Specific antibody production in herpes keratitis: intraocular inflammation and corneal neovascularisation as predicting factors.
OBJECTIVE
The purpose of the study is to investigate whether analysis of specific antibody synthesis can aid the diagnosis of herpes keratitis.


METHODS
Aqueous humor was collected from 39 patients with presumed recurrent herpes keratitis, including 23 consulting for keratitis and 16 patients scheduled for penetrating keratoplasty. Local antibody production was ascertained by analysis of paired aqueous humor/serum samples, using a modified micro-ELISA technique.


RESULTS
Local production of antibodies was found in 32 patients (82%): anti-herpes simplex virus (HSV) antibodies in 26 (67%) and anti-varicella zoster virus (VZV) antibodies in 11 (28%). Twenty of 23 patients with active keratitis (87%), and 12 of 16 undergoing keratoplasty (75%), tested positive. Five patients had local production of both anti-HSV and anti-VZV antibodies, whereas seven patients tested negative. Local antibody production was significantly associated with intraocular inflammation (P<0.05), corneal neovascularisation (P<0.05), and positive response to anti-viral treatment (P<0.05). No complications were encountered in sampling aqueous humor.


CONCLUSIONS
Assessment of local anti-HSV and -VZV antibody production is a safe and reliable diagnostic procedure for recurrent herpes keratitis. It might be particularly helpful in patients presenting with intraocular inflammation and neovascularisation since it discriminates between herpes and non-herpes pathologies and may therefore be useful for preventive and therapeutic strategies.
Robert
Pierre-Yves
PY
Department of Ophthalmology, CHU Dupuytren, 2 av. Martin Luther King, 87042, Limoges Cedex, France.
Liekfeld
Anja
A
Metzner
Sylvia
S
Ranger-Rogez
Sylvie
S
Adenis
Jean-Paul
JP
Denis
François
F
Hartmann
Christian
C
Pleyer
Uwe
U
D000212:Acyclovir / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000914:Antibodies, Viral / Q000032:analysis*; D000998:Antiviral Agents / Q000627:therapeutic use; D001082:Aqueous Humor / Q000276:immunology*; D016510:Corneal Neovascularization / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D018259:Herpesvirus 1, Human / Q000276:immunology*; D014645:Herpesvirus 3, Human / Q000276:immunology*; D006801:Humans; D016849:Keratitis, Herpetic / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*; D015948:Keratoplasty, Penetrating; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012307:Risk Factors; D014605:Uveitis / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology*
D000914:Antibodies, Viral; D000998:Antiviral Agents; D000212:Acyclovir