To examine viral and parasitic etiologies of anterior uveitis (AU) in an Iranian cohort using PCR, identifying clinical predictors to enhance therapeutic precision, particularly in resource-limited settings.
Approach:
Key Findings:
54 out of 81 samples (66.7%) were PCR-positive: VZV (50.0%), HSV (46.3%), CMV (3.7%).
PCR confirmed diagnosis in 62.9% of cases and prompted treatment changes in 24.7%.
Iris atrophy and ocular hypertension were identified as predictors of PCR positivity.
Interpretation:
VZV and HSV are predominant pathogens in AU in Iran, with moderate PCR sensitivity and specificity, necessitating clinical correlation due to low NPV.
Limitations:
Single-center design and small sample size limit generalizability, potentially affecting the reliability of findings.
Prior antiviral therapy may have reduced PCR sensitivity, impacting diagnostic accuracy.
Lack of viral load quantification limits differentiation between active and latent infections, complicating treatment decisions.
Conclusion:
PCR is a valuable adjunct in diagnosing AU in resource-limited settings like Iran, particularly for patients with iris atrophy or hypertension, highlighting the need for tailored diagnostic approaches.
