Sun Chuan-Bin, Chen Ying, Li Jian, Xiao Qing, Liu Genghao, Liu Zhe
Eye Center, Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, China.
Shaanxi Eye Hospital, Xi'an People's Hospital (Xi'an Fourth Hospital), Affiliated People's Hospital of Northwest University, Xi'an, China.
Ocul Immunol Inflamm. 2024 Jul 30:1-6. doi: 10.1080/09273948.2024.2382914.
To investigate the value of metagenomic next-generation sequencing (mNGS) for virus detection in patients with suspected viral infectious uveitis.
In this retrospective, multicenter case series study, 70 patients with suspected viral infectious uveitis were recruited. All patients underwent mNGS test using intraocular fluid samples and serological screening tests for pathogens. Twelve cases also underwent a PCR panel test for herpetic viruses using intraocular fluid samples; 7 cases also underwent aqueous anti-herpetic viral IgG level tests.
Among 70 patients with suspected viral infectious uveitis, 34 cases were female, mean age was 45.3 years with a range from 6 to 78 years; 53 cases (75.7%) were diagnosed as infectious uveitis, 17 cases (24.3%) diagnosed as non-infectious uveitis. Among 53 cases with infectious uveitis, herpetic viruses, Bartonella henselae, Toxoplasma gondii, and Treponema pallidum were detected in 43, 6, 4, and 1 case, respectively. Among 43 cases with viral infectious uveitis, herpetic virus was detected in 39 cases by mNGS, the other 4 cases showed negative results in mNGS test, but positive results in 2 cases in serological screening tests, in 1 case in PCR, and in 1 case in aqueous anti-herpetic viral IgG level test, respectively. The sensitivity, specificity, positive predictive value, negative predictive value of mNGS in detecting viruses were 90.7%, 100%, 100%, and 81.0%, respectively.
mNGS is a sensitive and valuable method to detect viruses in intraocular fluid samples, and an alternative for pathogen detection in cases with suspected viral infectious uveitis but negative test results in PCR.
探讨宏基因组下一代测序（mNGS）在疑似病毒性感染性葡萄膜炎患者病毒检测中的价值。
在这项回顾性、多中心病例系列研究中，招募了70例疑似病毒性感染性葡萄膜炎患者。所有患者均使用眼内液样本进行mNGS检测，并进行病原体血清学筛查试验。12例患者还使用眼内液样本进行了疱疹病毒PCR检测；7例患者还进行了房水抗疱疹病毒IgG水平检测。
70例疑似病毒性感染性葡萄膜炎患者中，女性34例，平均年龄45.3岁，年龄范围为6至78岁；53例（75.7%）被诊断为感染性葡萄膜炎，17例（24.3%）被诊断为非感染性葡萄膜炎。在53例感染性葡萄膜炎患者中，分别检测到疱疹病毒、汉赛巴尔通体、弓形虫和梅毒螺旋体43例、6例、4例和1例。在43例病毒性感染性葡萄膜炎患者中，mNGS检测到疱疹病毒39例，另外4例mNGS检测结果为阴性，但血清学筛查试验分别有2例、PCR检测有1例、房水抗疱疹病毒IgG水平检测有1例为阳性。mNGS检测病毒的敏感性、特异性、阳性预测值和阴性预测值分别为90.7%、100%、100%和81.0%。
mNGS是检测眼内液样本中病毒的一种敏感且有价值的方法，对于疑似病毒性感染性葡萄膜炎但PCR检测结果为阴性的病例，是病原体检测的一种替代方法。
