Purpose: To clarify the actual status of the use of polymerase chain reaction (PCR) analysis of intraocular fluids for infectious uveitis diagnosis.
Subjects and methods: A questionnaire survey was conducted in a total of 151 facilities across Japan, including university hospitals, core training hospitals, and facilities to which the councilors of the Japanese Ocular Inflammation Society and the Japanese Association for Ocular Infection are affiliated. The total number of PCR analyses performed from January 2018 to June 2018, and the number of on-site and outsourcing tests of single item PCR analysis and comprehensive PCR analysis among them were examined. As further investigation, in 10 facilities where advanced medicine of "rapid diagnosis (using PCR method) of refractory infectious diseases of the eye" was carried out at the time of this study, the number, validity and presence of adverse events of PCR analyses performed as advanced medicine during the period from January 2014 to June 2018 were investigated.
Results: The questionnaire survey was sent to 151 facilities, of which 131 (87%) provided a response. Response was also provided from all facilities performing advanced medicine. For infectious uveitis, PCR analysis using intraocular fluid was performed in 101 facilities (77%), of which 70% were outsourcing tests. The number of PCR analyses performed during the 6-month period was 1,616, in total, of which 674 (42%) were comprehensive PCR. As for advanced medicine, 409 cases of PCR for virus detection and 112 cases of PCR for bacterial and fungal detection were performed in 4 years and 6 months. Overall, 407 cases (99.5%) of viral PCR and all cases of bacterial and fungal PCR were validated. There were no reports of adverse events.
Conclusion: Intraocular fluid PCR is considered to play an important role in the diagnosis/diagnosis of exclusion of infectious diseases in the current uveitis treatment in Japan.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 123: 764-770, 2019.