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Journal of Clinical Microbiology, August 2003, p. 3537-3541, Vol. 41, No. 8
0095-1137/03/$08.00+0     DOI: 10.1128/JCM.41.8.3537-3541.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.

Comparison of Enzyme-Linked Immunosorbent Assay, Immunoblotting, and PCR for Diagnosis of Toxoplasmic Chorioretinitis

Odile Villard,1* Denis Filisetti,1 Florence Roch-Deries,1 Justus Garweg,2 Jacques Flament,3 and Ermanno Candolfi1

Institut de Parasitologie et Pathologie Tropicale, F-67000 Strasbourg,1 Service d'Ophtalmologie, Hôpitaux Universitaires de Strasbourg, F-67091 Strasbourg, France,3 Department of Ophthalmology, University of Bern, CH-3010 Bern, Switzerland2

Received 13 March 2003/ Returned for modification 12 May 2003/ Accepted 24 May 2003

Ocular toxoplasmosis is the major cause of posterior uvetis in European populations. The clinical diagnosis of toxoplasmic chorioretinitis is based upon ophthalmoscopic findings, which are often but not always typical. Laboratory testing is therefore important to confirm the etiology of the disease. In the present 2-year prospective study, the relative diagnostic sensitivities of the three analytical techniques (enzyme-linked immunosorbent assay [ELISA], immunoblotting, and PCR) were compared by using a group of patients (n = 19) with suspected ocular toxoplasmosis. The relative specificities of the three techniques were assessed by including two control groups of patients: one with nontoxoplasmic and noninflammatory ocular disease (n = 48) and the other with nontoxoplasmic and inflammatory ocular disease (n = 20). All 19 of the clinically suspect patients had serological evidence of exposure to Toxoplasma gondii: 17 had been previously infected, and 2 had current infection. The analysis of paired aqueous humor and serum samples by ELISA and immunoblotting revealed the local production of specific antibodies of the immunoglobulin G type in 63% (12 of 19) and 53% (10 of 19) of patients, respectively. PCR analysis of aqueous humor samples confirmed the presence of T. gondii DNA in 28% (5 of 18) of cases. When combined, ELISA, immunoblotting, and PCR findings confirmed the toxoplasmic origin of retinal lesions in 83% (15 of 18) of patients. The relative specificities of the three techniques were 89% for ELISA and immunoblotting and 100% for PCR.

* Corresponding author. Mailing address: Institut de Parasitologie et de Pathologie Tropicale, Faculté de Médecine, 3 rue Koeberlé, 67000 Strasbourg, France. Phone: 33-3-90-24-37-00. Fax: 33-3-90-24-36-93. E-mail: odile.villard{at}medecine.u-strasbg.fr.

Journal of Clinical Microbiology, August 2003, p. 3537-3541, Vol. 41, No. 8
0095-1137/03/$08.00+0     DOI: 10.1128/JCM.41.8.3537-3541.2003
Copyright © 2003, American Society for Microbiology. All Rights Reserved.



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