TY - JOUR
T1 - RETINAL FINDINGS IN PRESUMED INFECTIOUS POSTERIOR UVEITIS AND CORRELATION WITH POLYMERASE CHAIN REACTION RESULTS
AU - Elyashiv, Sivan M.
AU - Samson, C. Michael
AU - Jabs, Douglas A.
N1 - Publisher Copyright:
Copyright © by Ophthalmic Communications Society, Inc.
PY - 2020/3/1
Y1 - 2020/3/1
N2 - Purpose:To correlate demographics, retinal lesion characteristics, and host immune status with the pathogen found on polymerase chain reaction analysis of aqueous fluid in patients with suspected infectious posterior uveitis.Methods:Medical records of patients who underwent anterior chamber paracentesis for suspected infectious posterior uveitis and had retinal photographs between 2014 and 2016 at a single institution were reviewed. Data collection included demographics, clinical appearance of the lesions, and polymerase chain reaction results. Fundus photographs were evaluated by two masked observers for the clinical features of the retinitis.Results:Twenty-eight patients were included in the study. There was substantial to almost perfect agreement on retinitis location ( = 0.67) and number ( = 0.76) between the masked photograph graders. Polymerase chain reaction results were positive for herpes simplex virus or varicella zoster virus in 43%, cytomegalovirus in 11%, and toxoplasmosis in 3%; 43% had negative polymerase chain reaction results. Detection of herpes simplex virus or varicella zoster virus on polymerase chain reaction of the aqueous was associated with paucifocal lesions (82%, P = 0.021) and lesions involving the peripheral retina (91%, P = 0.023), consistent with the diagnosis of acute retinal necrosis.Conclusion:These data suggest that the diagnosis of acute retinal necrosis can be reasonably inferred on clinical examination, providing a guide for initial empiric therapy.
AB - Purpose:To correlate demographics, retinal lesion characteristics, and host immune status with the pathogen found on polymerase chain reaction analysis of aqueous fluid in patients with suspected infectious posterior uveitis.Methods:Medical records of patients who underwent anterior chamber paracentesis for suspected infectious posterior uveitis and had retinal photographs between 2014 and 2016 at a single institution were reviewed. Data collection included demographics, clinical appearance of the lesions, and polymerase chain reaction results. Fundus photographs were evaluated by two masked observers for the clinical features of the retinitis.Results:Twenty-eight patients were included in the study. There was substantial to almost perfect agreement on retinitis location ( = 0.67) and number ( = 0.76) between the masked photograph graders. Polymerase chain reaction results were positive for herpes simplex virus or varicella zoster virus in 43%, cytomegalovirus in 11%, and toxoplasmosis in 3%; 43% had negative polymerase chain reaction results. Detection of herpes simplex virus or varicella zoster virus on polymerase chain reaction of the aqueous was associated with paucifocal lesions (82%, P = 0.021) and lesions involving the peripheral retina (91%, P = 0.023), consistent with the diagnosis of acute retinal necrosis.Conclusion:These data suggest that the diagnosis of acute retinal necrosis can be reasonably inferred on clinical examination, providing a guide for initial empiric therapy.
KW - acute retinal necrosis
KW - cytomegalovirus retinitis
KW - herpes simplex virus
KW - infectious retinitis
KW - polymerase chain reaction
KW - posterior uveitis
KW - toxoplasmosis
KW - varicella zoster virus
UR - http://www.scopus.com/inward/record.url?scp=85078851079&partnerID=8YFLogxK
U2 - 10.1097/IAE.0000000000002423
DO - 10.1097/IAE.0000000000002423
M3 - Article
C2 - 30601389
AN - SCOPUS:85078851079
SN - 0275-004X
VL - 40
SP - 567
EP - 571
JO - Retina
JF - Retina
IS - 3
ER -