Classification Criteria for Varicella Zoster Virus Anterior Uveitis - 21/10/21

Doi : 10.1016/j.ajo.2021.03.037

The Standardization of Uveitis Nomenclature (SUN) Working Group^¹
Members of the SUN Working Group are listed online at AJO.com.
^{^{2
Writing Committee: Douglas A. Jabs^1,2, Nisha R. Acharya³, Laure Caspers⁴, Soon-Phaik Chee⁵, Debra Goldstein⁶, Peter McCluskey⁷, Philip I. Murray⁸, Neal Oden⁹, Alan G. Palestine¹⁰, James T. Rosenbaum^11,12, Jennifer E. Thorne^1,2, and Brett E. Trusko¹³.}}^{^{3
Writing Committee Affiliations: From the ¹Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA (D.A.J., J.E.T.); the ²Wilmer Eye Institute, Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA (D.A.J., J.E.T.); the ³Francis I. Proctor Foundation, University of California, San Francisco School of Medicine, San Francisco, California, USA (N.R.A.); the ⁴Department of Ophthalmology, CHU St. Pierre, Université Libre de Bruxelles, Brussels, Belgium (L.C.); the ⁵Singapore National Eye Centre, Singapore Eye Research Institute, Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Duke-NUS Medical School, Singapore (S.-P.C.); the ⁶Department of Ophthalmology, Northwestern Feinberg School of Medicine, Chicago, Illinois, USA (D.G.); the ⁷Save Sight Institute, Department of Ophthalmology, University of Sydney School of Medicine, Sydney, New South Wales, Australia (P.M.); the ⁸Academic Unit of Ophthalmology, University of Birmingham, Birmingham, United Kingdom (P.I.M.); the ⁹The Emmes Company, LLC, Rockville, Maryland, USA (N.O.); the ¹⁰Department of Ophthalmology, University of Colorado School of Medicine, Aurora, Colorado, USA (A.G.P.); the ¹¹Departments of Medicine and Ophthalmology, Oregon Health and Science University, Portland, Oregon, USA (J.T.R.); the ¹²Legacy Devers Eye Institute, Portland, Oregon, USA (J.T.R.); and the ¹³Department of Medicine, Texas A&M University, College Station, Texas, USA (B.E.T.).}}^{^{⁎
Inquiries to Douglas A. Jabs, Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, 615 N Wolfe St, Room E7138, Baltimore, MD 21205, USA.}}
Douglas A. Jabs, Nisha R. Acharya, Laure Caspers, Soon-Phaik Chee, Debra Goldstein, Peter McCluskey, Philip I. Murray, Neal Oden, Alan G. Palestine, James T. Rosenbaum, Jennifer E. Thorne, Brett E. Trusko

Résumé

Purpose

To determine classification criteria for varicella zoster virus (VZV) anterior uveitis.

Design

Machine learning of cases with VZV 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 123 cases of VZV 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 VZV anterior uveitis included unilateral anterior uveitis with either (1) positive aqueous humor polymerase chain reaction assay for VZV; (2) sectoral iris atrophy in a patient ≥60 years of age; or (3) concurrent or recent dermatomal herpes zoster. The misclassification rates for VZV anterior uveitis were 0.9% in the training set and 0% in the validation set, respectively.

Conclusions

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

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Plan

Methods

Informatics

Case Collection and Case Selection

Machine Learning

Comparison of Cases With and Without Dermatomal Herpes Zoster and With and Without Polymerase Chain Reaction Confirmation of Varicella Zoster Virus in the Anterior Chamber

Results

Discussion

CRediT roles

Supplemental Material available at AJO.com.

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Vol 228

P. 165-173 - août 2021 Retour au numéro

Article précédent

Classification Criteria for Intermediate Uveitis, Non–Pars Planitis Type
The Standardization of Uveitis Nomenclature (SUN) Working Group, Douglas A. Jabs, Alastair K. Denniston, Andrew D. Dick, James P. Dunn, Michal Kramer, Neal Oden, Annabelle A. Okada, Alan G. Palestine, Russell W. Read, Jennifer E. Thorne, Brett E. Trusko, Steven Yeh

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Classification Criteria for Acute Posterior Multifocal Placoid Pigment Epitheliopathy
The Standardization of Uveitis Nomenclature (SUN) Working Group, Douglas A. Jabs, Antoine P. Brezin, Andrew D. Dick, Ralph D. Levinson, Lyndell L. Lim, Peter McCluskey, Neal Oden, Alan G. Palestine, Jennifer E. Thorne, Brett E. Trusko, Albert Vitale, Susan E. Wittenberg

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Classification Criteria for Varicella Zoster Virus Anterior Uveitis - 21/10/21

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