Classification Criteria for Cytomegalovirus Anterior Uveitis

Am J Ophthalmol. 2021 Aug:228:89-95. doi: 10.1016/j.ajo.2021.03.060. Epub 2021 Apr 9.

Abstract

Purpose: To determine classification criteria for cytomegalovirus (CMV) anterior uveitis.

Design: Machine learning of cases with CMV 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 89 cases of CMV 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 CMV anterior uveitis included unilateral anterior uveitis with a positive aqueous humor polymerase chain reaction assay for CMV. No clinical features reliably diagnosed CMV anterior uveitis. The misclassification rates for CMV anterior uveitis were 1.3% in the training set and 0% in the validation set.

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

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aqueous Humor / virology
  • Consensus*
  • Cytomegalovirus / genetics
  • Cytomegalovirus Infections / classification*
  • Cytomegalovirus Infections / virology
  • DNA, Viral / analysis
  • Eye Infections, Viral / classification*
  • Eye Infections, Viral / diagnosis
  • Eye Infections, Viral / virology
  • Female
  • Humans
  • Machine Learning*
  • Male
  • Middle Aged
  • Uveitis, Anterior / classification*
  • Uveitis, Anterior / diagnosis
  • Uveitis, Anterior / etiology
  • Young Adult

Substances

  • DNA, Viral