Putera Ikhwanuliman, La Distia Nora Rina, Utami Nunik, Karuniawati Anis, Yasmon Andi, Wulandari Dewi, Edwar Lukman, Susiyanti Made, Aziza Yulia, Jessica Priscilla, Riasanti Mei, Sitompul Ratna
Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia - Cipto Mangunkusumo Kirana Eye Hospital, Jakarta, Indonesia.
Department of Immunology, Erasmus Medical Center, Rotterdam, the Netherlands.
Heliyon. 2022 Oct 8;8(10):e10988. doi: 10.1016/j.heliyon.2022.e10988. eCollection 2022 Oct.
To assess the clinical value of aqueous humor real-time polymerase chain reaction (RT-PCR) and serological antibody tests among uveitis patients in Indonesian cohort.
In this prospective cohort study, single-plex RT-PCR analysis of aqueous samples from 86 new uveitis patients was performed to detect , , cytomegalovirus, herpes simplex virus, varicella-zoster virus, Epstein-Barr virus, and rubella virus. Specific serological antibodies for suspected pathogens were also obtained. Comparison of PCR and serological antibodies with the initial and final diagnosis were presented.
The diagnostic positivity of aqueous RT-PCR in our cohort was 20% (17/86). The rate of infection as final etiological classification was higher after RT-PCR was performed (45 patients, 52%) compared to initial diagnosis based on clinical presentation alone (38 patients, 44%). In particular, the RT-PCR positivity among patients with infection as the final etiological classification was 33.33% (15/45). A significant difference in the IgG but not IgM toxoplasma value among those with ocular toxoplasmosis as the final diagnosis compared to the other etiologies were observed (3953 (IQR 2707-19562) IU/mL vs 428 (IQR 82-1807) IU/mL; p < 0.0001).
RT-PCR analysis of aqueous fluid from uveitis patients helped confirm a third of infectious uveitis cases in Indonesia. In ocular toxoplasmosis, high IgG but not IgM antibody value might help differentiate those with other etiology.
评估实时聚合酶链反应（RT-PCR）检测房水及血清学抗体检测在印度尼西亚葡萄膜炎患者队列中的临床价值。
在这项前瞻性队列研究中，对86例新发葡萄膜炎患者的房水样本进行单重RT-PCR分析，以检测 、 、巨细胞病毒、单纯疱疹病毒、水痘-带状疱疹病毒、EB病毒和风疹病毒。还获取了针对可疑病原体的特异性血清学抗体。将PCR和血清学抗体结果与初始诊断和最终诊断进行比较。
我们队列中房水RT-PCR的诊断阳性率为20%（17/86）。与仅基于临床表现的初始诊断（38例患者，44%）相比，进行RT-PCR后作为最终病因分类的感染率更高（45例患者，52%）。特别是，以感染作为最终病因分类的患者中RT-PCR阳性率为33.33%（15/45）。与其他病因相比，最终诊断为眼弓形虫病的患者中，IgG弓形虫值有显著差异，但IgM无显著差异（3953（四分位间距2707 - 19562）IU/mL对428（四分位间距82 - 1807）IU/mL；p < 0.0001）。
对葡萄膜炎患者的房水进行RT-PCR分析有助于在印度尼西亚确诊三分之一的感染性葡萄膜炎病例。在眼弓形虫病中，高IgG但非IgM抗体值可能有助于鉴别其他病因的患者。
