眼房水和玻璃体分析在感染性葡萄膜炎中的作用。
Usefulness of aqueous and vitreous humor analysis in infectious uveitis.
机构信息
Servico de Uveites, Departmento de Oftalmologia, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR.
Secao de Biologia Molecular, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, SP, BR.
出版信息
Clinics (Sao Paulo). 2020 Jan 24;75:e1498. doi: 10.6061/clinics/2020/e1498. eCollection 2020.
OBJECTIVE
To evaluate the role of intraocular fluid analysis as a diagnostic aid for uveitis.
METHODS
Twenty-eight samples (27 patients including 3 HIV-infected patients) with active (n=24) or non-active (n=4) uveitis were submitted to aqueous (AH; n=12) or vitreous humor (VH) analysis (n=16). All samples were analyzed by quantitative PCR for herpes simplex virus (HSV), varicella zoster virus (VZV), cytomegalovirus (CMV), Epstein-Barr virus (EBV) and Toxoplasma gondii.
RESULTS
The positivity of the PCR in AH was 41.7% (5/12), with 50% (2/4) in immunocompetent and 67% (2/3) in HIV+ patients. The positivity of the PCR in VH was 31.2% (5/16), with 13% (1/8) in immunocompetent and 50% (4/8) in immunosuppressed HIV negative patients. The analysis was a determinant in the diagnostic definition in 58% of HA and 50% of VH.
CONCLUSION
Even in posterior uveitis, initial AH analysis may be helpful. A careful formulation of possible clinical diagnosis seems to increase the chance of intraocular sample analysis being meaningful.
目的
评估眼内液分析在葡萄膜炎诊断中的作用。
方法
27 例（3 例为 HIV 感染者）活动性（n=24）或非活动性（n=4）葡萄膜炎患者的 28 份样本（包括 28 份样本）分别进行房水（AH；n=12）或玻璃体分析（n=16）。所有样本均采用定量 PCR 法检测单纯疱疹病毒（HSV）、水痘带状疱疹病毒（VZV）、巨细胞病毒（CMV）、EB 病毒（EBV）和刚地弓形虫。
结果
AH 中 PCR 的阳性率为 41.7%（5/12），免疫功能正常者为 50%（2/4），HIV 阳性者为 67%（2/3）。VH 中 PCR 的阳性率为 31.2%（5/16），免疫功能正常者为 13%（1/8），免疫抑制 HIV 阴性患者为 50%（4/8）。分析结果在 58%的 HA 和 50%的 VH 中有助于确定诊断。
结论
即使是后部葡萄膜炎，初始 AH 分析也可能有帮助。仔细制定可能的临床诊断似乎可以增加眼内样本分析有意义的机会。
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