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. 2000 Nov;84(11):1238–1243. doi: 10.1136/bjo.84.11.1238

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

B E van Gelderen 1, A Van der Lelij 1, W Treffers 1, R van der Gaag 1
PMCID: PMC1723286  PMID: 11049947

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.



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Figure 1  .

Figure 1  

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Electrophoresis gels of corneal DNA samples. The product sizes of the PCR for HSV-1, HSV-2, and VZV are indicated in (A), (B), and (C) respectively. Neg = negative control, Pos = positive control (explained in Materials and methods).

Figure 2  .

Figure 2  

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Cases with positive PCR results in the PCR for HSV-1 had significantly shorter time periods between the last episode of HSK and PKP then cases with negative PCRs (Mann-Whitney test, p=0.004). The median time period was 10 months (range 1-125 months) with positive HSV-1 PCRs and 41 months (range 11-210 months) with negative PCR results.

Selected References

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