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Title	Aqueous Humor Epstein-Barr virus Polymerase Chain Reaction and Metagenomics Data in a Patient with Chronic Uveitis – Case Report

Purpose	To report aqueous EBV PCR and metagenomics results in a case of chronic uveitis.
Methods	Interventional case report.
Results	A 72-year-old male with diabetes and herpes zoster history complained of redness and blurred vision OD. AC cells, mutton-fat KP, and vitreous haze were noted. FA revealed dye leakage from retinal vessels without retinal ischemic changes. Aqueous PCR for VZV, HSV, CMV, and EBV was negative. Inflammation recurred and vitreous haze worsened after discontinuing nine-month topical ganciclovir and oral prednisolone treatment. Oral prednisolone and cyclosporin were given for three months with moderate response. EBV PCR turned out to be positive. Shotgun metagenomics revealed 1459 classified sequences (1.62%). Topical ganciclovir and methylprednisolone treatment were continued. His BCVA remained 20/40 for one year.
Conclusion	Elderly patients with diabetes or under immunosuppression may be susceptible to chronic uveitis associated with subsequent EBV infection. Repeated aqueous humor PCR was an important tool in the diagnosis of chronic indolent panuveitis. There is a trend toward the use of clinical metagenomics in the identification of ocular pathogens. However, the ability to identify live organisms with certainty will require optimized collection and sample storage methods.
Conflict of interest	No

Authors 1

Last name	LIN
Initials of first name(s)	CJ
Department	Department of Ophthalmology
City	Taichung
Country	Taiwan

Authors 2

Last name	Hsia
Initials of first name(s)	NY
Department	Department of Ophthalmology
City	Taichung
Country	Taiwan

Authors 3

Last name	Lin
Initials of first name(s)	CY
Department	Department of Ophthalmology
City	Taichung
Country	Taiwan

Authors 4

Last name	Lai
Initials of first name(s)	CT
Department	Department of Ophthalmology
City	Taichung
Country	Taiwan

Authors 5

Last name	Bair
Initials of first name(s)	H
Department	Department of Ophthalmology
City	Taichung
Country	Taiwan

Authors 6

Last name	Lin
Initials of first name(s)	JM
Department	Department of Ophthalmology
City	Taichung
Country	Taiwan

Authors 7

Last name	Tsai
Initials of first name(s)	YY
Department	Department of Ophthalmology
City	Taichung
Country	Taiwan