April 2011
Volume 52, Issue 14
Free
ARVO Annual Meeting Abstract  |   April 2011
A Comparison Of The Clinical And Molecular Diagnosis Of Herpes Simplex Keratitis
Author Affiliations & Notes
  • Sarah D. Atkinson
    University of Ulster at Coleraine - E Titles, Coleraine, United Kingdom
  • Victoria E. McGilligan
    University of Ulster at Coleraine - E Titles, Coleraine, United Kingdom
  • Jonathan E. Moore
    University of Ulster at Coleraine - E Titles, Coleraine, United Kingdom
    Ophthalmology,
    Belfast Health and Social Care Trust, Belfast, United Kingdom
  • Mohammad Tallouzi
    Birmingham and Midland Eye Centre, Birmingham, United Kingdom
  • Susan Feeney
    Virology,
    Belfast Health and Social Care Trust, Belfast, United Kingdom
  • Anant Sharma
    University of Ulster at Coleraine - E Titles, Coleraine, United Kingdom
    Ophthalmology, Moorfields, Bedford, United Kingdom
  • Sunil Shah
    University of Ulster at Coleraine - E Titles, Coleraine, United Kingdom
    Birmingham and Midland Eye Centre, Birmingham, United Kingdom
  • Jonathan Jackson
    Ophthalmology,
    Belfast Health and Social Care Trust, Belfast, United Kingdom
  • David G. Frazer
    Ophthalmology,
    Belfast Health and Social Care Trust, Belfast, United Kingdom
  • Tara C. Moore
    University of Ulster at Coleraine - E Titles, Coleraine, United Kingdom
Investigative Ophthalmology & Visual Science April 2011, Vol.52, 6630. doi:
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      Sarah D. Atkinson, Victoria E. McGilligan, Jonathan E. Moore, Mohammad Tallouzi, Susan Feeney, Anant Sharma, Sunil Shah, Jonathan Jackson, David G. Frazer, Tara C. Moore; A Comparison Of The Clinical And Molecular Diagnosis Of Herpes Simplex Keratitis. Invest. Ophthalmol. Vis. Sci. 2011;52(14):6630.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: : A comparison of the clinical and molecular diagnosis of Herpes Simplex Keratitis (HSK).

Methods: : Conjunctival swabs were obtained from 146 participants. The cohort consisted of participants with typical dendrite presentation of HSK (n=54), various atypical presentations of HSK (n=38), old cases of HSK (n=17) and other ocular conditions or a normal ocular surface (n=37). Samples were processed for the detection of viral DNA: HSV1; HSV2; Varicella Zoster Virus (VZV) and Adenovirus (ADV) using two real time PCR methods.

Results: : Participants who displayed clinical signs of typical or atypical HSK were positive for HSV1 in 46% and 8% of cases respectively, when using primers against the GpD region of the virus. When the samples were retested with primers against the GpB region, four additional participants were positive for HSV1. Three participants (6%) diagnosed with typical HSK and three (8%) with atypical HSK were positive for ADV DNA. Antiviral use by participants at the time of sampling was shown to significantly effect the PCR results of this study, suggesting viral clearance prior to sampling (p<0.05). All non-clinically diagnosed HSK control participants were negative for HSV1 DNA. Sample quantity was confirmed by testing for housekeeping control genes. PCR results from in vitro control investigations of HSV1 and 2 infected corneal rims and conjunctival epithelial cells were 100% positive for infected and 100% negative for uninfected samples when assessed using both PCR methods.

Conclusions: : This study demonstrated a moderate level of agreement (kappa = 0.485, p<0.0001) between the clinical and molecular diagnosis of typical cases of HSK. Twenty percent (n=11) of the typical HSK cases presented remained without a definitive diagnosis. Results indicate that other ocular surface infections with similar presentations should be considered when making a clinical diagnosis and for molecular diagnosis when using PCR, the use of an antiviral at the time of sampling and the variability between the primers used for the detection of HSV1 DNA should be deliberated.

Keywords: herpes simplex virus • adenovirus • clinical laboratory testing 
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