title: Evaluation of direct immunofluorescence assay and cytological examination in comparison to polymerase chain reaction of conjunctival swabs in patients with adult inclusion conjunctivitis.
abstract: OBJECTIVE
  To evaluate PCR, direct immunofluorescence assay (DIA) and cytological test of conjunctival swabs for the diagnosis of adult follicular conjunctivitis (AFC).
  
  
  METHODS
  Eighty-three adult patients with chronic conjunctivitis and sixteen healthy individuals were included. Conjunctival scrapings underwent PCR, DIA and cytological analysis. Exams were repeated two weeks after treatment application. Sensitivity, specificity and agreement rate with PCR of DIA and Cytology were evaluated and correlated with clinical symptoms/signs.
  
  
  RESULTS
  Cytology test was more sensitive than DIA and presented an acceptable agreement with PCR (K=0.44) in treatment-naïve patients, concerning especially the combination of both conventional exams (K = 0.77). Inferior diagnostic performance of was detected post-treatment, considering the combination as well (K=0.40). Negative post-treatment PCR correlated well with significant relief of symptoms/signs.
  
  
  CONCLUSIONS
  Combination of Cytology and DIA seems to be a useful diagnostic option for treatment naïve AFC patients. However, PCR remains the most reliable test for post-treatment evaluation.
authors.affiliation: Department of Ophthalmology, G. Gennimatas General Hospital, Athens, Greece.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Malamos
authors.forename: Ilias
authors.initials: I
authors.lastname: Georgalas
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Rallis
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Andrianopoulos
authors.forename: Panteleimon
authors.initials: P
authors.lastname: Konstantoulakis
authors.forename: Gerasimos
authors.initials: G
authors.lastname: Georgopoulos
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Theodosiadis
authors.forename: Nikos N
authors.initials: NN
authors.lastname: Markomichelakis
mesh_terms: D002908:Chronic Disease; D003228:Conjunctiva / Q000473:pathology*; D003235:Conjunctivitis, Inclusion / Q000175:diagnosis*; D003584:Cytological Techniques; D005189:False Positive Reactions; D019085:Fluorescent Antibody Technique, Direct; D006801:Humans; D008875:Middle Aged; D011237:Predictive Value of Tests; D060888:Real-Time Polymerase Chain Reaction; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires