Tear HSV-Specific Secretory IgA as a Potential Indicator for Recurrent Stromal Herpes Simplex Keratitis

Huang, Feifei; Wang, Zhujian; Zhang, Chaoran

doi:10.1097/ico.0b013e31828a8b96

Cited by 9 publications

(5 citation statements)

References 19 publications

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“…Our previous study tested the tear HSV-sIgA concentrations of 41 stromal HSK and suggested that the levels of tear sIgA could be a potential prognostic parameter for the recurrence of stromal HSK [7]. This present research had enlarged the samples and prolonged the follow-up time, and the results showed that in univariate analysis tear HSV-sIgA, tear HSV-DNA and the episodes were potential risk factors for HSK recurrence.…”

Section: Discussionmentioning

confidence: 58%

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Analysis of Prophylactic Parameters and the Relative Cut-off Values for Predicting Stromal Herpes Simplex Keratitis Recurrence

Huang

Wang

Cao

et al. 2022

Preprint

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Background: To assess the potential values of clinical characters, tear HSV-sIgA and tear HSV-DNA for prediction of stromal HSK recurrence.Methods: Tears and serum IgG/IgM/IgA from 187 stromal HSK patients were collected. All the 187 tear samples serum samples were tested by ELISA for sIgA/ IgG/IgM/IgA. 146 tear samples were also tested by PCR for tear HSV-DNA. Subsequent follow-up time for monitoring recurrence was performed on all the 187 patients for 2 to 55 months.Results: The positive rate of tear HSV-sIgA was 36.90% (69/187), while for tear HSV-DNA, the positive rate was 10.96% (16/146). Totally 29 of the 187 participants experienced recurrence (15.51%). Previous episodes, tear HSV-sIgA–positive and tear HSV-DNA-positive patients had significantly shorter relapse-free survival (P<0.01, P<0.01 and P=0.0123 respectively). Patients combined univariate and multivariate analysis together, only tear HSV-sIgA was the factor for predicting the risk of herpes keratitis recurrence (HR=2.768, 95% CI =1.148-6.674, p= 0.023). By using Youden index, the concentration of tear HSV-sIgA >= 22.34 U/ul indicated a higher risks for relapse (sensitivity=79.31%, specificity=63.92%, Youden index=0.43).Conclusions: Though episode, tear HSV-sIgA and tear HSV-DNA all have high correlation with recurrent herpes keratitis, only tear HSV-sIgA is considered to be the most appropriated candidate for predicting the risk of recrudescent HSK. As tear HSV-sIgA >=22.34 U/ul, the risks for recurrence will be much higher. It is might be an appropriate cut-off value for predicting recurrence.

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Section: Discussionmentioning

confidence: 58%

“…Tear HSV-sIgA is proved an adjunct to HSK diagnosis [6]. Our previous study has found that tear HSV-sIgA could be a potential prognostic parameter for the recurrence of stromal HSK [7].…”

Section: Introductionmentioning

confidence: 99%

Analysis of Prophylactic Parameters and the Relative Cut-off Values for Predicting Stromal Herpes Simplex Keratitis Recurrence

Huang

Wang

Cao

et al. 2022

Preprint

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“…In our report, only 1 of the 5 cases was promptly diagnosed with its typical dendritic shape under corneal fluorescent staining. Therefore, an early and accurate diagnosis is very important, for which the tear HSV-sIgA examination can be very useful in diagnosing stromal HSK and predicting recurrence, even for atypical or unsuspected cases [ 11 , 12 ]. Two of our cases were quickly diagnosed with elevated tear HSV-sIgA, and successfully controlled with antiviral treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Corneal scrapings were performed in all cases under topical anesthesia and then inoculated directly into primary culture media for bacteria and fungi. Tear samples from the lower fornixes of both eyes were collected and assayed by enzyme-linked immunosorbent assay (ELISA) to detect HSV sIgA [ 12 ]. For cases with negative tear HSV-sIgA, small cornea tissue around the ulcer was scraped and processed for DNA extraction, and then a corneal HSV DNA polymerase chain reaction (PCR), or next-generation metagenomics sequencing (mNGS) test was chosen to detect the HSV pathogen load [ 13 ].…”

Section: Case Reportmentioning

confidence: 99%

“…Clinical diagnosis in acute keratitis is usually not difficult, but laboratory diagnosis is frequently recommended, since HSK ulcers do not often present a classic dendritic or geographic appearance, particularly if it is the first episode of occurrence without a previously confirmed diagnosis [ 4 ]. Detecting HSV-specific tear secretory IgA (sIgA) has been shown to be highly efficient, with the benefits of safety and convenience [ 11 , 12 ]. This retrospective study describes the presentation of HSK after pterygium surgery in 5 patients without a history of herpetic disease.…”

Section: Introductionmentioning

confidence: 99%

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Herpes Simplex Keratitis as a Complication of Pterygium Surgery

Cui,

Qiu,

Huang

et al. 2024

Am J Case Rep

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Case series Patients: Male, 69-year-old • Male, 62-year-old • Male, 64-year-old • Male, 42-year-old • Male, 73-year-old Final Diagnosis: Herpes simplex keratitis Symptoms: Eye pain and redness Clinical Procedure: — Specialty: Ophthalmology Objective: Rare disease Background: Infectious keratitis after pterygium surgery is a rare but potentially devastating complication. The present study presents 5 cases of herpes simplex keratitis (HSK) after pterygium surgery. Case Report: This study was conducted in our clinic in a 5-year period from February 2017 to September 2021. The 5 patients were men, aged between 42 and 73 years, with no prior history of herpes simplex virus (HSV) infections. Symptoms appeared near 1 month (median 30 days, range 10 to 70 days) after primary pterygium surgery. Diagnosis was based on clinical symptoms and laboratory test results, such as tear HSV-sIgA, corneal tissue polymerase chain reaction, and next-generation sequencing of metagenomics. The epithelial (1/5) and stromal (4/5) subtypes of HSK were identified. The patients received topical ganciclovir gel, immunosuppressive eye-drops, and oral acyclovir tablets, along with additional surgical interventions if necessary. Three were healed with conservative therapy, 1 eye required amniotic membrane transplantation due to corneal melt, and 1 was perforated and followed by corneal grafting. Finally, a literature review of previous publications on HSK after ocular surgeries was conducted. Conclusions: HSK is a rare but serious complication that can arise after uneventful pterygium surgery. It is worthy of attention that both epithelial and stromal forms can occur. Timely diagnosis and treatment are crucial to prevent unfavorable outcomes. Consequently, routine corneal fluorescein staining, tear sIgA examination, and corneal scraping for polymerase chain reaction or next-generation sequencing of metagenomics should be performed in any suspected cases.

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Tear Off the Disease

Prashar¹

2019

Shed Tears for Diagnostics

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Tear HSV-Specific Secretory IgA as a Potential Indicator for Recurrent Stromal Herpes Simplex Keratitis

Abstract: This is the first preliminary study suggesting that the levels of tear sIgA could be a potential prognostic parameter for the recurrence of HSK.

Cited by 9 publications

References 19 publications

Analysis of Prophylactic Parameters and the Relative Cut-off Values for Predicting Stromal Herpes Simplex Keratitis Recurrence

Analysis of Prophylactic Parameters and the Relative Cut-off Values for Predicting Stromal Herpes Simplex Keratitis Recurrence

Herpes Simplex Keratitis as a Complication of Pterygium Surgery

Tear Off the Disease

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