the 23 ocular fluid samples obtained during active cytomegalovirus retinitis, whereas local antibody production analysis was negative in all cases. In acute retinal necrosis, varicella-zoster virus or herpes simplex virus could be established as the inciting agent in 81% of the cases, using the combination of both techniques. Polymerase chain reaction was positive in all samples obtained within two weeks after the onset of disease. Toxoplasma gondii DNA was detected in 4 of 13 samples (31%) from immuno-competent patients with active toxoplasmic retinochoroiditis; in each case, local antibody production was also detected. In contrast, no local antibody production was observed in two of three samples from transplant recipients that were positive for T. gondii DNA. All the control samples tested were negative for the above-mentioned tests.

CONCLUSIONS: In patients with AIDS, polymerase chain reaction analysis is preferable above local antibody production in detecting the inciting agent of retinitis. In other cases, the combination of both techniques can make a valuable contribution to the diagnosis.

Original language	English
Pages (from-to)	650-8
Number of pages	9
Journal	American Journal of Ophthalmology
Volume	121
Issue number	6
DOIs	https://doi.org/10.1016/s0002-9394(14)70631-2
Publication status	Published - Jun 1996

Keywords

AIDS-Related Opportunistic Infections/diagnosis
Animals
Antibodies, Protozoan/analysis
Antibodies, Viral/analysis
Aqueous Humor/parasitology
Base Sequence
Cytomegalovirus/genetics
DNA Primers/chemistry
DNA, Protozoan/analysis
DNA, Viral/analysis
Eye Infections, Viral/diagnosis
Herpesvirus 1, Human/genetics
Herpesvirus 2, Human/genetics
Herpesvirus 3, Human/genetics
Humans
Immunocompromised Host
Molecular Sequence Data
Polymerase Chain Reaction/methods
Retinitis/parasitology
Serologic Tests
Toxoplasma/genetics
Toxoplasmosis, Ocular/diagnosis
Uveitis, Posterior/diagnosis
Vitreous Body/parasitology

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10.1016/s0002-9394(14)70631-2

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de Boer, J. H., Verhagen, C., Bruinenberg, M., Rothova, A., de Jong, P. T., Baarsma, G. S., Van der Lelij, A., Ooyman, F. M., Bollemeijer, J. G., Derhaag, P. J., & Kijlstra, A. (1996). Serologic and polymerase chain reaction analysis of intraocular fluids in the diagnosis of infectious uveitis. American Journal of Ophthalmology, 121(6), 650-8. https://doi.org/10.1016/s0002-9394(14)70631-2

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title = "Serologic and polymerase chain reaction analysis of intraocular fluids in the diagnosis of infectious uveitis",

abstract = "PURPOSE: Infectious uveitis entities are usually rapidly progressive blinding diseases that can be prevented by prompt administration of specific antimicrobial therapy. With the aim of improving early diagnosis in patients with infectious uveitis, intraocular fluid samples from patients with sight-threatening posterior uveitis were investigated to determine the causative agent.METHODS: Thirty-eight patients with acquired immunodeficiency syndrome (AIDS) and retinitis, eight immunosuppressed patients with retinitis, 16 immunocompetent patients with acute retinal necrosis, and 22 immunocompetent patients with toxoplasmic retinochoroiditis were analyzed by polymerase chain reaction for the presence of herpesviruses and Toxoplasma gondii DNA and for local antibody production against these microorganisms.RESULTS: In patients with AIDS and retinitis, polymerase chain reaction was positive for cytomegalovirus DNA in 21 (91%) of the 23 ocular fluid samples obtained during active cytomegalovirus retinitis, whereas local antibody production analysis was negative in all cases. In acute retinal necrosis, varicella-zoster virus or herpes simplex virus could be established as the inciting agent in 81% of the cases, using the combination of both techniques. Polymerase chain reaction was positive in all samples obtained within two weeks after the onset of disease. Toxoplasma gondii DNA was detected in 4 of 13 samples (31%) from immuno-competent patients with active toxoplasmic retinochoroiditis; in each case, local antibody production was also detected. In contrast, no local antibody production was observed in two of three samples from transplant recipients that were positive for T. gondii DNA. All the control samples tested were negative for the above-mentioned tests.CONCLUSIONS: In patients with AIDS, polymerase chain reaction analysis is preferable above local antibody production in detecting the inciting agent of retinitis. In other cases, the combination of both techniques can make a valuable contribution to the diagnosis.",

