Correlation of Clinical Outcomes with Quantitative Polymerase Chain Reaction DNA Copy Number in Patients with Acute Retinal Necrosis

Ocul Immunol Inflamm. 2017 Apr;25(2):246-252. doi: 10.3109/09273948.2015.1115081. Epub 2016 Jan 30.

Abstract

Purpose: To correlate visual acuity outcomes and clinical features with quantitative PCR DNA copy number in patients with acute retinal necrosis (ARN).

Methods: Retrospective, consecutive case series.

Results: In total, 14 eyes of 13 patients were diagnosed with ARN, based on the American Uveitis Society criteria, and were followed for a mean of 324.5 days (median 250.5 days, SD ± 214 days). Anterior chamber fluid analyzed by quantitative PCR identified viral DNA in 11 of 14 eyes (78.5%). Varicella zoster virus (VZV) was identified in seven eyes (50%) and herpes simplex virus (HSV) in four eyes (28.5%). Mean DNA copy number was 7.9 × 106/mL (median 2.10 × 106/mL, range: 0-5.60 × 107/mL). Eyes with quantitative PCR DNA copy number of ≥5.0 × 106/mL (n = 6 eyes) had worse baseline visual acuity (logMAR 1.48 ± 0.71 vs 0.94 ± 0.76, p = 0.196) and final visual acuity (logMAR 2.10 ± 0.60 vs 0.82 ± 0.81, p = 0.007) compared with patients with a DNA copy number <5.0 × 106/mL (n = 8 eyes). Patients with a DNA copy number of ≥5.0 × 106/mL were more likely to have at least 5 clock hours of retinitis on funduscopic exam (p = 0.03) and developed retinal detachment more frequently (p = 0.08).

Conclusions: Quantitative DNA copy number of ≥5.0 × 106/mL is associated with more extensive retinitis, worse visual acuity, and development of retinal detachment in patients with acute retinal necrosis.

Keywords: Acute retinal necrosis; herpes simplex virus; necrotizing retinitis; polymerase chain reaction; retinitis.

MeSH terms

  • Acyclovir / analogs & derivatives
  • Acyclovir / therapeutic use
  • Adult
  • Aged
  • Aged, 80 and over
  • Antiviral Agents / therapeutic use
  • Aqueous Humor / virology
  • DNA, Viral / analysis*
  • Eye Infections, Viral / diagnosis*
  • Eye Infections, Viral / drug therapy
  • Eye Infections, Viral / virology
  • Female
  • Gene Dosage*
  • Herpes Simplex / diagnosis*
  • Herpes Simplex / drug therapy
  • Herpes Simplex / virology
  • Herpes Zoster Ophthalmicus / diagnosis*
  • Herpes Zoster Ophthalmicus / drug therapy
  • Herpes Zoster Ophthalmicus / virology
  • Herpesvirus 3, Human / genetics
  • Herpesvirus 3, Human / isolation & purification
  • Humans
  • Male
  • Middle Aged
  • Real-Time Polymerase Chain Reaction
  • Retinal Necrosis Syndrome, Acute / diagnosis*
  • Retinal Necrosis Syndrome, Acute / drug therapy
  • Retinal Necrosis Syndrome, Acute / virology
  • Retrospective Studies
  • Simplexvirus / genetics
  • Simplexvirus / isolation & purification
  • Statistics as Topic
  • Valacyclovir
  • Valine / analogs & derivatives
  • Valine / therapeutic use
  • Visual Acuity / physiology
  • Young Adult

Substances

  • Antiviral Agents
  • DNA, Viral
  • Valine
  • Valacyclovir
  • Acyclovir