USE OF POLYMERASE CHAIN-REACTION ASSAYS OF AQUEOUS-HUMOR IN THE DIFFERENTIAL-DIAGNOSIS OF RETINITIS IN PATIENTS INFECTED WITH HUMAN-IMMUNODEFICIENCY-VIRUS

We performed polymerase chain reaction (PCR) for detection of cytomega lovirus (CMV), varicella-zoster virus (VZV), herpes simplex virus (HSV ), and Toxoplasma gondii DNA in aqueous humor from 15 patients who wer e infected with human immunodeficiency virus (HIV) and who had retinit is of unclear origin; these patients were selected from among 820 pati ents evaluated by ophthalmoscopic examination. On the basis of the fin al response to treatment, CMV, VZV, and T. gondii retinitis was diagno sed in 5, 2, and 4 of the 15 patients, respectively, No final etiologi c diagnosis was reached for four patients. All 5 patients with CMV ret initis were CMV DNA-positive, 1 of 2 patients with VZV retinopathy wer e VZV DNA-positive, and 3 of 4 patients with T. gondii retinitis were T. gondii DNA-positive. All PCR assays of aqueous humor from the four patients without infectious retinitis were negative. PCR assay of aque ous humor is helpful in the etiologic diagnosis of retinitis of unclea r origin in HIV-infected patients.