keywords = "AIDS-Related Opportunistic Infections/diagnosis, Animals, Antibodies, Protozoan/analysis, Antibodies, Viral/analysis, Aqueous Humor/parasitology, Base Sequence, Cytomegalovirus/genetics, DNA Primers/chemistry, DNA, Protozoan/analysis, DNA, Viral/analysis, Eye Infections, Viral/diagnosis, Herpesvirus 1, Human/genetics, Herpesvirus 2, Human/genetics, Herpesvirus 3, Human/genetics, Humans, Immunocompromised Host, Molecular Sequence Data, Polymerase Chain Reaction/methods, Retinitis/parasitology, Serologic Tests, Toxoplasma/genetics, Toxoplasmosis, Ocular/diagnosis, Uveitis, Posterior/diagnosis, Vitreous Body/parasitology",

author = "{de Boer}, {J H} and C Verhagen and M Bruinenberg and A Rothova and {de Jong}, {P T} and Baarsma, {G S} and {Van der Lelij}, A and Ooyman, {F M} and Bollemeijer, {J G} and Derhaag, {P J} and A Kijlstra",

year = "1996",

month = jun,

doi = "10.1016/s0002-9394(14)70631-2",

language = "English",

volume = "121",

pages = "650--8",

number = "6",

}

de Boer, JH, Verhagen, C, Bruinenberg, M, Rothova, A, de Jong, PT, Baarsma, GS, Van der Lelij, A, Ooyman, FM, Bollemeijer, JG, Derhaag, PJ & Kijlstra, A 1996, 'Serologic and polymerase chain reaction analysis of intraocular fluids in the diagnosis of infectious uveitis', American Journal of Ophthalmology, vol. 121, no. 6, pp. 650-8. https://doi.org/10.1016/s0002-9394(14)70631-2

TY - JOUR

T1 - Serologic and polymerase chain reaction analysis of intraocular fluids in the diagnosis of infectious uveitis

AU - de Boer, J H

AU - Verhagen, C

AU - Bruinenberg, M

AU - Rothova, A

AU - de Jong, P T

AU - Baarsma, G S

AU - Van der Lelij, A

AU - Ooyman, F M

AU - Bollemeijer, J G

AU - Derhaag, P J

AU - Kijlstra, A

PY - 1996/6

Y1 - 1996/6

N2 - PURPOSE: Infectious uveitis entities are usually rapidly progressive blinding diseases that can be prevented by prompt administration of specific antimicrobial therapy. With the aim of improving early diagnosis in patients with infectious uveitis, intraocular fluid samples from patients with sight-threatening posterior uveitis were investigated to determine the causative agent.METHODS: Thirty-eight patients with acquired immunodeficiency syndrome (AIDS) and retinitis, eight immunosuppressed patients with retinitis, 16 immunocompetent patients with acute retinal necrosis, and 22 immunocompetent patients with toxoplasmic retinochoroiditis were analyzed by polymerase chain reaction for the presence of herpesviruses and Toxoplasma gondii DNA and for local antibody production against these microorganisms.RESULTS: In patients with AIDS and retinitis, polymerase chain reaction was positive for cytomegalovirus DNA in 21 (91%) of the 23 ocular fluid samples obtained during active cytomegalovirus retinitis, whereas local antibody production analysis was negative in all cases. In acute retinal necrosis, varicella-zoster virus or herpes simplex virus could be established as the inciting agent in 81% of the cases, using the combination of both techniques. Polymerase chain reaction was positive in all samples obtained within two weeks after the onset of disease. Toxoplasma gondii DNA was detected in 4 of 13 samples (31%) from immuno-competent patients with active toxoplasmic retinochoroiditis; in each case, local antibody production was also detected. In contrast, no local antibody production was observed in two of three samples from transplant recipients that were positive for T. gondii DNA. All the control samples tested were negative for the above-mentioned tests.CONCLUSIONS: In patients with AIDS, polymerase chain reaction analysis is preferable above local antibody production in detecting the inciting agent of retinitis. In other cases, the combination of both techniques can make a valuable contribution to the diagnosis.

