Corneal Sub-Basal Nerve Changes in Patients with Herpetic Keratitis during Acute Phase and after 6 Months

Abstract

Background and objectives: The purpose of this study was to describe corneal sensitivity and the morphological changes of sub-basal corneal nerves using in vivo laser scanning confocal microscopy (LSCM) in herpes simplex virus (HSV) keratitis-affected eyes, and to compare with both contralateral eyes and with the eyes of patients with a previous history of herpes labialis but no history of herpetic eye disease, and with healthy patients with no history of any HSV diseases, during the acute phase of the disease and after six months. Materials and Methods: A prospective clinical study included 269 patients. All of them underwent a complete ophthalmological examination, Cochet-Bonnet aesthesiometry and LSCM within the central 5 mm of the cornea. After six months, all the patients with herpetic eye disease underwent the same examination. Serology tests of the serum to detect HSV 1/2 IgG and IgM were performed. Results: HSV-affected eyes compared with contralateral eyes, herpes labialis and healthy control group eyes demonstrated a significant decrease in corneal sensitivity, corneal nerve fibre density, corneal nerve branch density, corneal nerve fibre length and corneal nerve total branch density (p < 0.05). During follow up after six months, corneal sensitivity and sub-basal nerve parameters had increased but did not reach the parameters of contralateral eyes (p < 0.05). Previous herpes labialis did not influence corneal sensitivity and was not a risk factor for herpetic eye disease. Conclusions: Corneal sensitivity and sub-basal nerve changes in HSV-affected eyes revealed a significant decrease compared with contralateral eyes, and with the eyes of patients with a previous history of herpes labialis, and of healthy controls. Following six months, corneal sensitivity and sub-basal nerve parameters increased; however, they did not reach the parameters of contralateral eyes and the eyes of healthy controls. The best recovery of corneal sensitivity was seen in patients with epithelial keratitis. Herpes labialis was not a risk factor for herpetic eye disease.

Altered Corneal Innervation and Ocular Surface Homeostasis in FHV-1-Exposed Cats: A Preliminary Study Suggesting Metaherpetic Disease

“…Several local and systemic etiologies can compromise corneal innervation in humans and veterinary species, including diabetes mellitus, dry eye, surgery, and ocular infections (1,(5)(6)(7). The latter is particularly wellrecognized for viruses belonging to the Herpesviridae family given their neurotropic nature and lifelong persistence in the sensory neurons, with herpes simplex virus-1 (HSV-1) disrupting corneal innervation in humans (8)(9)(10)(11) and canine herpesvirus-1 (CHV-1) recently associated with corneal hypoesthesia in a dog with protracted corneal disease (12). However, to the best of our knowledge, no published information exists for cats affected with feline herpesvirus-1 (FHV-1) despite the high (over 90%) prevalence of this infectious agent in the general feline population (13).…”

Clinico-microbiological profile of Burkholderia cepacia keratitis: a case series

“…Matoba et al also presented a patient with herpetic stroma keratitis, under oral acyclovir and topical prednisolone acetate treatment, who developed polymicrobial keratitis including B. ambifaria (belonging to the B. cepacia complex), Enterococcus spp., and Staphylococcus aureus [ 7 ]. Infection with herpes virus might cause sub-basal nerve damage of the cornea [ 12 , 13 ]. The impaired corneal sensory innervation leads to a reduction of protective reflexes and trophic neuromodulators, which affect the wound-healing function of the cornea [ 14 ], making its surface an easy target for opportunistic bacteria such as B. cepacia .…”

Clinico-microbiological Profile of Burkholderia cepacia Keratitis: a Case Series

“…Matoba et al also presented a patient with herpetic stroma keratitis, under oral acyclovir and topical prednisolone acetate treatment, who developed polymicrobial keratitis including B. ambifaria (belonging to the B. cepacia complex), Enterococcus spp., and Staphylococcus aureus [7]. Infection with herpes virus might cause subbasal nerve damage of the cornea [12,13]. The impaired corneal sensory innervation leads to a reduction of protective re exes and trophic neuromodulators, which affect the wound-healing function of the cornea [14], making its surface an easy target for opportunistic bacteria such as B. cepacia.…”