Department of Ophthalmology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
Retina. 2022 Aug 1;42(8):1560-1567. doi: 10.1097/IAE.0000000000003491.
To evaluate the value of the β- d -glucan (BDG) testing of intraocular fluid for the diagnosis of fungal endophthalmitis (FE).
Twenty patients (22 eyes) with FE were diagnosed using both culture and nonculture methods. Intraocular fluid was collected for BDG testing, including 22 eyes of FE and 55 eyes of control group. Under different BDG cutoff points as the test-positives, the BDG sensitivity, specificity, positive predictive value, and negative predictive value for FE were analyzed.
The BDG testing value was 1,022.78 ± 1,362.40 pg/mL in the FE group, significantly higher than that of the control group (105.0 ± 180.80 pg/mL, P < 0.001). The area under the receiver operating characteristic (ROC) curve was 0.885 (95% confidence interval, 0.793-0.978; P < 0.001). With the prespecified BDG cutoff 107.83 pg/ml as the test-positive, sensitivity was 81.8%, specificity was 87.5%, and the Youden index was 0.693. When the BDG cutoff was depicted as 202.05 pg/mL, sensitivity reduced to 77.3%, specificity increased at 95.8%, and the Youden index reached the highest value of 0.731.
β- d -glucan testing of intraocular fluid demonstrated good sensitivity and specificity regarding the diagnosis of FE, which can provide earlier diagnosis to achieve better outcomes.
评估眼内液β-D-葡聚糖（BDG）检测在真菌性眼内炎（FE）诊断中的价值。
采用培养和非培养方法联合诊断 20 例（22 只眼）FE 患者。收集眼内液进行 BDG 检测，包括 22 只 FE 眼和 55 只对照组眼。以不同的 BDG 截断值作为阳性测试，分析 BDG 对 FE 的敏感性、特异性、阳性预测值和阴性预测值。
FE 组眼内液 BDG 检测值为 1022.78±1362.40 pg/mL，明显高于对照组（105.0±180.80 pg/mL，P<0.001）。受试者工作特征（ROC）曲线下面积为 0.885（95%置信区间，0.793-0.978；P<0.001）。以预设的 BDG 截断值 107.83 pg/ml 作为阳性测试，敏感性为 81.8%，特异性为 87.5%，约登指数为 0.693。当 BDG 截断值描绘为 202.05 pg/ml 时，敏感性降至 77.3%，特异性增至 95.8%，约登指数达到最高值 0.731。
眼内液 BDG 检测对 FE 的诊断具有良好的敏感性和特异性，有助于早期诊断，改善治疗效果。
