1Pleyer U., 1Koll B., 2Döcke W., 2Volk H. D., 1Velhagen K. H.

1Department of Ophthalmology, Charité Campus Virchow and 2Institute of Medical Immunology, Charité, Humboldt University, Berlin, Germany.

Purpose: Procalcitonin (PCT), the precursor protein of the hormone calcitonin, appears to be an early marker of the presence of severe systemic infection. It is strongly increased in inflammation and claimed to have discriminatory value for bacterial infection. We therefore investigated the expression of this protein in postoperative endophthalmitis.
Methods: PCT concentrations were measured by an immunoluminometric assay (LUMItest Brahms, Berlin, detection limit 80 pg/ml) in intraocular (vitreous, aqueous) and serum samples of 32 patients with endophthalmitis or infectious uveitis. The specific etiology for infectious uveitis was established on intraocular antibody response to viral (herpes virus) or parasitic (toxoplasma gondii) antigens. Patients with non-infectious ocular diseases (n=7) undergoing vitrectomy served as controls.
Results: Procalcitonin was significantly (p=0.02) higher in vitreous specimen of endophthalmitis patients (mean 762.2 ± 155.7 pg/ml) compared with normal controls (mean 138.9 ± 9.7 pg/ml) whereas serum levels did not differ (p=0.45) in both groups. In contrast, intraocular samples of patients, with viral (mean 135.8 ± 9.6 pg/ml) or parasitic uveitis (mean 116.4 ± 2.6 pg/ml) did not differ in PCT levels from control patients (p>0.05).
Conclusions: This is the first study analyzing the intraocular expression of PCT. We conclude from our data that PCT may be used as a sensitive marker to differentiate intraocular bacterial infections from other etiologies in patients following intraocular surgery.
Supported by DFG (Pl 150/10-1 and Vo 489/6-1) and Charité, Forschungsförderung

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