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Comprehensive analysis of vitreous specimens for uveitis classification: a prospective multicentre observational study.

ABSTRACT: PURPOSE:To determine the clinical relevance of vitreous biomarkers in patients with uveitis. DESIGN:Multicentre, prospective, observational study. SETTING:Uveitis outpatient clinics of two academic medical centres in Japan. PATIENT POPULATION:This study included 234 eyes of 191 patients with various uveitis aetiologies: definitive sarcoidosis (61 eyes of 46 patients), suspected sarcoidosis (60 eyes of 45 patients), intraocular tumour (34 eyes of 27 patients), viral infection (20 eyes of 18 patients), non-sarcoidosis (16 eyes of 16 patients) and unknown aetiology (43 eyes of 39 patients). OBSERVATION PROCEDURE:Vitreous samples (taken by pars planta vitrectomy) were analysed with flow cytometry, cytology and multiplex PCR analysis. MAIN OUTCOME MEASURES:The primary outcome measures were the diagnostic values of various biomarkers (T cells, B cells and pathogen DNA) in vitreous samples. The secondary outcome was visual acuity after vitrectomy. RESULTS:Sarcoidosis showed higher CD4/CD8 or CD4+ measurements than other aetiologies (p<0.01). In samples with viral infection, pathogen DNA was detected, and CD8+ counts were higher than the other aetiologies (p<0.01). Eyes with tumour had higher CD19+ (p<0.05). Non-sarcoidosis had lower CD4/CD8 than sarcoidosis, higher CD8+ than sarcoidosis and lower CD19+ than tumour (p<0.01). Unknown uveitis had lower CD4/CD8 than sarcoidosis (p<0.01), and higher CD4/CD8 than non-sarcoidosis, viral infection or tumour (p<0.001). Visual acuity improved after vitrectomy (p<0.001). CONCLUSIONS:Uveitis aetiologies had distinct vitreous biomarker profiles, especially of infiltrating lymphocytes. Analyses of CD4/CD8 ratio, T-lymphocyte and B-lymphocyte subset, and pathogen DNA in vitreous samples have good safety profiles and high diagnostic value for uveitis classification. TRIAL REGISTRATION NUMBER:UMIN000004980; Pre-results.

SUBMITTER: Maruyama K

PROVIDER: S-EPMC5701993 | biostudies-literature | 2017 Nov

REPOSITORIES: biostudies-literature

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Comprehensive analysis of vitreous specimens for uveitis classification: a prospective multicentre observational study.

Maruyama Kazuichi K Inaba Tohru T Sugita Sunao S Ichinohasama Ryo R Nagata Kenji K Kinoshita Shigeru S Mochizuki Manabu M Nakazawa Toru T

BMJ open 20171116 11

<h4>Purpose</h4>To determine the clinical relevance of vitreous biomarkers in patients with uveitis.<h4>Design</h4>Multicentre, prospective, observational study.<h4>Setting</h4>Uveitis outpatient clinics of two academic medical centres in Japan.<h4>Patient population</h4>This study included 234 eyes of 191 patients with various uveitis aetiologies: definitive sarcoidosis (61 eyes of 46 patients), suspected sarcoidosis (60 eyes of 45 patients), intraocular tumour (34 eyes of 27 patients), viral i ...[more]

PMID: 29150462

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Comprehensive analysis of vitreous specimens for uveitis classification: a prospective multicentre observational study.

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Comprehensive analysis of vitreous specimens for uveitis classification: a prospective multicentre observational study.

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