The diagnostic significance of enzyme linked immuno-sorbent assay for herpes simplex, varicella zoster and cytomegalovirus retinitis.
OBJECTIVE
To evaluate the diagnostic usefulness of enzyme linked immuno-sorbent assay (ELISA) in single serum samples to associate herpes simplex virus (HSV), varicella zoster virus (VZV) or cytomegalovirus (CMV) with viral retinitis as against polymerase chain reaction (PCR) on intraocular specimens. It was also designed to study the seroprevalence in normal healthy individuals, and the genomic prevalence of HSV, VZV and CMV in patients without an active viral inflammatory process.


METHODS
PCR for the detection of HSV, VZV and CMV genomes was done on 33 and 90 intraocular fluids from viral retinal patients and non-viral controls respectively. ELISA was done on 30 and 100 serum samples from viral retinitis patients and normal healthy controls respectively.


RESULTS
PCR did not detect HSV, VZV and CMV genomes except one, in which VZV-DNA was detected. ELISA showed prevalence rates of 28%, 83% and 90% for antibodies against HSV, VZV and CMV respectively in the normal population. In the 30 viral retinitis patients, PCR detected HSV-DNA in 2 (6.7%), VZV-DNA in 7 (23.3%) and CMV-DNA in 6 (20.0%) patients, while ELISA detected antibodies against HSV, VZV and CMV in 13 (43.3%), 24 (80.0%) and 23 (76.7%) patients respectively. ELISA was of value in indirect diagnosis only in 6 (20.0%) as compared to 15 (50.0%) of 30 patients by PCR, this difference was statistically significant (McNemar test, P value = 0.005).


CONCLUSIONS
Serology by ELISA is no longer a useful diagnostic tool to associate HSV, VZV and CMV viruses with viral retinitis.
Madhavan
Hajib N
HN
L & T Microbiology Centre, Vision Research Foundation, Sankara Nethralaya, Chennai, India. drhnm@sankaranethralaya.org
Priya
Kannian
K
D000293:Adolescent; D000328:Adult; D000914:Antibodies, Viral / Q000097:blood*; D001082:Aqueous Humor / Q000821:virology; D003587:Cytomegalovirus / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D017726:Cytomegalovirus Retinitis / Q000175:diagnosis* / Q000276:immunology / Q000821:virology; D004279:DNA, Viral / Q000032:analysis; D004797:Enzyme-Linked Immunosorbent Assay; D015828:Eye Infections, Viral / Q000175:diagnosis / Q000276:immunology / Q000821:virology; D016679:Genome, Viral; D006561:Herpes Simplex / Q000175:diagnosis* / Q000276:immunology / Q000821:virology; D006563:Herpes Zoster Ophthalmicus / Q000175:diagnosis* / Q000276:immunology / Q000821:virology; D018259:Herpesvirus 1, Human / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D014645:Herpesvirus 3, Human / Q000235:genetics / Q000276:immunology / Q000302:isolation & purification; D006801:Humans; D016133:Polymerase Chain Reaction; D012173:Retinitis / Q000175:diagnosis / Q000276:immunology / Q000821:virology; D012680:Sensitivity and Specificity; D014822:Vitreous Body / Q000821:virology
D000914:Antibodies, Viral; D004279:DNA, Viral