AB - PURPOSE: Infectious uveitis entities are usually rapidly progressive blinding diseases that can be prevented by prompt administration of specific antimicrobial therapy. With the aim of improving early diagnosis in patients with infectious uveitis, intraocular fluid samples from patients with sight-threatening posterior uveitis were investigated to determine the causative agent.METHODS: Thirty-eight patients with acquired immunodeficiency syndrome (AIDS) and retinitis, eight immunosuppressed patients with retinitis, 16 immunocompetent patients with acute retinal necrosis, and 22 immunocompetent patients with toxoplasmic retinochoroiditis were analyzed by polymerase chain reaction for the presence of herpesviruses and Toxoplasma gondii DNA and for local antibody production against these microorganisms.RESULTS: In patients with AIDS and retinitis, polymerase chain reaction was positive for cytomegalovirus DNA in 21 (91%) of the 23 ocular fluid samples obtained during active cytomegalovirus retinitis, whereas local antibody production analysis was negative in all cases. In acute retinal necrosis, varicella-zoster virus or herpes simplex virus could be established as the inciting agent in 81% of the cases, using the combination of both techniques. Polymerase chain reaction was positive in all samples obtained within two weeks after the onset of disease. Toxoplasma gondii DNA was detected in 4 of 13 samples (31%) from immuno-competent patients with active toxoplasmic retinochoroiditis; in each case, local antibody production was also detected. In contrast, no local antibody production was observed in two of three samples from transplant recipients that were positive for T. gondii DNA. All the control samples tested were negative for the above-mentioned tests.CONCLUSIONS: In patients with AIDS, polymerase chain reaction analysis is preferable above local antibody production in detecting the inciting agent of retinitis. In other cases, the combination of both techniques can make a valuable contribution to the diagnosis.

KW - AIDS-Related Opportunistic Infections/diagnosis

KW - Animals

KW - Antibodies, Protozoan/analysis

KW - Antibodies, Viral/analysis

KW - Aqueous Humor/parasitology

KW - Base Sequence

KW - Cytomegalovirus/genetics

KW - DNA Primers/chemistry

KW - DNA, Protozoan/analysis

KW - DNA, Viral/analysis

KW - Eye Infections, Viral/diagnosis

KW - Herpesvirus 1, Human/genetics

KW - Herpesvirus 2, Human/genetics

KW - Herpesvirus 3, Human/genetics

KW - Humans

KW - Immunocompromised Host

KW - Molecular Sequence Data

KW - Polymerase Chain Reaction/methods

KW - Retinitis/parasitology

KW - Serologic Tests

KW - Toxoplasma/genetics

KW - Toxoplasmosis, Ocular/diagnosis

KW - Uveitis, Posterior/diagnosis

KW - Vitreous Body/parasitology

U2 - 10.1016/s0002-9394(14)70631-2

DO - 10.1016/s0002-9394(14)70631-2

M3 - Article

C2 - 8644808

SN - 0002-9394

VL - 121

SP - 650

EP - 658

JO - American Journal of Ophthalmology

JF - American Journal of Ophthalmology

IS - 6

ER -

Serologic and polymerase chain reaction analysis of intraocular fluids in the diagnosis of infectious uveitis

Abstract

Keywords

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