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PubMed2006

Adult-onset syphilitic stromal keratitis.

PURPOSE: To characterize the clinical features and therapeutic outcome of stromal keratitis associated with syphilis in adults. DESIGN: Observational case series. METHODS: We examined the clinical and laboratory records at a single center of individuals with active stromal keratitis who had serological evidence of syphilis by a treponemal specific test. RESULTS: Five patients, 36 to 81 years of age, developed stromal keratitis during late syphilis. One patient with developmental signs of congenital syphilis had bilateral stromal keratitis. The others were otherwise healthy when they presented with unilateral, nonulcerative, infiltrative keratitis with stromal edema of the peripheral or paracentral cornea and mild to moderate corneal vascularization. All had an appropriate response to topical corticosteroid therapy, and two recovered good vision. Stromal keratitis recurred in two patients months to years later. CONCLUSIONS: Nonulcerative stromal keratitis presents in adults with syphilis as marginal, central, or multifocal stromal inflammation with neovascularization that responds to corticosteroid therapy but occasionally recurs.

Administration, Topical↗
PubMed2005

Microbial keratitis predisposing factors and morbidity.

PURPOSE: To examine predisposing factors, treatment costs, and visual outcome of microbial keratitis in an ophthalmic casualty and inpatient population. DESIGN: Retrospective medical records review. PARTICIPANTS: Fifteen- to 64-year-olds with microbial keratitis treated at the Royal Victorian Eye and Ear Hospital between May 2001 and April 2003 (n = 291). METHODS: Risk factors were identified from patient files. Demographic, clinical, and microbiological data; severity; outpatient visits; hospital bed days; and vision loss were examined. MAIN OUTCOME MEASURES: Cost to treat (Australian dollars), vision loss, and factors influencing these outcomes. RESULTS: Ocular trauma (106/291 [36.4%]) and contact lens (CL) wear (98/291 [33.7%]) were the most commonly identified predisposing factors; 18 (6.1%) had multiple predisposing factors; 17 (5.8%), ocular surface disease; 20 (6.9%), herpetic eye disease; 4 (1.4%), systemic associations; 5 (1.7%), other; and 23 (7.9%), unknown cause. Of trauma cases, 90.6% involved males, compared with 44% to 57% for other groups (P<0.001). Contact lens wearers were younger than the other groups--mean age 30 years, compared with 40 to 47 years (P<0.01). Gram-negative organisms were isolated more frequently in CL wearers than trauma cases (18.7% vs. 6.5%, P = 0.01). The number of outpatient visits was 4+/-1 (median +/- interquartile range), and 19.6% (57/291) were hospitalized for 5+/-2 days. Hospital resource use and vision loss were similar for predisposing factors but differed by causative microorganism. Eighty-eight percent of cases were scraped: acanthamoeba keratitis was the most expensive to treat, followed by fungal and herpetic keratitis and, lastly, culture-proven bacterial keratitis or culture-negative cases (P<0.0001). After treatment, 21.7% exhibited >2 lines of vision loss, and 1.6% of cases had > or =10 lines of vision loss. Vision loss was associated with clinical severity (P = 0.005). CONCLUSIONS: Ocular trauma and CL wear are the major predisposing factors for microbial keratitis in this age range. These cases require significant hospital resources during treatment, and the keratitis may result in loss of vision.

Acanthamoeba Keratitis↗
PubMed1999

Latanoprost increases the severity and recurrence of herpetic keratitis in the rabbit.

PURPOSE: To determine whether topically applied latanoprost increases the severity of acute herpes simplex keratitis, the rate of recurrence of herpes keratitis, or both, in the rabbit. METHODS: To determine the effect on severity of acute herpetic keratitis, the corneas of New Zealand white rabbits were infected with either the less-corticosteroid-sensitive McKrae strain or the corticosteroid-sensitive F(MP)E strain of herpes simplex virus type 1. Rabbits were randomly assigned to twice-a-day treatment with latanoprost 0.005%, dexamethasone sodium phosphate 0.1%, or balanced saline solution within 3 days of infection and evaluated daily for up to 13 days after infection. The severity of keratitis was graded in a masked manner. To determine the effect on recurrences of herpetic keratitis, animals infected with McKrae strain herpes simplex virus type 1 that survived to day 32 after infection were randomized to treatment with latanoprost 0.005% or balanced saline solution and evaluated for the presence of corneal lesions from postinfection day 32 to day 47. RESULTS: In the severity studies, treatment of F(MP)E-infected corneas with latanoprost or dexamethasone significantly worsened herpetic keratitis; by postinfection day 5, F(MP)E-infected eyes treated with dexamethasone or latanoprost demonstrated significantly higher severity scores than the eyes treated with balanced saline solution (P = .0001 and .008, respectively). Scores of McKrae-infected corneas treated with latanoprost or dexamethasone were not significantly different from scores of balanced saline solution-treated corneas. In the recurrence study, treatment with latanoprost significantly increased the appearance of clinical recurrences in McKrae-infected eyes, compared with balanced saline solution treatment (P = .0064). CONCLUSION: Latanoprost may worsen acute herpetic keratitis in the rabbit eye and increase the risk of recurrences in latently infected animals.

