Scholarlink

Purpose <p>To evaluate the diagnostic utility and real-world clinical impact of polymerase chain reaction (PCR) analysis of aqueous humor (AH) and vitreous samples in patients with uveitis including suspected infectious and mixed (infectious/non-infectious) etiologies. Although intraocular PCR is a well-established diagnostic technique, its contribution to diagnostic revision and clinical decision-making in routine practice remains incompletely characterized. This study addresses this gap by assessing the impact of PCR on diagnostic revision, clinical management and regional epidemiological patterns in a tertiary referral center in Turkey.</p> Methods <p>A retrospective review was conducted on 45 eyes of 45 patients with uveitis. PCR testing was performed on AH (<i>n</i> = 24) and vitreous samples (<i>n</i> = 21) for <i>Herpes simplex virus</i> (HSV), <i>Varicella zoster virus</i> (VZV), <i>Cytomegalovirus</i> (CMV), <i>Toxoplasma gondii</i>, and <i>Mycobacterium tuberculosis</i> based on clinical suspicion. Pathogen-specific uniplex real-time PCR assays providing qualitative and quantitative results were used. PCR findings were evaluated in conjunction with clinical presentation to assess their contribution to diagnostic revision, diagnostic certainty, and clinical management.</p> Results <p>The mean patient age was 47.4 ± 17.3 years, and 51.1% of the patients were female; 28.9% were immunosuppressed. Overall PCR positivity was 42.2% (19/45). PCR positivity was higher in immunosuppressed patients than in immunocompetent patients (62.0% vs. 34.4%), although this difference did not reach statistical significance (<i>p</i> = 0.094). PCR positivity was higher in AH samples than in vitreous samples (50.0% vs. 33.3%). PCR analysis led to diagnostic revision in 33.3% (15/45) of patients and influenced clinical management decisions in 80.0% of cases. Positive PCR results were significantly associated with diagnostic certainty (<i>p</i> = 0.006), whereas PCR-negative patients had a markedly higher likelihood of requiring diagnostic and therapeutic modification compared to PCR-positive patients (OR 21.0, 95% CI 2.4–182, <i>p</i> = 0.001).</p> Conclusion <p>PCR analysis of intraocular fluids provides meaningful diagnostic value in the evaluation of uveitis. Both positive and negative results inform clinical decision-making by guiding diagnostic revision and supporting appropriate management strategies. These findings provide region-specific epidemiological data and reinforce intraocular PCR as a key adjunct in complex uveitis cases where clinical features alone are insufficient.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Diagnostic and therapeutic impact of PCR in uveitis: real-world data from intraocular fluid analysis of 45 uveitis patients in a tertiary referral center in Turkey

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年6月22日

查看全文
  • Nilüfer Zorlutuna Kaymak,
  • İpek Pekel,
  • Serap Demir Tekol,
  • Güzide Akçay,
  • Murat Oklar,
  • Burak Tanyıldız

摘要

Purpose

To evaluate the diagnostic utility and real-world clinical impact of polymerase chain reaction (PCR) analysis of aqueous humor (AH) and vitreous samples in patients with uveitis including suspected infectious and mixed (infectious/non-infectious) etiologies. Although intraocular PCR is a well-established diagnostic technique, its contribution to diagnostic revision and clinical decision-making in routine practice remains incompletely characterized. This study addresses this gap by assessing the impact of PCR on diagnostic revision, clinical management and regional epidemiological patterns in a tertiary referral center in Turkey.

Methods

A retrospective review was conducted on 45 eyes of 45 patients with uveitis. PCR testing was performed on AH (n = 24) and vitreous samples (n = 21) for Herpes simplex virus (HSV), Varicella zoster virus (VZV), Cytomegalovirus (CMV), Toxoplasma gondii, and Mycobacterium tuberculosis based on clinical suspicion. Pathogen-specific uniplex real-time PCR assays providing qualitative and quantitative results were used. PCR findings were evaluated in conjunction with clinical presentation to assess their contribution to diagnostic revision, diagnostic certainty, and clinical management.

Results

The mean patient age was 47.4 ± 17.3 years, and 51.1% of the patients were female; 28.9% were immunosuppressed. Overall PCR positivity was 42.2% (19/45). PCR positivity was higher in immunosuppressed patients than in immunocompetent patients (62.0% vs. 34.4%), although this difference did not reach statistical significance (p = 0.094). PCR positivity was higher in AH samples than in vitreous samples (50.0% vs. 33.3%). PCR analysis led to diagnostic revision in 33.3% (15/45) of patients and influenced clinical management decisions in 80.0% of cases. Positive PCR results were significantly associated with diagnostic certainty (p = 0.006), whereas PCR-negative patients had a markedly higher likelihood of requiring diagnostic and therapeutic modification compared to PCR-positive patients (OR 21.0, 95% CI 2.4–182, p = 0.001).

Conclusion

PCR analysis of intraocular fluids provides meaningful diagnostic value in the evaluation of uveitis. Both positive and negative results inform clinical decision-making by guiding diagnostic revision and supporting appropriate management strategies. These findings provide region-specific epidemiological data and reinforce intraocular PCR as a key adjunct in complex uveitis cases where clinical features alone are insufficient.