Current aspects of clinical and laboratory diagnosis of chlamydia infection of the posterior eye segment

The relevance of chlamydia infection is explained by an increase in the global incidence, which is about 129 million new cases of Chlamydia trachomatis infection in patients aged 15–49 years. There is recent evidence of a significant role of this pathogen in vitreoretinal damage. Chronic infection is latent and can present with chorioretinitis and vitreous dystrophy, with a high pathogen detection rate in subretinal fluid in rhegmatogenous retinal detachment (50.8%–71.4%), which suggests that this obligate intracellular pathogen is involved in the development and maintenance of inflammation. Chlamydia infection of the posterior segment is clearly substantially challenging to confirm because of the variety of clinical forms, limited symptoms, and technical difficulties of detecting the pathogen in the eye. Therefore, new approaches are needed for reliable clinical and laboratory diagnosis of this infection, which are based on molecular biology, immunofluorescence, culture, and serological test methods. The reliability of the results is determined by the quality of obtaining biological material during vitrectomy (vitreous humor, subretinal fluid), compliance with transport and sample storage conditions, and technical equipment in laboratories. In clinical practice, a set of diagnostic methods, examination of material taken directly from the posterior segment, and interdisciplinary interaction of ophthalmologists with relative specialists are required. Resolution of this challenge will ensure adequate treatment and improve visual prognosis.