ArticleDie Ophthalmologie2026
[The value of aqueous humor aspiration in the diagnostics of uveitis-Experience from a tertiary university center].
Article in Die Ophthalmologie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundDespite advances in diagnostic techniques, determining the etiology of uveitis remains a clinical challenge. In addition to infectious causes, neoplastic entities, such as intraocular lymphoma can mimic inflammatory diseases. Aqueous humor sampling enables direct detection of infectious pathogens and can provide clues to underlying neoplastic diseases. PURPOSE: To evaluate the diagnostic utility of aqueous humor sampling in patients with uveitis in the clinical routine of a tertiary university referral center.
methodsIn this retrospective single-center study 59 aqueous humor samples obtained between 2015 and 2020 at the Department of Ophthalmology, University Hospital Essen, were analyzed. The cohort included anterior, intermediate, posterior and panuveitis cases. Demographic data, clinical course, pretreatment status, virological and microbiological findings from aqueous humor analysis as well as complementary findings from vitreous body or tissue biopsies were recorded.
resultsAn etiologically relevant finding was identified in 18 cases (30.5%), including direct detection of infectious pathogens in 16 aqueous humor samples and 2 intraocular lymphomas confirmed during follow-up by vitreous body or tissue biopsy. Toxoplasmagondii and herpesviruses were the most frequently detected pathogens. Descriptively, comparable detection rates were observed between pretreated and treatment-naïve patients. In selected clinical cases aqueous humor polymerase chain reaction (PCR) enabled early etiological classification of herpes simplex virus type 1 (HSV-1)-associated retinitis and detection of cytomegalovirus (CMV)-associated uveitis with immediate therapeutic consequences.
conclusionAqueous humor sampling represents a valuable diagnostic tool in the evaluation of uveitis and can facilitate targeted therapy, particularly in infectious diseases. In atypical or treatment-refractory cases, it can contribute to the detection of tumor-associated intraocular disease within a stepwise diagnostic approach.
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