Ocular Microbiology and Immunology Group
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2024 OMIG Abstract

Seasonal Hyperacute Panuveitis (SHAPU) is associated with Streptococcus pneumonia infection

Kenji Nakamichi¹, S Shreshtha², M Sundararajan¹, B Karmacharya², M Poudel², R Upreti², AR Maharjan²,
P Banjara², A Shreshtha³, A Sandt¹, G Turski¹, E Buhr¹, A Chowdhary¹, A Manandhar^2*, RN Van Gelder<sup>1

1</sup>Department of Ophthalmology and Karalis Johnson Retina Center, University of Washington School of Medicine, Seattle, WA; ²Tilganga Eye Hospital, Kathmandu, Nepal; ³Dulikhal Hospital, Dulikhal, Nepal

Purpose: To survey vitreous biopsy samples from patients with SHAPU for presence of potential pathogens using metagenomic DNA sequencing.

Methods: DNA was extracted from vitreous biopsy of 53 subjects with SHAPU and was sequenced using nanopore long read sequencing and analyzed using the Scalable Metagenomics Analysis Research Tool (SMART).

Results: Adequate DNA was obtained from 32 samples. 15 samples yielded bacteria on culture, with 14 S. pneumonia and one Staph isolate recovered. DNA was detected by whole genome sequencing in 29/32 cases. S. pneumonia was recovered as the predominant organism in all but one sample. Bacterial loads ranged up to 10,000 bacteria/human cell indicating active infection. No pathogens were detected in control samples. Visual outcomes were mixed, with seven patients having hypotonus eyes at 6 months but 8 patients having better than 20/200 vision. No relationship could be discerned between initial bacterial load and visual outcome.

Conclusions: The majority of SHAPU cases show molecular evidence for concurrent S. pneumonia infection. Good visual results are possible in treating SHAPU as endophthalmitis.


Disclosure:

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