Diagnostic techniques for inflammatory eye disease: past, present and future: a review

Abstract

Investigations used to aid diagnosis and prognosticate outcomes in ocular inflammatory disorders are based on techniques that have evolved over the last two centuries have dramatically evolved with the advances in molecular biological and imaging technology. Our improved understanding of basic biological processes of infective drives of innate immunity bridging the engagement of adaptive immunity have formed techniques to tailor and develop assays, and deliver targeted treatment options. Diagnostic techniques are paramount to distinguish infective from non-infective intraocular inflammatory disease, particularly in atypical cases. The advances have enabled our ability to multiplex assay small amount of specimen quantities of intraocular samples including aqueous, vitreous or small tissue samples. Nevertheless to achieve diagnosis, techniques often require a range of assays from traditional hypersensitivity reactions and microbe specific immunoglobulin analysis to modern molecular techniques and cytokine analysis. Such approaches capitalise on the advantages of each technique, thereby improving the sensitivity and specificity of diagnoses. This review article highlights the development of laboratory diagnostic techniques for intraocular inflammatory disorders now readily available to assist in accurate identification of infective agents and appropriation of appropriate therapies as well as formulating patient stratification alongside clinical diagnoses into disease groups for clinical trials.

Primary extranodal marginal zone B-cell lymphoma with diffuse uveal involvement and focal infiltration of the trabecular meshwork: a case report and review of literature

“…Despite the rarity, uveal EMZL should be included in the differential diagnosis of uveal inflammation or tumors, particularly in patients with persistent signs and symptoms. Non-resolving or recurrent masquerade syndromes not responding to standard treatment should lead to prompt biopsy [ 33 ].…”

Revisiting Mantoux test in the era of immunization and Multi-drug resistant tuberculosis

“…A recent study has observed that mantoux test can be used for the diagnosis of ocular TB, which remains to be least invasive and cost effective procedure. The drawback being that the tuberculin skin test cannot differentiate between infections of Mycobacterium TB from that of atypical Mycobacteria [17]. An epidemiological report published recently from Korea has indicated that with a reaction of >10 mm diameter taken as a cut off, there has been a decrease in the positivity against tuberculin skin test from 2005 (28%) to 2009 (15%), which was associated to BCG vaccination [18].…”

The eye: a window of opportunity in rheumatoid arthritis?

“…Advanced imaging tools (such as MRI or ultra sono graphy) enable direct visualization and accurate measure ment of joint specific inflammation, at the same time, 9 tools that determine the severity of ocular disease (such as levels of cytokines in tears, impres sion cyto logy, automated grading of conjunctival hyperae mia and in vivo imag ing of immune cells and lymphatics) have advanced the study of ocular surface immun ology. 10 Knowledge of shared and organspecific processes should shape em erging and future therapeutic approaches to dry eye.…”