Polymerae Chain Reaction and Goldmann-Witmer Coefficient Analyi Are Complimentary for the Diagnoi of Infectiou Uveiti

Purpoe To determine the relative contribution of the analyi of intraocular antibody production and the polymerae chain reaction (PCR) in aqueou humor (AH) to the diagnoi of infectiou uveiti. Deign Retropective cae-control tudy. Method Paired AH and erum ample from 230 patient upected of infectiou uveiti were examined for intraocular antibody production againt herpe implex viru (HV), varicella zoter viru (VZV), and Toxoplama gondii by calculating the Goldmann-Witmer coefficient (GWC). In addition, AH ample were invetigated by real-time PCR to determine the preence of microbial DNA. Reult Poitive reult were obtained in 54 cae (23%): 13 HV (24%), 16 VZV (30%), and 25 T gondii (46%). Of thee, 23 (43%) were poitive for both GWC and PCR, 26 (48%) only for GWC, and 5 (9%) only for PCR. With PCR a the ole diagnotic approach, a correct diagnoi of the infectiou etiology would have been mied in 34% of cae for the herpe virue and in 64% for T gondii. Analyi of the relationhip between a poitive laboratory diagnoi and the time of ampling after onet of ocular dieae demontrated that intraocular antibody production wa found throughout the coure of the dieae. Viral DNA wa more readily detected early in infection. In contrat, T gondii nucleic acid wa not detected until 3 week after onet of ocular dieae. Concluion Analyi of intraocular antibody production contributed coniderably to the etiological diagnoi of infectiou uveiti, mot notably of ocular toxoplamoi early after onet of dieae. Therefore, both PCR and GWC determination might be performed for comprehenive diagnoi of intraocular infection.