Abstract
Purpose: The diagnosis of cytomegalovirus (CMV) anterior uveitis in immunocompetent patients requires confirmation by polymerase chain reaction (PCR) analysis and/or intraocular antibody index (AI) assay. In this study, we analyzed the different contributions of PCR and AI to CMV diagnosis by performing one single aqueous tap. Methods: A retrospective chart review was conducted of HIV-negative patients attending the Ocular Immunology Unit of Azienda Unità Sanitaria Locale – IRCCS, Reggio Emilia, Italy, from March 2015 to April 2018 with a diagnosis of hypertensive anterior granulomatous uveitis compatible with suspected CMV etiology. Diagnosis was confirmed by real-time PCR (RT-PCR) and intraocular antibody production against CMV on aqueous humor samples. Clinical features were compared to antibody titer and diagnostic delay. Results: Twenty-three patients with suspected CMV uveitis (13 males, 10 females, mean age 48 ± 16 years) were included in the analysis. AI was positive in 20/23 (87%) samples, and PCR tested positive in 9/23 (39%). By combining both tests, the sensitivity was 100%. Median diagnostic delay was 29 months (IQR 9–107). Diagnostic delay and antibody titer were significantly associated with glaucoma (r = 0.714, p < 0.0001; r = 0.476, p = 0.02, respectively). Conclusions: Our data suggest that to improve the diagnostic accuracy of CMV anterior uveitis, PCR and AI are both useful and complimentary. In our series, AI was the most sensitive diagnostic tool. One single aqueous tap is sufficient to achieve 100% sensitivity in CMV diagnosis. Early diagnosis is necessary to prevent the development of glaucoma.
| Original language | English |
|---|---|
| Pages (from-to) | 181-186 |
| Number of pages | 6 |
| Journal | Graefe's Archive for Clinical and Experimental Ophthalmology |
| Volume | 257 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Jan 28 2019 |
Fingerprint
Keywords
- Antibody index
- Cytomegalovirus
- Glaucoma
- Goldmann-Witmer coefficient
- PCR
- Viral anterior uveitis
ASJC Scopus subject areas
- Ophthalmology
- Sensory Systems
- Cellular and Molecular Neuroscience
Cite this
Aqueous tap and rapid diagnosis of cytomegalovirus anterior uveitis : the Reggio Emilia experience. / De Simone, L.; Belloni, L.; Aldigeri, R.; Zerbini, A.; Mastrofilippo, V.; Sangiovanni, A.; Parmeggiani, M.; Fontana, L.; Cimino, Luca.
In: Graefe's Archive for Clinical and Experimental Ophthalmology, Vol. 257, No. 1, 28.01.2019, p. 181-186.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Aqueous tap and rapid diagnosis of cytomegalovirus anterior uveitis
T2 - the Reggio Emilia experience
AU - De Simone, L.
AU - Belloni, L.
AU - Aldigeri, R.
AU - Zerbini, A.
AU - Mastrofilippo, V.
AU - Sangiovanni, A.
AU - Parmeggiani, M.
AU - Fontana, L.
AU - Cimino, Luca
PY - 2019/1/28
Y1 - 2019/1/28
N2 - Purpose: The diagnosis of cytomegalovirus (CMV) anterior uveitis in immunocompetent patients requires confirmation by polymerase chain reaction (PCR) analysis and/or intraocular antibody index (AI) assay. In this study, we analyzed the different contributions of PCR and AI to CMV diagnosis by performing one single aqueous tap. Methods: A retrospective chart review was conducted of HIV-negative patients attending the Ocular Immunology Unit of Azienda Unità Sanitaria Locale – IRCCS, Reggio Emilia, Italy, from March 2015 to April 2018 with a diagnosis of hypertensive anterior granulomatous uveitis compatible with suspected CMV etiology. Diagnosis was confirmed by real-time PCR (RT-PCR) and intraocular antibody production against CMV on aqueous humor samples. Clinical features were compared to antibody titer and diagnostic delay. Results: Twenty-three patients with suspected CMV uveitis (13 males, 10 females, mean age 48 ± 16 years) were included in the analysis. AI was positive in 20/23 (87%) samples, and PCR tested positive in 9/23 (39%). By combining both tests, the sensitivity was 100%. Median diagnostic delay was 29 months (IQR 9–107). Diagnostic delay and antibody titer were significantly associated with glaucoma (r = 0.714, p < 0.0001; r = 0.476, p = 0.02, respectively). Conclusions: Our data suggest that to improve the diagnostic accuracy of CMV anterior uveitis, PCR and AI are both useful and complimentary. In our series, AI was the most sensitive diagnostic tool. One single aqueous tap is sufficient to achieve 100% sensitivity in CMV diagnosis. Early diagnosis is necessary to prevent the development of glaucoma.
AB - Purpose: The diagnosis of cytomegalovirus (CMV) anterior uveitis in immunocompetent patients requires confirmation by polymerase chain reaction (PCR) analysis and/or intraocular antibody index (AI) assay. In this study, we analyzed the different contributions of PCR and AI to CMV diagnosis by performing one single aqueous tap. Methods: A retrospective chart review was conducted of HIV-negative patients attending the Ocular Immunology Unit of Azienda Unità Sanitaria Locale – IRCCS, Reggio Emilia, Italy, from March 2015 to April 2018 with a diagnosis of hypertensive anterior granulomatous uveitis compatible with suspected CMV etiology. Diagnosis was confirmed by real-time PCR (RT-PCR) and intraocular antibody production against CMV on aqueous humor samples. Clinical features were compared to antibody titer and diagnostic delay. Results: Twenty-three patients with suspected CMV uveitis (13 males, 10 females, mean age 48 ± 16 years) were included in the analysis. AI was positive in 20/23 (87%) samples, and PCR tested positive in 9/23 (39%). By combining both tests, the sensitivity was 100%. Median diagnostic delay was 29 months (IQR 9–107). Diagnostic delay and antibody titer were significantly associated with glaucoma (r = 0.714, p < 0.0001; r = 0.476, p = 0.02, respectively). Conclusions: Our data suggest that to improve the diagnostic accuracy of CMV anterior uveitis, PCR and AI are both useful and complimentary. In our series, AI was the most sensitive diagnostic tool. One single aqueous tap is sufficient to achieve 100% sensitivity in CMV diagnosis. Early diagnosis is necessary to prevent the development of glaucoma.
KW - Antibody index
KW - Cytomegalovirus
KW - Glaucoma
KW - Goldmann-Witmer coefficient
KW - PCR
KW - Viral anterior uveitis
UR - http://www.scopus.com/inward/record.url?scp=85056122488&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85056122488&partnerID=8YFLogxK
U2 - 10.1007/s00417-018-4180-9
DO - 10.1007/s00417-018-4180-9
M3 - Article
VL - 257
SP - 181
EP - 186
JO - Graefe's Archive for Clinical and Experimental Ophthalmology
JF - Graefe's Archive for Clinical and Experimental Ophthalmology
SN - 0721-832X
IS - 1
ER -