P 390 A retinitis caused by cytomegalovirus (CMV); An unusual presentation

b&g$y, With the aim of tmproving early dtiagnosis In infectious weitts, the results of PCR and serological anel~sis of intraocular fluads wwe evaluated. b$&~&. Aqueous humor or vitmous samples of panrntr with dcula re~mal nccros~s IARN;” z. 161, rotm~trs 4” AlDS (n 381, toxoplasma choriorerhwis cn = 221 and different uvorfis entmcs (n 371 were te:itad lor the presence of Varicalla-zoster wus, Herpes simplex virus, Cbromogalovirus and TOXODlaSma DNA ~4th PCR. The same sampler w:ro alS0 tested for local antibody produclion by calculating tha Gc ldmann Witmor coofftcionr aBains1 the aforemontionod agents. f&nrclu_ In ARN, the GW-coefficient for VZV or HSV was positive in 6S% and PCR for VZV or ~ISV DNA in 50%. Combination of both techniques yielded a posttlvo lost result In 81%. In toxoplasma ch0riore!init& 68% had a posrtiva GW-coefficient for toxoplasms and PCH was positive in 18%. None of the ocular fluid samples of ,mmunocompet0nt persons was positwe for CMV. In patients with AIDS. PCR was poslrivo for CMV DNA In 61% of the OCdar fluia sanples tested. Four ocular flwd samples of AIDS patients w0re positive for VZV DNA and thr00 of lheae patients ware diagnosed as progressive outfr retinal necrosis. The GW-coelhci0nt was negative I” 311 the patients wrrh AIDS dospirc the prescncr? ot harpesviral DNA. Ccntrol aqueous or virroous samples In =38) did not contain dotoctable horposwrsl or toxoplasma DNA. J;PIJ&~ The combination ot PCA and local antibody ptoductior, Improvas the datcctiqn of infectious causes II-I uveius in immunocwnpetont parsons In patients with AIDS, PCR is a more swsitivo techniqua to establish on etiologic dlagnosls than ,wwlysra 01 local antibody pruduction.