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. 2021 Aug:228:89-95.
doi: 10.1016/j.ajo.2021.03.060. Epub 2021 Apr 9.

Classification Criteria for Cytomegalovirus Anterior Uveitis

Standardization of Uveitis Nomenclature (SUN) Working Group
Collaborators

Classification Criteria for Cytomegalovirus Anterior Uveitis

Standardization of Uveitis Nomenclature (SUN) Working Group. Am J Ophthalmol. 2021 Aug.

Abstract

Purpose: To determine classification criteria for cytomegalovirus (CMV) anterior uveitis.

Design: Machine learning of cases with CMV anterior uveitis and 8 other anterior uveitides.

Methods: Cases of anterior uveitides were collected in an informatics-designed preliminary database, and a final database was constructed of cases achieving supermajority agreement on the diagnosis, using formal consensus techniques. Cases were split into a training set and a validation set. Machine learning using multinomial logistic regression was used on the training set to determine a parsimonious set of criteria that minimized the misclassification rate among the anterior uveitides. The resulting criteria were evaluated on the validation set.

Results: One thousand eighty-three cases of anterior uveitides, including 89 cases of CMV anterior uveitis, were evaluated by machine learning. The overall accuracy for anterior uveitides was 97.5% in the training set and 96.7% in the validation set (95% confidence interval 92.4, 98.6). Key criteria for CMV anterior uveitis included unilateral anterior uveitis with a positive aqueous humor polymerase chain reaction assay for CMV. No clinical features reliably diagnosed CMV anterior uveitis. The misclassification rates for CMV anterior uveitis were 1.3% in the training set and 0% in the validation set.

Conclusions: The criteria for CMV anterior uveitis had a low misclassification rate and seemed to perform sufficiently well for use in clinical and translational research.

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Conflict of interest statement

Conflict of Interest: Douglas A. Jabs: none; Laure Caspers: none; Soon-Phaik Chee: consultant and grant support: AbbVie Pte, Ltd, Alcon Laboratories, Inc., Bausch & Lomb Surgical, Carl Zeiss, Inc., HOYA Medical Singapore Pte, Ltd, Johnson & Johnson Vision, Leica Microsystems, Inc., Ziemer Ophthalmics AG; grant support only: Allergan, Gilead Sciences, Inc., Santen Pharmaceutical Asia Pte, Ltd, Ziemer Ophthalmics AG; Anat Galor, MD: none; Debra Goldstein: none; Peter McCluskey: none; Philip I. Murray: none; Neal Oden: none; Alan G. Palestine: none; James T. Rosenbaum: consultant: AbbVie, Eyevensys, Gilead, Horizon, Janssen, Novartis, Roche, Santen, UCB; grant support: Pfizer; royalties: UpToDate; Jennifer E. Thorne: Dr. Thorne engaged in part of this research as a consultant and was compensated for the consulting service; Brett E. Trusko: none.

Figures

Figure 1.
Figure 1.
Nummular corneal endothelial lesion in a case with cytomegalovirus anterior uveitis.
See this image and copyright information in PMC

References

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