The impact of aqueous humor polymerase chain reaction and serological test results for establishing infectious uveitis diagnosis: An Indonesian experience

• Published in: Heliyon 2022-10, Vol.8 (10), p.e10988, Article e10988
• Main Authors: 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
• Format: Article
• Language: English
• Subjects: antibodies; Aqueous humor; cohort studies; Cytomegalovirus; etiology; herpes simplex; Human alphaherpesvirus 3; Human gammaherpesvirus 4; Immunoglobulin; immunologic techniques; Indonesia; Infectious uveitis; Mycobacterium tuberculosis; Polymerase chain reaction; quantitative polymerase chain reaction; reverse transcriptase polymerase chain reaction; Rubella virus; Serum; Toxoplasma; toxoplasmosis; viruses
• ISSN: 2405-8440; 2405-8440
• DOI: 10.1016/j.heliyon.2022.e10988

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 Mycobacterium tuberculosis, Toxoplasmosis gondii, 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. Aqueous humor; Infectious uveitis; Polymerase chain reaction; Immunoglobulin; Serum.