Detection of herpes simplex virus type 1, 2 and varicella zoster virus DNA in recipient corneal buttons

Abstract

Aim-To study the value of polymerase chain reaction (PCR) analysis, to detect viral DNA in recipient corneal buttons taken at the time of penetrating keratoplasty (PKP) in patients with an initial diagnosis of herpetic stromal keratitis (HSK). Since HSK has a tendency to recur, an accurate diagnosis of previous HSK could be the reason to start antiviral treatment immediately, thereby possibly decreasing the number of graft failures due to recurrent herpetic keratitis. Methods-Recipient corneal buttons and aqueous humour (AH) samples were obtained at the time of PKP from HSK patients (n=31) and from other patients (n=78). Eye bank corneas were also used (n=23). Herpes simplex virus type 1 (HSV-1), type 2 (HSV-2), and varicella zoster virus (VZV) infection were assessed by PCR and antibody detection. Results-The clinical diagnosis HSK could be confirmed by PCR for HSV-1 in 10/31 (32%). In these corneal buttons HSV-2 DNA was detected in 1/31 (3%) and VZV DNA in 6/31 (19%). Intraocular anti-HSV antibody production was detected in 9/28 AH samples tested (32%). In the other patient derived corneas HSV-1 DNA was detected in 13/78 (17%), including eight failed corneal grafts without clinically obvious herpetic keratitis in the medical history. In clear eye bank corneas HSV-1 was detected in 1/23 (4%). Conclusions-PCR of HSV-1 on corneal buttons can be a useful diagnostic tool in addition to detection of intraocular anti-HSV antibody production. Furthermore, the results were suggestive for the involvement of corneal HSV infection during allograft failure of corneas without previous clinical characteristic signs of herpetic keratitis.

Specific antibody production in herpes keratitis: intraocular inflammation and corneal neovascularisation as predicting factors

“…In the cornea, although intracorneal latency is suspected but not proven, there is now compelling evidence that HSV DNA may be found in corneas with herpetic lesions, non-herpetic lesions, and in clear corneas [2,5,13,31]. We postulate that in patients with a history of recurrent herpes, this HSV DNA present in corneal tissue may trigger antibody production even in the absence of acute manifestation of the disease.…”

Herpes simplex virus DNA in corneal transplants: Prospective study of 38 recipients

“…HSV DNA has been found by PCR and by in situ hybridization in the corneal tissue of patients with a history of herpetic keratitis, but also in patients with no clinical signs of herpes infection [Cantin et al, 1991;Kaye et al, 1991;Openshaw et al, 1995;Biney and Orrett, 1997;Biswas et al, 2000;Kaye et al, 2000;Van Gelderen et al, 2000].…”

The relationship of graft survival and herpes simplex virus latency in recipient corneal buttons

“…HSV virus can also undergo latency and reactivation in the cornea as an extraneuronal site after HSK disease (Pavan-Langston et al 1989;Rong et al 1991). In previous studies HSV detection rate by PCR ranged from 32% to 82% in donor cornea buttons of subjects with a past history of herpes keratitis (Cantin et al 1991;van Gelderen et al 2000;Kaye et al 2000).…”