Koizumi N, Nishida K, Adachi W, Tei M, Honma Y, Dota A, Sotozono C, Yokoi N, Yamamoto S, Kinoshita S
Department of Ophthalmology, Kyoto Prefectural University of Medicine, Japan.
Br J Ophthalmol. 1999 Aug;83(8):957-60. doi: 10.1136/bjo.83.8.957.
To study herpes simplex virus (HSV) DNA in tears from patients with atypical epithelial keratitis of unknown aetiology.
Tear samples were collected from 17 affected eyes of 17 consecutive patients suffering from epithelial keratitis in whom HSV keratitis was suspected but whose diagnosis was difficult on the basis of clinical manifestations alone. Using reduced sensitivity polymerase chain reaction (PCR), tear samples were tested for HSV DNA. Tears from the unaffected eyes of the 17 patients were also examined, along with 38 tear samples from 19 normal volunteers. Southern blot analysis was performed to confirm that amplified DNA bands were specific for HSV. Clinical correlation with photographs of corneal lesions was also investigated.
HSV DNA was detected in tears from the affected eyes of eight of the 17 patients with suspected HSV keratitis. Tears from the affected eyes of the other patients were PCR negative, as were tears from the unaffected eyes of all 17 patients, and from the 38 normal eyes. There was no correlation between PCR results and clinical manifestation of keratitis.
Based on the sensitivity of the PCR system, eight of 17 suspected HSV keratitis patients were confirmed as suffering from HSV keratitis. HSV keratitis should therefore be considered as a possible diagnosis in atypical epithelial keratitis.
研究病因不明的非典型上皮性角膜炎患者泪液中的单纯疱疹病毒（HSV）DNA。
收集17例连续上皮性角膜炎患者的17只患眼的泪液样本，这些患者疑似患有HSV角膜炎，但仅根据临床表现难以确诊。使用敏感性降低的聚合酶链反应（PCR）检测泪液样本中的HSV DNA。还检查了这17例患者未受影响眼的泪液，以及19名正常志愿者的38份泪液样本。进行Southern印迹分析以确认扩增的DNA条带对HSV具有特异性。还研究了与角膜病变照片的临床相关性。
17例疑似HSV角膜炎患者中，8例患眼的泪液检测到HSV DNA。其他患者患眼的泪液PCR检测为阴性，17例患者未受影响眼的泪液以及38只正常眼的泪液PCR检测也均为阴性。PCR结果与角膜炎的临床表现之间无相关性。
根据PCR系统的敏感性，17例疑似HSV角膜炎患者中有8例被确诊为患有HSV角膜炎。因此，在非典型上皮性角膜炎中应考虑HSV角膜炎作为可能的诊断。
