Use of polymerase chain reaction in the diagnosis of fungal endophthalmitis

Objective: To evaluate the usefulness of polymerase chain reaction (PCR) co mpared with the conventional mycologic methods in the diagnosis of fungal e ndophthalmitis. Design: Prospective comparative validation of diagnostic testing - case-con trol study. Participants and Controls: Thirty subjects in whom fungal endophthalmitis w as suspected and 20 controls with noninfections, Intervention Testing: Collection of intraocular specimens and testing for t he presence of fungus by PCR and conventional methods. Main Outcome Measures: Detection of fungus by microscopy, growth by culture , and fungal DNA by PCR for definitive and rapid diagnosis of fungal endoph thalmitis. Results: None of the controls was positive by microscopy, culture, or PCR, Among the 43 intraocular specimens from 30 subjects, 24 were positive by co nventional mycologic methods and 32 were positive by PCR, PCR increased the sensitivity of detection by 18.6%, which was statistically significant (Mc Nemar test: P = 0.039). Conclusions: PCR was a more sensitive and rapid diagnostic tool compared wi th the conventional mycologic methods in the diagnosis of fungal endophthal mitis, Ophthalmology 2001;108:326-330 (C) 2001 by the American Academy of O phthalmology.