Acute Disease↗
PubMed2004

Topical antibacterial therapy for mycobacterial keratitis: potential for surgical prophylaxis and treatment.

BACKGROUND: Mycobacterium chelonae and Mycobacterium fortuitum are the 2 most commonly implicated species of nontuberculous mycobacteria in cases of bacterial keratitis. OBJECTIVES: This article summarizes available data on the in vitro antibacterial activity against M chelonae or M fortuitum of 2 agents-amikacin and clarithromycin-that have been used in the treatment of bacterial keratitis. In addition, the article reviews the in vitro activity of 5 commercially available topical ocular fluoro-quinolones (in order of availability, ciprofloxacin, ofloxacin, levofloxacin, gatifloxacin, and moxifloxacin) that may have potential in the surgical prophylaxis and treatment of keratitis caused by M chelonae or M fortuitum. METHODS: A search of the English-language literature indexed on the MEDLINE, Life Sciences, EMBASE, BIOSIS, and Pharmaprojects databases from 1966 to October 7, 2003, was conducted using the terms Mycobacterium chelonae, Mycobacterium fortuitum, bacterial keratitis, topical antibiotic therapy, ocular infection-mycobacteria, and LASIK infections. Data on the minimum concentrations at which 90% of isolates were inhibited (MIC(90)s) were reviewed and compared. RESULTS: In the literature reviewed, the MIC(90) against M fortuitum was from 1 to 16 microg/mL for amikacin, from </=2 to >/=8 microg/mL for clarithromycin, from 0.1 to 1 microg/mL for ciprofloxacin, from 0.5 to 3.13 microg/mL for ofloxacin, and </=2 microg/mL for levofloxacin. The results were similar against M chelonae. The fourth-generation fluoroquinolones-gatifloxacin and moxifloxacin-had similar MIC(90)s against M fortuitum (both, 0.2 to 1 microg/mL); however, moxifloxacin had greater activity than gatifloxacin against M chelonae (minimum inhibitory concentration range: moxifloxacin, </=1 to 1.6 microg/mL; gatifloxacin, 3.2 to 6.25 microg/mL). CONCLUSIONS: Topical fluoroquinolones may be beneficial for ocular surgical prophylaxis and for the treatment of keratitis caused by M chelonae or M fortuitum. Based on their reported MIC(90)s, none of the antibacterials reviewed had greater in vitro activity than moxifloxacin. In addition, moxifloxacin had greater in vitro activity than gatifloxacin against M chelonae, one of the predominant nontuberculous mycobacterial species involved in bacterial keratitis. Pending the conduct of controlled clinical studies, these findings suggest that moxifloxacin may have utility in the prevention and treatment of atypical mycobacterial keratitis.

Administration, Topical↗
PubMed2001

An in vitro resistance study of levofloxacin, ciprofloxacin, and ofloxacin using keratitis isolates of Staphylococcus aureus and Pseudomonas aeruginosa.

PURPOSE: We compared levofloxacin with ciprofloxacin and ofloxacin using the in vitro susceptibilities of Staphylococcus aureus (SA) and Pseudomonas aeruginosa (PA) keratitis isolates. DESIGN: Retrospective, clinical laboratory study of antibiotic susceptibility among keratitis isolates. PARTICIPANTS: Keratitis isolates from 200 patients with either SA or PA keratitis. METHODS: Minimum inhibitory concentrations (MICs) were determined for levofloxacin, ofloxacin, and ciprofloxacin for 93 SA keratitis isolates (68 fluoroquinolone-resistant and 25 susceptible, as determined by disk diffusion) and 107 PA keratitis isolates (13 fluoroquinolone-resistant and 94 susceptible). National Committee for Clinical Laboratory Standards susceptibilities were determined and analyzed statistically. Time kill studies were determined for fluoroquinolone-susceptible and -resistant isolates to all antibiotics at 8 microg/ml. The killing rates were determined by regression, and the colony count decreases were analyzed. MAIN OUTCOME MEASURES: The susceptibilities and potencies of levofloxacin, ciprofloxacin, and ofloxacin to SA and PA were determined from the MICs. Time kill studies determined the killing rates and decreases in colony counts. RESULTS: The fluoroquinolone-resistant SA susceptibilities to levofloxacin, ofloxacin, and ciprofloxacin were only 22%, 10%, and 3%, respectively. The fluoroquinolone-susceptible SA were 100% susceptible to all antibiotics, with levofloxacin demonstrating the best potency. The fluoroquinolone-resistant PA were resistant to all antibiotics. The fluoroquinolone-susceptible PA isolates were highly susceptible to levofloxacin, ofloxacin, and ciprofloxacin, with ciprofloxacin demonstrating the highest potency. For fluoroquinolone-susceptible SA and PA, the time kill studies determined that the killing rates and decreases in colony counts were equivalent for all three antibiotics tested. The time kill studies demonstrated no colony count decreases for the fluoroquinolone-resistant SA and PA. CONCLUSIONS: Taken together, our susceptibility and time kill data failed to demonstrate convincing differences in the susceptibility of SA and PA keratitis isolates to levofloxacin, ciprofloxacin, and ofloxacin. In general, bacterial isolates that were resistant to ciprofloxacin and ofloxacin were also resistant to levofloxacin.

