INCREASED PRESENCE OF EPSTEIN-BARR-VIRUS DNA IN OCULAR FLUID SAMPLES FROM HIV-NEGATIVE IMMUNOCOMPROMISED PATIENTS WITH UVEITIS

Aims-To investigate whether routine testing for Epstein-Barr virus (EB V) is necessary in the examination of a patient with uveitis. Methods- Intraocular EBV DNA was determined in 183 ocular fluid samples taken f rom patients with AIDS and uveitis, HIV negative immunocompromised uve itis, acute retinal necrosis, toxoplasma chorioretinitis, intraocular lymphoma, anterior uveitis, and miscellaneous uveitis of unknown cause . In 82 samples from this group of patients paired serum/ocular fluid analysis was performed to detect local antibody production against EBV . Controls (n=46) included ocular fluid samples taken during surgery f or diabetic retinopathy, macular pucker, or cataract. Results-Serum an tibody titres to EBV capsid antigen proved to be significantly increas ed in HIV negative immunocompromised patients with uveitis (p<0.01) co mpared with controls. Local antibody production revealed only three po sitive cases out of 82 patients tested, two results were borderline po sitive and one patient had uveitis caused by VZV. EBV DNA was detected in three out of 46 control ocular fluid samples. In the different uve itis groups EBV DNA was noted, but was not significantly higher than i n the controls, except in six out of 11 HIV negative immunocompromised patients (p=0.0008). In four out of these six cases another infectiou s agent (VZV, HSV, CMV, or Toxoplasma gondii) had previously been iden tified as the cause of the uveitis. Conclusions-When comparing various groups of uveitis patients, EBV DNA was found more often in HIV negat ive immunocompromised patients with uveitis. Testing for EBV does not have to be included in the routine management of patients with uveitis , since indications for an important role of this virus were not found in the pathogenesis of intraocular inflammation.