Monitoring herpesvirus DNA in three cases of acute retinal necrosis by real-time PCR.
BACKGROUND
It is not clear whether quantitative analysis of viral DNA in ocular specimens is correlated with disease activities of acute retinal necrosis (ARN).


OBJECTIVE
To monitor viral load in ocular specimens collected from patients with ARN by real-time polymerase chain reaction (PCR).


METHODS
Ocular samples (aqueous humor and vitreous) were serially collected from three patients with ARN. Viral load in those samples was evaluated by real-time PCR.


CONCLUSIONS
In case 1, large amounts of varicella zoster virus (VZV) DNA (4.8 x 10(6) to 5.5 x 10(6) copies/ml) were detected in aqueous humor during the first 2 weeks after admission. The viral load in vitreous was higher than that in aqueous humor at the time of vitrectomy. As ophthamoscopic findings and visual acuity improved through acyclovir (ACV) treatment, the viral load in aqueous humor decreased dramatically. In case 2, the patient was treated with intravenous ACV at first, but clinical features did not improve. The herpes simplex virus (HSV)-2 viral load in aqueous humor remained stable (2.3 x 10(3) to 2.8 x 10(3) copies/ml) during the first 3 weeks after admission. The amount of HSV-2 DNA in vitreous was again higher than that in aqueous humor. Although neither clinical features nor viral load had changed by ACV, intra-ocular ganciclovir (GCV) injection improved clinical features, and decreased viral load to undetectable levels. In case 3, the patient developed ARN within 1 month after the onset of varicella and demonstrated only mild clinical symptoms. She was treated with ACV administration alone and recovered quickly. In contrast to case 1, the copy number of VZV DNA at the time of admission was low (9 x 10(2) copies/ml), and decreased quickly in response to the treatment. Correlation between viral load in ocular specimens and clinical course of the disease was demonstrated in these patients.
Department of Ophthalmology, Nagoya University School of Medicine, Nagoya, Aichi 4668550, Japan.
Shinya
S
Asano
Tetsushi
T
Yoshikawa
Hiroshi
H
Kimura
Yoshihiko
Y
Enomoto
Masahiro
M
Ohashi
Hiroko
H
Terasaki
Yukihiro
Y
Nishiyama
D000328:Adult; D001082:Aqueous Humor / Q000821:virology; D004279:DNA, Viral / Q000032:analysis*; D005260:Female; D018258:Herpesvirus 2, Human / Q000235:genetics / Q000302:isolation & purification*; D014645:Herpesvirus 3, Human / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods*; D015882:Retinal Necrosis Syndrome, Acute / Q000821:virology*; D014821:Vitrectomy; D014822:Vitreous Body / Q000821:virology
D004279:DNA, Viral