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A 13-year retrospective review of polymerase chain reaction testing for infectious agents from ocular samples
Paul P Thompson1, Regis P Kowalski
1Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.
Purpose:
Polymerase chain reaction (PCR) is a molecular technique for the diagnosis of ocular infectious disease. In this large patient sample and multiyear study, the impact of PCR for detecting infectious agents from ocular samples was reviewed in comparison with nonmolecular diagnostic techniques.
Design:
A retrospective laboratory review of PCR testing.
Participants:
Three thousand fifty-six patient samples with a differential of ocular infection.
Methods:
The daily laboratory logs for diagnostic testing were reviewed for PCR, cell culture isolation, shell vial isolation, and Acanthamoeba isolation from January 1997 through May 2010 for herpes simplex virus (HSV), adenovirus, varicella zoster virus (VZV), Chlamydia trachomatis, Acanthamoeba, and infrequent pathogens of intraocular inflammation.
Main Outcome Measures:
Incidence of the positive presence of ocular infectious agents.
Results:
Polymerase chain reaction results were positive more often than culture results for HSV (P = 0.0001), VZV (P = 0.00001), C. trachomatis (P = 0.00005), and Acanthamoeba (P = 0.04). For adenovirus, cell culture isolation results were positive more often than PCR results (P = 0.001). Polymerase chain reaction was the primary diagnostic test for detecting cytomegalovirus and Toxoplasma.
Conclusions:
The current study demonstrated the importance of PCR as a routine diagnostic test for detecting both common and infrequent ocular pathogens. Cell culture isolation is still a definitive test for adenovirus and a confirmatory test for HSV and Acanthamoeba.
Insights
Polymerase chain reaction (PCR) is a valuable diagnostic tool for ocular infections, detecting more pathogens than traditional methods. While PCR excels for many agents, cell culture remains crucial for adenovirus diagnosis.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Molecular Diagnostics
Background:
- Ocular infectious diseases require accurate and timely diagnosis.
- Traditional diagnostic methods include cell culture and isolation techniques.
- Molecular techniques like PCR offer potential advancements in pathogen detection.
Purpose of the Study:
- To evaluate the impact and effectiveness of Polymerase Chain Reaction (PCR) in diagnosing ocular infections.
- To compare PCR diagnostic performance against non-molecular methods using a large patient sample over multiple years.
Main Methods:
- A retrospective laboratory review of diagnostic testing data from January 1997 to May 2010.
- Analysis of 3,056 patient samples with suspected ocular infections.
- Comparison of PCR results with cell culture, shell vial isolation, and Acanthamoeba isolation for various pathogens including HSV, adenovirus, VZV, C. trachomatis, and Acanthamoeba.
Main Results:
- PCR demonstrated higher positive detection rates than culture for herpes simplex virus (HSV), varicella zoster virus (VZV), Chlamydia trachomatis, and Acanthamoeba.
- Cell culture isolation was more effective than PCR for detecting adenovirus.
- PCR served as the primary diagnostic method for cytomegalovirus and Toxoplasma detection.
Conclusions:
- Polymerase chain reaction (PCR) is essential for routine diagnosis of common and rare ocular pathogens.
- Cell culture remains a definitive method for adenovirus and a confirmatory test for HSV and Acanthamoeba.
