Usefulness of aqueous and vitreous humor analysis in infectious uveitis

Santos, Helen Nazareth Veloso dos; Ferracioli-Oda, Eduardo; Barbosa, Thaisa Silveira; Otani, Camila Sayuri Vicentini; Tanaka, Tatiana; Silva, Luciane de Carvalho Sarahyba da; Lopes, Guilherme de Oliveira; Doi, Andre; Hirata, Carlos Eduardo; Yamamoto, Joyce Hisae

OBJECTIVE:

To evaluate the role of intraocular fluid analysis as a diagnostic aid for uveitis.

METHODS:

Twenty-eight samples (27 patients including 3 HIV-infected patients) with active (n=24) or non-active (n=4) uveitis were submitted to aqueous (AH; n=12) or vitreous humor (VH) analysis (n=16). All samples were analyzed by quantitative PCR for herpes simplex virus (HSV), varicella zoster virus (VZV), cytomegalovirus (CMV), Epstein-Barr virus (EBV) and Toxoplasma gondii.

RESULTS:

The positivity of the PCR in AH was 41.7% (5/12), with 50% (2/4) in immunocompetent and 67% (2/3) in HIV+ patients. The positivity of the PCR in VH was 31.2% (5/16), with 13% (1/8) in immunocompetent and 50% (4/8) in immunosuppressed HIV negative patients. The analysis was a determinant in the diagnostic definition in 58% of HA and 50% of VH.

CONCLUSION:

Even in posterior uveitis, initial AH analysis may be helpful. A careful formulation of possible clinical diagnosis seems to increase the chance of intraocular sample analysis being meaningful.