CLINICAL UTILITY OF BETA-D-GLUCAN TESTING FOR ENDOGENOUS FUNGAL CHORIORETINITIS OR ENDOPHTHALMITIS
| Autor: | Gui-Shuang Ying, Gideon Whitehead, Alexander J. Brucker, Anton M. Kolomeyer, Benjamin J. Kim, Robert Carroll, Michael J. Ammar |
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| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Adult Male medicine.medical_specialty beta-Glucans 030106 microbiology Endogeny Gastroenterology 03 medical and health sciences 0302 clinical medicine Endophthalmitis Predictive Value of Tests Internal medicine medicine Humans Eye Finding Retrospective Studies business.industry Chorioretinitis General Medicine Eye infection Middle Aged medicine.disease Fungal chorioretinitis Confidence interval Ophthalmology ROC Curve Case-Control Studies 030221 ophthalmology & optometry Biomarker (medicine) Female business Eye Infections Fungal Biomarkers |
| Zdroj: | Retina (Philadelphia, Pa.). 41(2) |
| ISSN: | 1539-2864 2013-2018 |
| Popis: | PURPOSE To evaluate serum beta-D-glucan (BDG) as a biomarker for endogenous fungal eye infection. METHODS Retrospective case-control study of 88 patients with a BDG test and eye examination at UPenn (2013-2018). Cases had endogenous fungal chorioretinitis or endophthalmitis diagnosed by eye examination and confirmed with positive culture; controls were without these fungal eye findings. Charts were reviewed for BDG values, blood/vitreous cultures, and eye examinations. Outcomes were BDG sensitivity, specificity, positive predictive value, and negative predictive value for fungal chorioretinitis or endophthalmitis, using prespecified BDG cut-off points of ≥80, ≥250, and ≥500 pg/mL as test positive. RESULTS Cases included six chorioretinitis and four endophthalmitis patients. Controls included 78 patients without chorioretinitis or endophthalmitis. Defining BDG ≥80 pg/mL as test positive, the BDG sensitivity (95% confidence interval) was 66.7% (22.3%-95.7%) for chorioretinitis and 100% (39.8%-100%) for endophthalmitis. The specificity was 74.4% (63.2%-83.6%) when BDG values ≥80 pg/mL were test positive, and 85.9% (76.2%-92.7%) when values ≥250 pg/mL were test positive. For a 1% endophthalmitis prevalence and BDG cut-off value of ≥80 pg/mL, the positive predictive value was 3.8% (2.4%-5.2%) and negative predictive value was 100% (99.1%-100%). CONCLUSION For endogenous fungal endophthalmitis, BDG's sensitivity and specificity seem good and the negative predictive value is high; a larger ophthalmic study is indicated. |
| Databáze: | OpenAIRE |
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