A systematic review on advances in diagnostics for herpes simplex keratitis

Area of Science:

• Ophthalmology
• Infectious Diseases
• Diagnostic Technologies

Background:

• Herpes simplex keratitis (HSK) is a leading cause of vision impairment globally.
• Current diagnostic methods, including slit lamp examination and polymerase chain reaction (PCR), face challenges with accuracy and concordance.
• Lack of standardized diagnostic criteria complicates HSK diagnosis and management.

Purpose of the Study:

• To evaluate recent studies on diagnostic techniques for herpes simplex keratitis (HSK).
• To assess the efficacy and accuracy of various diagnostic tools for HSK.
• To identify potential improvements and newer methods for HSK diagnosis.

Main Methods:

• Systematic review of 23 studies published between 2010 and 2020.
• Analysis of diagnostic techniques including in vivo confocal microscopy, PCR, enzyme-linked immunosorbent assay (ELISA), and other protein assays.
• Comparison of diagnostic accuracy based on sample type, with corneal scrapings showing higher detection rates.

Main Results:

• Polymerase chain reaction (PCR) efficacy often depends on protocol modifications.
• Tear film analysis using various protein assays showed varying accuracy.
• Corneal scrapings yielded higher positive detection rates compared to other sample types.
• Newer techniques like multiplex dot hybridization and immunochromatographic assays show promise for point-of-care diagnostics.

Conclusions:

• Accurate diagnosis of HSK remains a significant challenge for ophthalmologists.
• Standardized diagnostic protocols are needed to improve reliability and consistency.
• Emerging point-of-care diagnostic tools offer potential for rapid preliminary HSK detection.