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S. Ho, J. Y. Ng, L. W. Heng; The Use of Tetraplex Polymerase Chain Reaction (PCR) Analysis in the Diagnosis of Infectious Uveitis in Singapore. Invest. Ophthalmol. Vis. Sci. 2009;50(13):3116.
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© ARVO (1962-2015); The Authors (2016-present)
To review the use of tetraplex polymerase chain reaction (PCR) analysis of intraocular fluid for suspected infectious uveitis in our tertiary referral eye centre in Singapore
Retrospective case series.
Tetraplex PCR for detection of cytomegalovirus (CMV), herpes simplex virus (HSV), varicella zoster virus (VZV) and toxoplasma gondii genomes was performed on 100 samples (92 aqueous and 8 vitreous) collected from 95 uveitic patients (18 immunocompromised; 77 immunocompetent) from 1 January 2005 till 21 November 2008. The causes of immunocompromised status were HIV (13/18; 72%), autoimmune disorders requiring immunosuppressive therapy and post-chemotherapy for neoplastic condition. The most frequent clinical indication for PCR testing among the immunocompetent group was hypertensive anterior uveitis (44/81; 54%) and 32% (14/44) of this group were tested positive for CMV. There were also two cases of herpes simplex virus keratouveitis and two toxoplasma chorioretinitis confirmed by PCR in the immunocompetent group. Extensive chorioretinitis (14/19; 74%) was the commonest clinical feature for the immunocompromised group and twelve cases of CMV retinitis, one VZV acute retinal necrosis and one VZV progressive outer retinal necrosis were confirmed with this test. There were no cases that were tested positive for multiple organisms with tetraplex PCR. Out of the 8 vitreous samples collected, three were obtained from HIV host and all three were tested positive for CMV. The remaining five samples from immunocompetent hosts were negative for tetraplex PCR. Tetraplex PCR positivity rate for the immunocompetent group was 20% (16/81) and 79%(15/19) for the immunocompromised group. CMV was the most frequently detected organism for both groups.
Viral related uveitis especially CMV was common and could be confirmed using tetraplex PCR in our local Singapore population. Positivity rate was high especially for immunocompromised hosts. One third of our immunocompetent hypertensive anterior uveitis cases were tested positive for CMV.
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