In Response to: Smit D, Meyer D, Maritz J, et al. “Polymerase Chain Reaction and Goldmann-Witmer Coefficient to Examine the Role of Epstein-Barr Virus in Uveitis”

The Usefulness of Aqueous Fluid Analysis for Epstein–Barr Virus in Patients with Uveitis

“…We noted a lower PCR yield for EBV (3/201; 1%) when compared to previous literature (up to 17%). 5,6,13,14 The prevalence of GWC was not systematically performed in the past except one study, which reports on 3/82; 4% prevalence of positive EBV GWC in uveitis patients (out of which 1 had a higher GWC for VZV), which is similar to 9% found in the present study. 5 It should be however noted that the GWC results in our study were typically low and/or combined with multiple positive GWCs.…”

“…5,6 The common prevalence of immunosuppression (by HIV or immunosuppressive medication) in patients with positive PCR for EBV in intraocular fluids was made earlier. 6,13,14 In our study, solely 3 patients were PCR positive out of whom one was immunosuppressed; this limited number precludes any meaningful comparisons.…”

“…The only exception consisted of two patients with AIDS and primary central nervous system (CNS)/intraocular non-Hodgkin's lymphoma. 13,14 These previous findings show that intraocular replication of EBV in uveitis still remains to be proven. In addition, none of the patients exhibited simultaneous PCR and GWC for EBV.…”

“…[4][5][6][7][8][9][10][11][12] In one study examining the viral loads of EBV PCR positive patients, intraocular viral loads were always lower when compared to blood levels, which does not support the presumptive replication of EBV within the eye. 13,14 Herein we report on a large series of uveitis patients who underwent diagnostic intraocular fluid assessment by both PCR and GWC for EBV in addition to Herpes Simplex Virus (HSV), Varicella Zoster Virus (VZV), Cytomegalovirus (CMV), Rubellavirus (RV) and report on the clinical characteristics of patients with laboratory findings indicative of intraocular EBV infection.…”