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M. Asseraf, E. Delair, H. Talabani, A. Brezin; Ocular Toxoplasmosis : Biologic Tests in Aqueous Humor. Invest. Ophthalmol. Vis. Sci. 2008;49(13):972.
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To determine the contribution of aqueous humor analysis in the diagnosis of ocular toxoplasmosis in a cohort of patients with infectious retinochoroiditis.
Patients presenting infectious uveitis were followed in a single referral center between 2002 and 2007. To establish the causes of uveitis, patients underwent full ophthalmologic examination and laboratory blood analysis. When the causes of uveitis remained uncertain, aqueous humor analyses were performed using polymerase chain reaction (PCR), Desmont coefficient (DC) and Western Blot (WB). The diagnosis of ocular toxoplasmosis was made when at least one biologic test was positive or when clinical evolution was typical.We studied the influence of two parameters on the results of aqueous humor analyse : the delay between first clinical manifestations and aqueous humor analyse, and the retinochoroiditis size.
The origin of uveitis was infectious in 45 patients and ocular toxoplasmosis was the cause of the infection in 30.Among these 30 patients, DC, PCR and WB were respectively positive in 15, 14 and 11 patients. Four patients had 3 positive tests, 9 patients 2 positive tests, 9 patients 1 positive tests, 7 patients had no positive tests.Positive results with PCR were correlated with retinochoroiditis size and were more sensitive in immunocompromised patients.If we considered PCR+ group and PCR- group, no significant statistical difference (SDD) was found concerning the delay of aqueous humor analyse whereas there was a SSD concerning the retinochoroiditis size.If we considered WB + group and WB - group : no SDD was found concerning the delay of aqueous humor analyse neither concerning the retinochoroiditis size.If we considered DC + group and DC - group : a SDD was found concerning the delay of aqueous humor analyse but not concerning the retinochoroiditis size.If we considered immunocompromised group and immunocompetent group : no SDD was found concerning the delay of aqueous humor analyse whereas there was a SSD concerning the retinochoroiditis size.
In immunocompromised patients, the retinochoroiditis size is more important than in immunocompetent patients and PCR is more helpful to diagnose ocular toxoplasmosis.
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