Anti-Infective Agents↗
PubMed1994

Herpetic Eye Disease Study. A controlled trial of oral acyclovir for herpes simplex stromal keratitis.

PURPOSE: To evaluate the efficacy of oral acyclovir in treating stromal keratitis caused by herpes simplex virus (HSV) in patients receiving concomitant topical corticosteroids and trifluridine. METHODS: The authors performed a randomized, double-masked, placebo-controlled, multicenter trial in 104 patients with HSV stromal keratitis without accompanying HSV epithelial keratitis. Sample size was chosen so that a 5%, one-tailed test would have an 80% chance of detecting a doubling of the median time to treatment failure. Patients were randomized to receive a 10-week course of either oral acyclovir (400 mg 5 times daily, n = 51) or placebo (n = 53). All patients also received a standard regimen of topical prednisolone phosphate and trifluridine. Ophthalmologic examinations were performed weekly during the 10-week treatment period, every 2 weeks for an additional 6 weeks, and at 6 months after entry into the trial. RESULTS: The median time to treatment failure (defined as worsening or no improvement of stromal keratitis or an adverse event) was 84 days (95% confidence interval, 69-93 days) for the acyclovir group and 62 days (95% confidence interval, 57-90 days) for the placebo group. By 16 weeks, 38 patients (75%) in the acyclovir group and 39 patients (74%) in the placebo group had failed treatment. Also by that time, the keratitis had resolved with trial medications, and there was no subsequent worsening in nine patients (18%) in the acyclovir group and ten (19%) in the placebo group. None of these results were significantly different between the two groups. However, visual acuity improved over 6 months in significantly more patients in the acyclovir group than in the placebo group. CONCLUSION: There was no statistically or clinically significant beneficial effect of oral acyclovir in treating HSV stromal keratitis in patients receiving concomitant topical corticosteroids and trifluridine with regard to time to treatment failure, proportion of patients who failed treatment, proportion of patients whose keratitis resolved, time to resolution, or 6-month best-corrected visual acuity. Visual acuity improved over 6 months in more patients in the acyclovir group than in the placebo group.

Acyclovir↗
PubMed1994

Capnocytophaga keratitis. A clinicopathologic study of three patients, including electron microscopic observations.

BACKGROUND: Histopathologic studies of this unusual keratitis caused by Capnocytophaga species have not been reported previously. METHODS: The authors report the light microscopic and ultrastructural findings of three patients with a distinctive necrotizing keratitis caused by an anaerobic gram-negative bacillus. In three patients, ages 19, 81, and 91 years, a necrotizing stromal keratitis developed; two of these patients had a previous penetrating keratoplasty for pseudophakic bullous keratopathy. The first patient did not have ocular surgery previously and was treated initially for presumed Acanthamoeba keratitis. RESULTS: By light microscopy, all three keratectomy specimens were strikingly similar and showed a necrotizing and/or suppurative stromal keratitis displaying myriad slender, fusiform, gram-negative bacilli located anterior to Descemet's membrane and extending into the deep corneal stroma, assuming a "picket fence" appearance. Cultures of the cornea in case 1 grew Capnocytophaga ochracea. For the remaining two patients, a diagnosis presumptively was made based on characteristic histopathologic features. Results of electron microscopic examination showed numerous bacilli that were mostly extracellular; occasional organisms were phagocytosed by macrophages. CONCLUSION: The histopathologic features of Capnocytophaga keratitis are unique; therefore, a presumptive diagnosis can be made based on the morphology and location of the bacilli in the keratectomy specimens. To the authors' knowledge, this is the first study describing the typical histopathologic and electron microscopic findings of Capnocytophaga keratitis.

Adult↗
PubMed2001

Delayed diffuse lamellar keratitis after laser in situ keratomileusis.

