VALUABLE APPLICATION OF THE β- d -GLUCAN TESTING OF INTRAOCULAR FLUID FOR THE DIAGNOSIS OF FUNGAL ENDOPHTHALMITIS.

PURPOSE:To evaluate the value of the β- d -glucan (BDG) testing of intraocular fluid for the diagnosis of fungal endophthalmitis (FE). METHODS:Twenty patients (22 eyes) with FE were diagnosed using both culture and nonculture methods. Intraocular fluid was collected for BDG testing, including 22 eyes of FE and 55 eyes of control group. Under different BDG cutoff points as the test-positives, the BDG sensitivity, specificity, positive predictive value, and negative predictive value for FE were analyzed. RESULTS:The BDG testing value was 1,022.78 ± 1,362.40 pg/mL in the FE group, significantly higher than that of the control group (105.0 ± 180.80 pg/mL, P < 0.001). The area under the receiver operating characteristic (ROC) curve was 0.885 (95% confidence interval, 0.793-0.978; P < 0.001). With the prespecified BDG cutoff 107.83 pg/ml as the test-positive, sensitivity was 81.8%, specificity was 87.5%, and the Youden index was 0.693. When the BDG cutoff was depicted as 202.05 pg/mL, sensitivity reduced to 77.3%, specificity increased at 95.8%, and the Youden index reached the highest value of 0.731. CONCLUSIONS:β- d -glucan testing of intraocular fluid demonstrated good sensitivity and specificity regarding the diagnosis of FE, which can provide earlier diagnosis to achieve better outcomes.