Metagenomic Next-Generation Sequencing for the Diagnosis of Viral Infectious Uveitis and Its Mimics

ABSTRACT

Purpose

To investigate the value of metagenomic next-generation sequencing (mNGS) for virus detection in patients with suspected viral infectious uveitis.

Methods

In this retrospective, multicenter case series study, 70 patients with suspected viral infectious uveitis were recruited. All patients underwent mNGS test using intraocular fluid samples and serological screening tests for pathogens. Twelve cases also underwent a PCR panel test for herpetic viruses using intraocular fluid samples; 7 cases also underwent aqueous anti-herpetic viral IgG level tests.

Results

Among 70 patients with suspected viral infectious uveitis, 34 cases were female, mean age was 45.3 years with a range from 6 to 78 years; 53 cases (75.7%) were diagnosed as infectious uveitis, 17 cases (24.3%) diagnosed as non-infectious uveitis. Among 53 cases with infectious uveitis, herpetic viruses, Bartonella henselae, Toxoplasma gondii, and Treponema pallidum were detected in 43, 6, 4, and 1 case, respectively. Among 43 cases with viral infectious uveitis, herpetic virus was detected in 39 cases by mNGS, the other 4 cases showed negative results in mNGS test, but positive results in 2 cases in serological screening tests, in 1 case in PCR, and in 1 case in aqueous anti-herpetic viral IgG level test, respectively. The sensitivity, specificity, positive predictive value, negative predictive value of mNGS in detecting viruses were 90.7%, 100%, 100%, and 81.0%, respectively.

Conclusions

mNGS is a sensitive and valuable method to detect viruses in intraocular fluid samples, and an alternative for pathogen detection in cases with suspected viral infectious uveitis but negative test results in PCR.

KEYWORDS:

• Bartonella henselae
• herpetic viruses
• infectious uveitis
• metagenomic next-generation sequencing
• polymerase chain reaction

Acknowledgments

The authors would like to thank all patients for their trust and cooperation in this study.

Author contributions

CS and ZL designed the study and wrote the manuscript, QX, GL, YC, and JL collected the data, CS, YC, and JL analyzed the data.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The authors confirm that the data supporting the findings of this study are available within the article [and/or] its supplementary materials.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.