Metagenomic DNA Sequencing for the Diagnosis of Intraocular Infections

Detection of intraocular infections relies heavily on molecular diagnostics. A fundamental challenge is that only 100–300 μl of intraocular fluid can be safely obtained at any given time for diagnostic testing. The most widely available molecular diagnostic panel for infections in ophthalmology includes 4 separate pathogen-directed polymerase chain reactions (PCRs): cytomegalovirus (CMV), herpes simplex virus (HSV), varicella zoster virus (VZV), and Toxoplasma gondii. Not surprisingly, more than 50% of all presumed intraocular infections fail to have a pathogen identified.