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Ex Vivo Infection of Murine Epidermis with Herpes Simplex Virus Type 1
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Use of a corneal impression membrane and PCR for the detection of herpes simplex virus type-1

Matthias Brunner1, Tobi Somerville2,1, Caroline E Corless3

  • 1Department of Corneal and External Eye Diseases, Royal Liverpool University, Hospital, Liverpool, UK.

Journal of Medical Microbiology
|July 30, 2019
PubMed

Insights

A corneal impression membrane (CIM) shows higher detection rates for herpes simplex virus type 1 (HSV-1) in suspected herpes simplex keratitis (HSK) cases compared to traditional swabs. This study suggests CIM is a more effective diagnostic tool for HSK.

Area of Science:

  • Ophthalmology
  • Virology
  • Medical Diagnostics

Background:

  • Herpes simplex keratitis (HSK) is a significant cause of corneal blindness worldwide.
  • Accurate and timely diagnosis of HSK is crucial for effective treatment and prevention of vision loss.
  • Current diagnostic methods, primarily swabs, may have limitations in detecting herpes simplex virus type 1 (HSV-1).

Purpose of the Study:

  • To evaluate the efficacy of a novel corneal impression membrane (CIM) for detecting HSV-1 in patients with suspected HSK.
  • To compare the diagnostic performance of CIM with conventional corneal swabs for HSV-1 detection.
  • To assess the utility of CIM as an alternative diagnostic tool in HSK management.

Main Methods:

  • A laboratory study involved spiking polytetrafluoroethylene CIMs and swabs with various concentrations of HSV-1, followed by DNA extraction and real-time PCR.
  • A clinical study enrolled patients with suspected HSK, collecting samples via both CIM and swab from corneal lesions.
  • Patients were categorized into probable, presumed, and possible HSK based on clinical data.

Main Results:

  • In laboratory tests, no significant difference was found in primer set performance or between CIM and swab for HSV-1 detection across dilutions.
  • In clinical evaluation of 110 patients, CIM demonstrated a significantly higher HSV-1 detection rate (36.4%) compared to swabs (25.5%) (P=0.004).
  • The detection rate for probable HSK was notably higher with CIM (43.8%) versus swabs (27.4%) (P=0.004), with lower cycle threshold values for CIM samples.

Conclusions:

  • The corneal impression membrane (CIM) is a viable and effective alternative to traditional swabs for diagnosing HSV-1 in suspected herpes simplex keratitis.
  • CIM offers improved sensitivity in detecting HSV-1, particularly in cases with probable HSK.
  • This enhanced detection capability of CIM can potentially lead to earlier and more accurate diagnosis and treatment of HSK.
Keywords:
Herpes simplex keratitiscorneal impression membranedetection of HSV-1 DNAreal time PCR

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