Institut de Parasitologie et Pathologie Tropicale, Université de Strasbourg, Strasbourg, France
Institut de Parasitologie et Pathologie Tropicale, Université de Strasbourg, Strasbourg, France.
mSphere. 2019 Sep 25;4(5):e00636-19. doi: 10.1128/mSphere.00636-19.
Ocular toxoplasmosis (OT), i.e., the ocular manifestation of infection, is one of the leading causes of posterior uveitis. While ocular lesions are often typical, atypical forms often require biological confirmation of the diagnosis. Our study sought to review the biological OT diagnoses made in our laboratory to further assess the role of each test in the diagnostic procedure. All ocular samples sent to our laboratory over the last 9 years for OT diagnosis were included. These samples were analyzed using PCR and antibody detection by means of immunoblotting and Candolfi coefficient (CC) determinations, either alone or in combination. Since serum analysis is required to interpret both the CC and immunoblotting, blood serology for was also performed in most cases. Of the 249 samples analyzed, 80 (32.1%; 95% confidence interval [95%CI], 26.3 to 37.9) were positive for OT. Of these 80 cases, 52/80 (65.0%; 54.6 to 74.5) displayed a positive PCR, 15/80 (18.8%; 10.2 to 27.3) a positive CC, and 33/80 (41.3%; 95%CI, 30.5 to 52.0) a positive immunoblot result. Overall, 63 of the 80 OT diagnoses (78.8%; 95%CI, 69.8 to 87.7) were made on the basis of a single positive test result. Our study results remind us that current biological diagnostic tools for OT must be employed in combination to obtain an optimal diagnosis based on the precious ocular fluids sampled by ophthalmologists. Clinicobiological studies that are focused on correlating the performances of the different tests with clinical features are critically needed to improve our understanding of the pathophysiology and diagnosis of OT. Ocular toxoplasmosis (OT), a parasitic infection of the eye, is considered to be the most important infectious cause of posterior uveitis worldwide. Its prevalence is particularly high in South America, where aggressive strains are responsible for more-severe presentations. The particular pathophysiology of this infection leads, from recurrence to recurrence, to potentially severe vision impairment. The diagnosis of this infection is usually exclusively based on the clinical examination. However, the symptoms may be misleading and are not always sufficient to confirm a diagnosis of OT. In such cases, biological tests performed by means of several techniques on blood and ocular samples may facilitate the diagnosis. In this study, we analyzed the tests that were performed in our laboratory over a 9-year period every time OT was suspected. Our report highlights that the quality of ocular sampling by ophthalmologists and combinations of several techniques are critical for a reliable biological OT diagnosis.
眼弓形体病（OT），即感染的眼部表现，是后葡萄膜炎的主要原因之一。虽然眼部病变通常具有特征性，但不典型形式通常需要生物学确证诊断。我们的研究旨在回顾我们实验室做出的眼部弓形体病生物学诊断，以进一步评估每种检测在诊断程序中的作用。本研究纳入了过去 9 年中因 OT 诊断而送到我们实验室的所有眼部样本。使用聚合酶链反应（PCR）和免疫印迹法以及坎道夫系数（CC）测定法单独或联合检测这些样本。由于需要对血清进行分析以解释 CC 和免疫印迹法，因此在大多数情况下还对血清进行了针对 的血清学分析。在分析的 249 个样本中，80 个（32.1%；95%置信区间[95%CI]，26.3%至 37.9%）为 OT 阳性。在这 80 个病例中，52/80（65.0%；54.6%至 74.5%）PCR 阳性，15/80（18.8%；10.2%至 27.3%）CC 阳性，33/80（41.3%；95%CI，30.5%至 52.0%）免疫印迹阳性。总体而言，80 例 OT 诊断中的 63 例（78.8%；95%CI，69.8%至 87.7%）基于单一阳性检测结果做出。我们的研究结果提醒我们，目前用于 OT 的生物学诊断工具必须联合使用，以便根据眼科医生采集的珍贵眼部液体获得最佳诊断。迫切需要针对不同检测方法与临床特征的相关性进行临床生物学研究，以增进我们对 OT 的病理生理学和诊断的理解。眼弓形体病（OT）是一种眼部寄生虫感染，被认为是全球最重要的传染性后葡萄膜炎病因。其流行率在南美洲特别高，那里侵袭性 株导致更严重的表现。这种感染的特殊病理生理学导致反复发作，可能导致严重的视力损害。这种感染的诊断通常仅基于临床检查。然而，症状可能具有误导性，并不总是足以确认 OT 的诊断。在这种情况下，通过几种技术在血液和眼部样本上进行的生物学测试可能有助于诊断。在这项研究中，我们分析了在过去 9 年中每次怀疑 OT 时在我们实验室进行的测试。我们的报告强调了眼科医生进行眼部采样的质量和几种技术的组合对于可靠的眼部弓形体病生物学诊断至关重要。
