The impact of aqueous humor polymerase chain reaction and serological test results for establishing infectious uveitis diagnosis: An Indonesian experience

Ikhwanuliman Putera, Rina La Distia Nora, Nunik Utami, Anis Karuniawati, Andi Yasmon, Dewi Wulandari, Lukman Edwar, Made Susiyanti, Yulia Aziza, Priscilla Jessica, Mei Riasanti, Ratna Sitompul

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: To assess the clinical value of aqueous humor real-time polymerase chain reaction (RT-PCR) and serological antibody tests among uveitis patients in Indonesian cohort. Methods: In this prospective cohort study, single-plex RT-PCR analysis of aqueous samples from 86 new uveitis patients was performed to detect Mycobacterium tuberculosis, Toxoplasmosis gondii, cytomegalovirus, herpes simplex virus, varicella-zoster virus, Epstein-Barr virus, and rubella virus. Specific serological antibodies for suspected pathogens were also obtained. Comparison of PCR and serological antibodies with the initial and final diagnosis were presented. Results: The diagnostic positivity of aqueous RT-PCR in our cohort was 20% (17/86). The rate of infection as final etiological classification was higher after RT-PCR was performed (45 patients, 52%) compared to initial diagnosis based on clinical presentation alone (38 patients, 44%). In particular, the RT-PCR positivity among patients with infection as the final etiological classification was 33.33% (15/45). A significant difference in the IgG but not IgM toxoplasma value among those with ocular toxoplasmosis as the final diagnosis compared to the other etiologies were observed (3953 (IQR 2707–19562) IU/mL vs 428 (IQR 82–1807) IU/mL; p < 0.0001). Conclusion: RT-PCR analysis of aqueous fluid from uveitis patients helped confirm a third of infectious uveitis cases in Indonesia. In ocular toxoplasmosis, high IgG but not IgM antibody value might help differentiate those with other etiology.

Original languageEnglish
Article numbere10988
JournalHeliyon
Volume8
Issue number10
DOIs
Publication statusPublished - Oct 2022

Keywords

  • Aqueous humor
  • Immunoglobulin
  • Infectious uveitis
  • Polymerase chain reaction
  • Serum

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