Kijlstra A, van den Horn G J, Luyendijk L, Baarsma G S, Schweitzer C M, Zaal M J, Timmerman Z, Beintema M, Rothova A
The Netherlands Ophthalmic Research Institute, Amsterdam.
Doc Ophthalmol. 1990 Oct;75(3-4):225-31. doi: 10.1007/BF00164835.
Analysis of local intraocular antibody production is a valuable tool with which to confirm a suspected clinical diagnosis in uveitis. We have analysed paired serum and aqueous samples for the presence of specific antibodies against toxoplasma, cytomegalovirus, herpes simplex virus and varicella zoster virus. Of the patients retrospectively diagnosed as having toxoplasma chorioretinitis 75% had a positive antibody coefficient indicating specific antibody production in the eye. Local antibody production in the eye directed against CMV confirmed the suspected diagnosis of CMV retinitis in 50% of the AIDS patients investigated. So far we have not been able to demonstrate local antibody production against herpes simplex virus (26 samples tested). Two of three patients with acute retinal necrosis had a positive antibody coefficient against varicella zoster virus. Both of these patients had an even higher titer in the aqueous than in serum. Since the choice of therapy, in infectious uveitis, depends on the causative organisms, it is very important to confirm a suspected clinical diagnosis by means of aqueous humor analysis.
分析眼内局部抗体产生情况是一种有价值的工具，可用于确诊葡萄膜炎疑似临床诊断。我们分析了配对的血清和房水样本，以检测针对弓形虫、巨细胞病毒、单纯疱疹病毒和水痘带状疱疹病毒的特异性抗体。在回顾性诊断为弓形虫脉络膜视网膜炎的患者中，75%的患者抗体系数呈阳性，表明眼部有特异性抗体产生。在接受调查的50%艾滋病患者中，眼部针对巨细胞病毒产生的局部抗体证实了疑似巨细胞病毒视网膜炎的诊断。到目前为止，我们尚未在检测的26份样本中证明眼部针对单纯疱疹病毒产生局部抗体。在三例急性视网膜坏死患者中，有两例针对水痘带状疱疹病毒的抗体系数呈阳性。这两名患者房水中的滴度甚至高于血清中的滴度。由于感染性葡萄膜炎的治疗选择取决于致病微生物，因此通过房水分析确诊疑似临床诊断非常重要。
