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S.G. Baarsma, T.O. Missotten, R.W. Kuijpers, G.M. G. M. Verjans; PCR and Goldmann–Witmer Coefficient : Diagnostic Value in Uveitis of Suspected Infectious Origin . Invest. Ophthalmol. Vis. Sci. 2005;46(13):2383.
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© ARVO (1962-2015); The Authors (2016-present)
Purpose: In order to confirm suspected intra–ocular infection PCR, Culture and Antigen/Antibody detection methods have been advocated. In acute retinal necrosis (ARN) and parasitic ocular infections the additional benefit of determining the Goldmann–Witmer Coefficient (GWC) has been reported. GWC could be a useful tool in other uveitis of suspected infectious origin. Methods: In 92 patients with suspected infectious uveitis, work–up included aqueous or vitreous PCR and GWC calculation. Sampling was repeated in 8 eyes (total n samples = 100). Correlation analysis between clinical diagnosis, PCR and GWC results was performed. Results: Clinical diagnosis prior to sampling was ARN (37) / not–ARN (63). Not–ARN diagnosis included kerato–uveitis (4), anterior uveitis with iris sector atrophy (30) , posterior segment uveitis (26) and post–transplant CMV retinitis (3). 62% samples had a positive PCR, compared to 48% for GWC. In the 8 repeat samples, PCR was negative in 3 samples and confirmed previous results in 5 cases. Repeat GWC confirmed previous results in 4 samples, 3 samples showed additional herpetic AB production and 1 sample had a conflicting GWC (1st GWC HSV +ve, 2nd GWC VZV +ve). In the ARN group GWC revealed an additional 8% herpetic origin in PCR negative samples, and 14% additional herpetic origin in samples that were PCR toxoplasmosis positive. In the not–ARN group, GWC revealed an additional 13% herpetic origin in PCR negative samples and 3% additional herpetic origin in samples that were PCR toxoplasmosis positive. 8 samples showed different herpetic species results between PCR and GWC. Conclusions: In this group of uveitis of suspected infectious origin PCR seems to have a higher positive yield (62%) in comparison to GWC (48%). However GWC showed an additional herpetic presence in 22% (ARN group) and 16% (not–ARN group) of samples. This study demonstrates the complementary value of GWC in uveitis work–up of selected patients.
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