title: Polymerase chain reaction forMycobacterium tuberculosisDNA detection from ocular fluids in patients with various types of choroiditis in a referral eye center in India.
abstract: OBJECTIVE
  The aim of this study was to detect Mycobacterium tuberculosis (MTB) DNA with polymerase chain reaction (PCR) in aqueous or vitreous samples of patients suffering from choroiditis presumed to be infectious origin.
  
  
  METHODS
  Hospital-based, retrospective case-control study.
  
  
  METHODS
  In all, forty eyes of forty patients with choroiditis divided into two groups - Group A (serpiginous-like choroiditis, ampiginous choroiditis, multifocal choroiditis) and Group B (choroidal abscess, miliary tuberculosis (TB), choroidal tubercle) were analyzed retrospectively. In 27 controls (patients without uveitis undergoing phacoemulsification), anterior chamber aspirate was done and sample subjected to real-time PCR. Patients underwent nested PCR for MTB using IS6110 and MPB64 primers from aqueous (n = 39) or vitreous (n = 1). All patients underwent detailed ophthalmological examination by slit-lamp biomicroscopy, fundus examination by indirect ophthalmoscopy, and fundus photograph and fundus fluorescein angiography if required.
  
  
  METHODS
  Positive results of PCR for MTB within the group and between two groups were statistically analyzed using Chi-square test.
  
  
  RESULTS
  There were 25 males and 15 females. Mean age at presentation was 34.66 years (range, 14-62). PCR positivity rates were 41.3% (n = 12/29) and 81.82% (n = 9/11) in Groups A and B, respectively. No controls had PCR-positive result. Comparison of PCR positivity rates showed statistically significant difference between Groups A and B (P = 0.028). Systemic TB was detected in 57.14% (n = 12/21) of all PCR-positive cases (Group A - 33.3%, n = 4/12; Group B - 88.9%, n = 8/9). Systemic antitubercular treatment (ATT) for 9 months and oral steroids were successful in resolution of choroiditis in all PCR-positive patients (n = 21) without disease recurrence.
  
  
  CONCLUSIONS
  Eyes with choroiditis of suspected/presumed tubercular origin should be subjected to PCR for diagnosis of TB and subjected to ATT for prevention of recurrences.
authors.affiliation: Department of Uveitis, Medical Research Foundation, Chennai, Tamil Nadu, India.
authors.forename: Jyotirmay
authors.initials: J
authors.lastname: Biswas
authors.affiliation: Vitreoretinal Fellow, Shri Bhagwan Mahavir Vitreoretinal Services, Chennai, Tamil Nadu, India.
authors.forename: Mohmmad Salman
authors.initials: MS
authors.lastname: Kazi
authors.affiliation: Vitreoretinal Fellow, Shri Bhagwan Mahavir Vitreoretinal Services, Chennai, Tamil Nadu, India.
authors.forename: Vishvesh Ashokkumar
authors.initials: VA
authors.lastname: Agarwal
authors.affiliation: Orbit, Oculoplasty, Reconstructive and Aesthetic Services, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India.
authors.forename: Md Shahid
authors.initials: MS
authors.lastname: Alam
authors.affiliation: L & T Microbiology Research Centre, Kamalnayan Bajaj Institute for Research in Vision and Ophthalmology, Vision Research Foundation, Chennai, Tamil Nadu, India.
authors.forename: K Lily
authors.initials: KL
authors.lastname: Therese
mesh_terms: D000293:Adolescent; D000328:Adult; D001082:Aqueous Humor / Q000382:microbiology*; D002833:Choroiditis / Q000175:diagnosis* / Q000382:microbiology; D004269:DNA, Bacterial / Q000032:analysis*; D005260:Female; D005451:Fluorescein Angiography; D005654:Fundus Oculi; D006801:Humans; D007194:India / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000235:genetics* / Q000302:isolation & purification; D060888:Real-Time Polymerase Chain Reaction / Q000379:methods*; D012017:Referral and Consultation; D015203:Reproducibility of Results; D012189:Retrospective Studies; D014392:Tuberculosis, Ocular / Q000175:diagnosis* / Q000382:microbiology; D055815:Young Adult
chemical_list: D004269:DNA, Bacterial