Abstract
Purpose :
To determine the rate of positivity, time to diagnosis and visual outcomes in patients with uveitis undergoing diagnostic anterior chamber tap (AC tap) at a tertiary care center.
Methods :
A retrospective review from a uveitis registry of patients who had an AC tap at the University of Illinois from 2015 to 2018 was performed. Demographic information, AC tap results, time to diagnosis (symptom onset to AC tap), and visual acuity (VA) at presentation, 1 and 6 month follow up were recorded.
Results :
Twelve patients underwent AC taps: 6 anterior uveitis, 4 panuveitis and 2 posterior uveitis. The mean age was 53 years, 50% were male, and 50% were African American.
Four patients had positive AC taps (33.3%): 2 CMV (1 anterior, 1 panuveitis/ acute retinal necrosis (ARN) and 2 HSV (1 anterior, 1 posterior/ARN). Fifty percent of AC tap positive patients were male and African American.
Average time to diagnosis (with standard deviation) was 124.6±191.0 days. Average time to diagnosis was not significantly different (p=0.71) between patients with positive and negative tap results (139.9 ± 228.1 and 94.0 ± 102.3, respectively).
At the time of AC tap, 4 patients were on oral or topical antimicrobial therapy (valacyclovir, moxifloxacin, ofloxacin, and erythromycin): 3 negative and 1 positive AC tap. With positive AC tap, 3 were on immunosuppressive therapy. In total, 8 patients were on corticosteroids (4 systemic). All 12 had a change in management following AC tap; antiviral agents were added in all with positive AC tap. In AC tap negative patients, 5 added or increased corticosteroids, 3 added antimicrobials, 1 discontinued antivirals, and 1 discontinued corticosteroids.
The mean logMAR VA (with standard deviation) at presentation, 1 and 6 month follow up was 0.75± 0.70, 0.59±0.62, and 0.53±0.54, respectively, among all patients. There was no significant difference in mean logMAR VA at presentation, 1 and 6 month follow up between patients with positive (0.68, 0.74, 0.66, respectively) and negative (0.79, 0.55, 0.45) taps (p=0.78, 0.76, 0.44).
There was no significant difference between initial, 1 and 6 month visit mean logMAR VA when grouped by type of uveitis (anterior, posterior, or panuveitis).
Conclusions :
Although AC taps had a relatively low rate of positivity, change in management following AC tap was seen with all patients. Further study is needed determine significant characteristics between AC tap positive and negative groups.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.