Preliminary exploration of metagenomic sequencing for pathogenic identification in infectious uveitis

Purpose To evaluate the advantages and clinical utility of metagenomic sequencing (MGS) in diagnosing infectious uveitis pathogens. Methods A retrospective study was conducted on 20 infectious uveitis patients (20 eyes) who received treatments at the Affiliated Eye Hospital of Shandong University of Traditional Chinese Medicine from May 2020 to February 2021. Anterior aqueous humor of the patients was collected and analyzed using MGS. Then, pathogenic microorganisms that cause uveitis were identified through bioinformatic analyses based on the sequencing data of MGS. Finally, the pathogens identified by MGS were verified using both enzyme-linked immune sorbent assay (ELISA) and quantitative PCR (qPCR). Results MGS was used to detect viral pathogens in four patients, bacterial pathogens in two patients, and viral and bacterial pathogens in one patient. Among these seven subjects, five were verified by either ELISA or qPCR. Conclusions MGS holds significant value and promising potential in diagnosing infectious uveitis pathogens. However, it cannot completely replace the traditional diagnostic techniques and still needs to be integrated with conventional methods to enhance the sensitivity and specificity of pathogen detection. As a pioneering technology, MGS will advance the field of pathogen diagnosis in infectious uveitis.