Galactomannan Testing Effective in Diagnosing Aspergillus Endophthalmitis, finds study

A recent study published in the Retina journal highlighted the effectiveness of galactomannan testing in diagnosing Aspergillus endophthalmitis (AE). This retrospective study evaluated the utility of galactomannan testing in intraocular fluid which offers promising evidence for a rapid and accurate diagnosis of AE.

The study enrolled 3 distinct groups of patients which had 17 eyes diagnosed with AE, 20 eyes with intraocular infections caused by bacteria, viruses, or other fungi, and 19 eyes with cataracts serving as a control group. The intraocular fluid from these patients was tested for galactomannan levels which is commonly associated with Aspergillus species. This study determined whether the presence of galactomannan could reliably distinguish AE from other types of intraocular infections.

The results of the study found the mean optical density index (ODI) of galactomannan in the AE group to be at 5.77 ± 1.73. This was significantly higher when compared to the non-Aspergillus intraocular infection group, which had an ODI of 0.19 ± 0.11, and the cataract control group, with an ODI of 0.29 ± 0.27. The contrast in these values underlined the potential of galactomannan testing as a reliable marker for Aspergillus infections within the eye.

This study employed receiver operating characteristic (ROC) curves to evaluate the diagnostic significance of the galactomannan test. The area under the ROC curve for AE was a perfect 1.00 by indicating an exceptional ability of the test to differentiate between AE and other conditions. At a cutoff ODI of 1.88, the galactomannan test achieved a sensitivity and specificity of 100% by which it correctly identified all cases of AE without any false positives.

These findings are particularly important for clinical practice, where rapid and accurate diagnosis of AE is crucial for preventing severe vision loss. The high sensitivity and specificity of galactomannan testing suggest that it could become a potential diagnostic tool by offering ophthalmologist a faster way to initiate appropriate antifungal treatment. Overall, the outcomes of this study suggest that galactomannan testing of intraocular fluid promises high diagnostic accuracy and also stands out as a rapid and reliable modality for the diagnosis of Aspergillus endophthalmitis. 

Source:

Yu, T., Chen, L., Qian, Z., & Tao, Y. (2024). EXAMINATION OF GALACTOMANNAN LEVELS IN INTRAOCULAR FLUID TO ASSIST THE DIAGNOSIS OF ASPERGILLUS ENDOPHTHALMITIS. In Retina. Ovid Technologies (Wolters Kluwer Health). https://doi.org/10.1097/iae.0000000000004119