Classification Criteria for Herpes Simplex Virus Anterior Uveitis - 21/10/21

Doi : 10.1016/j.ajo.2021.03.053

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, 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, and Brett E. Trusko}}^{^{3
Writing Committee Affiliations: From the Department of Epidemiology (D.A.J., J.E.T.), Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA; Department of Ophthalmology (D.A.J., J.E.T.), Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA; Francis I. Proctor Foundation (N.R.A.), University of California San Francisco School of Medicine, San Francisco, California, USA; Department of Ophthalmology (L.C.), CHU St. Pierre, Universite Libre de Bruxelles, Brussels, Belgium; Department of Ophthalmology (S-P.C.), Singapore National Eye Centre, Singapore Eye Research Institute, Yong Loo Lin School of Medicine, National University of Singapore, Duke-National University of Singapore Medical School, Singapore; Department of Ophthalmology (D.G.), Northwestern Feinberg School of Medicine, Chicago, Illinois, USA; Department of Ophthalmology (P.M.), Save Sight Institute, University of Sydney School of Medicine, Sydney, New South Wales, Australia; Academic Unit of Ophthalmology (P.I.M.), University of Birmingham, Birmingham, UK; Emmes Co, LLC (NO), Rockville, Maryland, USA; Department of Ophthalmology (A.G.P.), University of Colorado School of Medicine, Aurora, Colorado, USA; Departments of Medicine and Ophthalmology (J.T.R.), Oregon Health and Science University, Portland, Oregon, USA; Legacy Devers Eye Institute (J.T.R.), Portland, Oregon, USA; and the Department of Medicine (B.E.T.), Texas A&M University, College Station, Texas, USA.}}^{^{4
Financial Disclosures: Douglas A. Jabs: none. Nisha R. Acharya: none. Laure Caspers: none. Soon-Phaik Chee is a consultant for and receives grant support from AbbVie, Alcon Laboratories, Bausch & Lomb Surgical, Carl Zeiss, HOYA Medical Singapore Pte, Johnson & Johnson Vision, Leica Microsystems, and Ziemer Ophthalmics; and receives grant support from Allergan, Gilead Sciences, Santen Pharmaceutical Asia, and Ziemer Ophthalmics. Debra Goldstein: none. Peter McCluskey: none. Philip I. Murray: none. Neal Oden: none. Alan G. Palestine: none. James T. Rosenbaum is a consultant for AbbVie, Eyevensys, Gilead, Horizon, Janssen, Novartis, Roche, Santen, and UCB; and receives grant support from Pfizer; and royalties from 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.}}^{^{⁎
Inquiries to Douglas A. Jabs, Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, 615 North Wolfe St, Baltimore, MD 21205, USA; E-mail: djabs@jhmi.edu.}}
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

The purpose of this study was to determine classification criteria for herpes simplex virus (HSV) anterior uveitis

Design

Machine learning of cases with HSV 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 in the training set to determine a parsimonious set of criteria that minimized the misclassification rate among the anterior uveitides. The resulting criteria were evaluated in the validation set.

Results

A total of 1,083 cases of anterior uveitides, including 101 cases of HSV 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 HSV anterior uveitis included unilateral anterior uveitis with either 1) positive aqueous humor polymerase chain reaction assay for HSV; 2) sectoral iris atrophy in a patient ≤50 years old; or 3) HSV keratitis. The misclassification rates for HSV anterior uveitis were 8.3% in the training set and 17% in the validation set.

Conclusions

The criteria for HSV anterior uveitis had a reasonably low misclassification rate and appeared to perform well enough for use in clinical and translational research.

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Plan

METHODS

Informatics

Case Collection and Case Selection

Supplemental Material available at AJO.com.

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Vol 228

P. 231-236 - août 2021 Retour au numéro

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Classification Criteria for Sarcoidosis-Associated Uveitis
The Standardization of Uveitis Nomenclature (SUN) Working Group, Douglas A. Jabs, Nisha R. Acharya, Alastair K. Denniston, Susan L. Lightman, Peter McCluskey, Neal Oden, Annabelle A. Okada, Alan G. Palestine, Jennifer E. Thorne, Brett E. Trusko, Albert Vitale

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Classification Criteria for Acute Retinal Necrosis Syndrome
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Classification Criteria for Herpes Simplex Virus Anterior Uveitis - 21/10/21

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