Two cases are reported of delayed diffuse lamellar keratitis after uneventful laser in situ keratomileusis. The first patient presented with an epithelial defect 6 weeks after laser in situ keratomileusis. Three days later the defect was healed but diffuse lamellar keratitis was noted. This was treated with topical dexamethasone and ketorolac with complete resolution of the diffuse lamellar keratitis over 3 weeks. The second patient presented with an epithelial defect and gross diffuse lamellar keratitis 10 weeks after laser in situ keratomileusis. Treatment was with topical dexamethasone and ciprofloxacin with gradual resolution of the diffuse lamellar keratitis. Common to both patients was a background of rosacea, implanted debris with no initial reaction, and epithelial defects leading to diffuse lamellar keratitis. It is suggested that these two cases represent epithelial defect associated corneal infiltration, which resembles classical diffuse lamellar keratitis with the spread of inflammatory cells through a path of least resistance.

Administration, Topical↗
PubMed2005

Leptin in corneas from keratoconus and infectious keratitis patients.

PURPOSE: Leptin is produced primarily by adipose tissue. More recent studies have shown extra sites of leptin production in physiologic and ill human tissues. However, whether leptin originates from human corneas in infectious keratitis and keratoconus is not known. The aim of this study was to demonstrate and quantitate leptin expression in corneas with infectious keratitis and keratoconus and make comparisons to control corneas. METHODS: We examined the immunohistochemical staining of leptin in nine corneas surgically excised from patients with infectious keratitis (3 patients), keratoconus (3 patients), and donor corneas (3 patients). RESULTS: The results were analyzed using a semiquantitative scoring system of mild, moderate, and strong. Cells of the infectious keratitis group had the strongest leptin staining intensity, the control group had moderate, and the keratoconus group had mild staining intensity. The more vascular corneas in the infectious keratitis group were also associated with the greatest leptin staining. CONCLUSIONS: Our findings indicate that leptin expression was present in all three sources of corneas (infectious keratitis, keratoconus, and normal control). Quantitative scoring would imply it may play a role in infectious keratitis, although further experiments are necessary to establish any causal relationship.

Adult↗
PubMed1987

Diagnosis and management of herpes simplex stromal keratitis.

The diagnosis and optimal management of herpes simplex stromal keratitis can be problematic. Clinical features that should be evaluated include the status of the epithelium and the location and type of stromal inflammation. Two principal forms are recognized: nonnecrotizing, or disciform, keratitis and necrotizing keratitis. Both types may coexist and are sometimes accompanied by iridocyclitis and secondary ocular hypertension. Laboratory evaluation is not usually performed, although, lacking a prior history of herpes simplex epithelial keratitis, testing should be considered to seek another cause of stromal inflammation. A topical steroid is generally contraindicated in the presence of herpes simplex epithelial keratitis and has been implicated in prolonging the course of herpetic eye disease. However, judicious topical steroid therapy can be beneficial when used with protective antiviral cover for herpes simplex stromal keratitis without epithelial keratitis. Systemic antiviral therapy may prove to be a valuable adjunctive treatment, and further clinical trials are anticipated.

Adrenal Cortex Hormones↗
PubMed2002

Peripheral keratitis associated with chronic myelomonocytic leukemia.

PURPOSE: To describe a case of peripheral keratitis in a patient with an acute exacerbation of chronic myelomonocytic leukemia (CMML). METHOD: Case report and review of the literature. RESULTS: This is the second reported case of peripheral keratitis in a patient with CMML. The previously reported patient presented with peripheral keratitis that led to the diagnosis of leukemia. Our patient had an established diagnosis of CMML, and peripheral keratitis occurred during an acute exacerbation of his chronic leukemia. The keratitis resolved with topical corticosteroids in our patient. CONCLUSION: Leukemia should be included in the differential diagnosis of peripheral keratitis. Elevated white blood cell count with abnormal differential in a patient with peripheral keratitis may help to establish a diagnosis of leukemia or identify an acute exacerbation of chronic leukemia.

Administration, Topical↗
PubMed1998

16S ribosomal DNA typing for identification of pathogens in patients with bacterial keratitis.

The identification of pathogens in patients with bacterial keratitis remains problematic because standard diagnostic tests are negative for 40 to 60% of patients. A cross-sectional study was undertaken to determine if PCR and sequence analysis of 16S ribosomal DNA (rDNA) could be used to detect bacterial pathogens in patients with keratitis. Corneal specimens were collected for culture and rDNA typing. Variable segments of each rDNA specimen were amplified by PCR, sequenced, and aligned with the sequences in GenBank. Eleven patients had microbiologically documented bacterial keratitis, while 17 patients had keratitis due to other causes. Nine (82%) of 11 bacterial keratitis patients were PCR positive; each sequencing result matched the culture results. