Navegando por Palavras-chave "uveíte/diagnóstico"

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    O uso da reação em cadeia da polimerase em tempo real no diagnóstico de uveítes infecciosas
    (Universidade Federal de São Paulo (UNIFESP), 2014-09-30) Santos, Fabio Felipe dos [UNIFESP]; Mattos Junior, Rubens Belfort [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
    Infectious uveitis is a disease of major morbidity and blindness in several countries. Real-time PCR (qPCR) has been demonstrated as a high sensitivity diagnostic method of infections caused by parasites, viruses, fungi and bacteria. The technique allows the diagnosis of atypical infectious uveitis that cannot be diagnosed and differentiated only by clinical examination. The objective of this study was to analyze the qPCR technique in the detection of Herpes simplex virus (HSV), varicella zoster (VZV), cytomegalovirus (CMV), Toxoplasma gondii (TOXO), and M. tuberculosis (TB), for the differential diagnosis of patients with infectious uveitis. This study was divided into two experiments: In the first experiment, 27 patients with posterior infectious uveitis were recruited. In the second, 90 patients were recruited, of which 65 were diagnosed with ocular toxoplasmosis, and 25 patients were used as controls (infectious uveitis from other causes and not infectious). All patients were from the Department of Ophthalmology and Visual Sciences of the EPM/UNIFESP,São Paulo-Brazil. DNA extraction in the blood, aqueous humor and vitreous humor were performed. Experiment I showed T. gondii, CMV, VZV or HSV present in 19.2% of the aqueous humor samples and in 30% of the vitreous samples. Only CMV was detected in the blood (3.7%). The qPCR was able to confirm the diagnosis in 26% of patients with infectious posterior uveitis. In experiment II, from the total of 65 patients, 57% were positive for T. gondii, considering all the analyzed samples (blood, aqueous or vitreous). The vitreous and the aqueous were positive in respectively 40% and 58% of the samples and the blood test was positive in 25%. In the group of toxoplasmosis where blood and aqueous were collected, qPCR was positive in 68% of patients: 45.1% in the aqueous only, and 19.4% were positive in blood and aqueous simultaneously. In the Toxoplasmosis group with samples from vitreous, aqueous and blood were studies, the qPCR was positive in 41.7%: 16.7% only in the vitreous, 16.7% in the aqueous and vitreous, and 8.3% in the blood and aqueous. In the first experiment qPCR was able to detect the DNA of pathogens with higher sensitivity in the vitreous humor. In the second experiment, the sensitivity was higher in the aqueous humor. The qPCR in blood samples allowed to detect the DNA of pathogens causing infectious uveitis, however, due to low sensitivity, was not a useful sample to complement the clinical diagnosis. In conclusion, qPCR can be a useful tool for the diagnosis of infectious uveitis, assisting in proper treatment of ocular diseases. This study showed that the ocular fluids have better accuracy in molecular diagnosis of infectious uveitis, and the aqueous humor shown with positive differential for being less invasive during collection.