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Updated: Jul 4, 2025
Recurrent Herpetic Stromal Keratitis in Mice, a Model for Studying Human HSK
Published on: December 18, 2012
Effect of atopic conditions on development and recurrences of infectious keratitis
Yutaka Omatsu1, Yumiko Shimizu1, Tomoko Haruki1
1Division of Ophthalmology and Visual Science, Faculty of Medicine, Tottori University, Tottori, Japan.
Background:
Atopic conditions are known to be associated with viral and bacterial infections. The purpose of this study was to determine the relationship between the effects of atopic conditions on the severity and recurrence of ocular infections including herpes simplex virus (HSV).
Methods:
This study was performed on 474 consecutive patients with infectious keratitis caused by bacteria, fungus, acanthamoeba, HSV, or varicella-zoster virus. The relationships between the atopic condition and specific infectious pathogens and HSV were determined using real-time PCR.
Results:
Our findings showed that atopic dermatitis (AD) was significantly associated with the incidence of HSV keratitis (odds ratio (OR), 10.2; P = 0.000). Other associations with AD were observed only with bacteria in an adverse manner. HSV proliferation in the lesions of patients with HSV keratitis whose AD was associated with non-infectious atopic blepharitis were significantly greater by 145-folds (P = 0.000). The presence of asthma or allergic rhinitis also increased the HSV DNA copy numbers. A recurrence of HSV keratitis was observed in 70 patients (43.2 %), and mean time to recurrence was 1647 days. Cox proportional hazard model indicated that the epithelial type of HSV recurrence but not the stromal type was associated with atopic conditions especially with AD. The factors significantly associated with a recurrence was AD associated with non-infectious atopic blepharitis (HR: 6.11, P = 0.000) and asthma (HR: 3.03, P = 0.025).
Conclusions:
Atopic conditions, especially AD with atopic blepharitis, are significantly associated with the development, increased proliferation, and shorter time to a recurrence on HSV keratitis.
Insights
Atopic conditions, particularly atopic dermatitis, significantly increase the risk and severity of herpes simplex virus (HSV) keratitis. These conditions also accelerate HSV keratitis recurrence, impacting patient outcomes.
Area of Science:
- Ophthalmology
- Immunology
- Infectious Diseases
Background:
- Atopic conditions are linked to increased susceptibility and severity of viral and bacterial infections.
- Understanding the specific impact of atopy on ocular infections, especially herpes simplex virus (HSV), is crucial.
Purpose of the Study:
- To investigate the relationship between atopic conditions and the severity and recurrence of ocular infections, with a focus on HSV keratitis.
- To determine how atopy influences the incidence, proliferation, and recurrence patterns of HSV keratitis.
Main Methods:
- A study involving 474 patients with infectious keratitis caused by various pathogens including HSV.
- Real-time PCR was utilized to assess the relationships between atopic conditions and specific infectious agents, particularly HSV.
- Cox proportional hazard models were employed to analyze factors associated with HSV keratitis recurrence.
Main Results:
- Atopic dermatitis (AD) showed a strong association with the incidence of HSV keratitis (OR, 10.2).
- HSV proliferation was significantly higher (145-fold increase) in patients with AD and atopic blepharitis.
- Atopic conditions, especially AD with atopic blepharitis and asthma, were significantly associated with increased recurrence of HSV keratitis.
Conclusions:
- Atopic conditions, particularly AD with atopic blepharitis, are significantly linked to the development and increased proliferation of HSV keratitis.
- Atopy is associated with a shorter time to recurrence of HSV keratitis, especially the epithelial type.
- Asthma and allergic rhinitis also contribute to increased HSV DNA copy numbers and recurrence risk.
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