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Presentation preference Poster and Rapid fire
TitleUtility of aqueous PCR in HIV/AIDS with atypical posterior/panuveitis
PurposeOcular inflammation in HIV/AIDS can be due to opportunistic infections(OI), drugs, HIV or immune recovery uveitis(IRU). Atypical manifestations leads to diagnostic dilemma. To evaluate utility of polymerase chain reaction(PCR) of aqueous in diagnosis and management of presumed infectious uveitis in HIV/AIDS patients with atypical posterior/panuveitis
MethodsRetrospective analysis of clinical characteristics, lab results and outcome of HIV patients seen between 2010-2019 with atypical posterior/panuveitis, who underwent PCR analysis of aqueous aspirate at a tertiary care eye hospital. Patients with classical clinical presentations-excluded
ResultsThirty seven patients-included. Two patients with hypopyon uveitis were managed as immune recovery uveitis(IRU) and rifabutin induced uveitis after PCR ruled out infection. In 12 patients with clinical suspicion of CMV retinitis, PCR-CMV positive in 7(59%). In 9 patients with panuveitis. PCR-VZV positive in 3(33%), PCR-CMV in 2 and PCR negative in 4(serology and systemic results confirmed ocular syphilis in 3 and tuberculosis(TB) in 1). In 3 patients with clinical diagnosis of toxoplasmosis, PCR-toxoplasma gondii positive in 1. In 4 patients with presumed ocular TB, PCR-MTB positive in 1. With adjunctive use of PCR, serology and systemic results, confirmed diagnosis was made in 84% patients. Modified therapy translated into improved/stable vision in 62%
ConclusionOcular inflammation with atypical presentations, clinical features alone is insufficient. PCR of aqueous helps clinch diagnosis. Appropriate management leads to improved inflammatory and visual outcome avoiding unnecessary surgical intervention
Conflict of interestNo
Author 1
Initials of first name(s)S
Author 2
Last nameMohanan
Initials of first name(s)A
Author 3
Last nameDhanurekha
Initials of first name(s)L