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Janet L Davis, Sulaiman Alhumaid; Polymerase Chain Reaction for the Diagnosis of Chorioretinal Infections: Comparative Study of Testing in a Single Institution. Invest. Ophthalmol. Vis. Sci. 2019;60(9):823.
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© ARVO (1962-2015); The Authors (2016-present)
To compare the patient characteristics and test results of PCR testing of intraocular fluids in two cohorts of patients with posterior inflammation from a single institution acquired 10 years apart.
Case logs from the Microbiology Lab were reviewed to identify patients with posterior segment inflammation who underwent PCR testing of intraocular fluids from January 2015 to December 2016. Information collected included sample type, tests performed, test results, patient demographics, vision, treatment, final diagnosis and outcome. Results were compared to an earlier published series with similar methods from the same institution to determine whether trends in utilization, diagnosis or testing efficiency were occurring.
Utilization increased between the two series, with 96 patients tested per year in the later series versus 26 patients per year in the earlier series. Simultaneously the frequency of obtaining a positive result fell by more than 50%. Patients with HIV and other types of immunocompromise accounted for double the proportion of cases in the earlier series. Mean vision was approximately twice as good in the later series as in the earlier series, both at presentation and during follow up. Examination of the final diagnoses suggests that more patients with keratitis, iridocyclitis and severe panuveitis were tested in the later series whereas the earlier series had more patients with chorioretinitis. In terms of absolute numbers of infections, there appeared to be more positive tests for herpes simplex viruses and toxoplasmosis per year in the later series.
The results suggest that the test is being overutilized. Adhering to guidelines for PCR testing in patients who are most at risk for infection will improve the efficiency of the test and reduce waste.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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