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Infectious causes of posterior uveitis and panuveitis in Thailand

Natedao Kongyai1, Kessara Pathanapitoon, Wasna Sirirungsi

  • 1Department of Medical Technology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand.

Japanese Journal of Ophthalmology
|April 28, 2012
PubMed
Abstract

Insights

Cytomegalovirus (CMV) and herpes simplex virus (HSV) are key infectious causes of posterior uveitis and panuveitis in HIV-negative Thai patients. PCR analysis of aqueous humor and vitreous samples yielded similar diagnostic results.

Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Molecular Diagnostics

Background:

  • Posterior uveitis (PU) and panuveitis (panU) can be caused by various infectious agents.
  • Accurate diagnosis is crucial for effective treatment of these sight-threatening conditions.

Purpose of the Study:

  • To identify the specific infectious etiologies of posterior uveitis and panuveitis in HIV-negative patients in Thailand.
  • To compare the diagnostic utility of intraocular fluid samples for PCR analysis.

Main Methods:

  • Real-time PCR was used to detect DNA of cytomegalovirus (CMV), herpes simplex virus (HSV-1, HSV-2), and Toxoplasma gondii (T. gondii) in intraocular samples from 80 HIV-negative patients.
  • Goldmann-Witmer coefficient (GWC) analysis for T. gondii was performed in 61 patients.
  • Aqueous humor and vitreous samples were analyzed.

Main Results:

  • Twenty-four (30%) patients tested positive via PCR.
  • Cytomegalovirus (CMV) was the most frequently identified pathogen overall.
  • Herpes simplex virus (HSV) was a common cause, particularly in patients not on immunosuppressive medication. CMV predominated in those on immunosuppressants.
  • CMV was most common in posterior uveitis, while CMV and HSV-2 were most frequent in panuveitis.
  • T. gondii was rarely detected by GWC analysis.
  • PCR results were comparable between aqueous humor and vitreous samples.

Conclusions:

  • Cytomegalovirus (CMV) is the leading infectious cause of posterior uveitis and panuveitis in HIV-negative Thai patients.
  • Intraocular PCR analysis is a valuable tool for diagnosing infectious uveitis.
  • Aqueous humor and vitreous samples offer similar diagnostic accuracy for PCR detection of infectious agents.

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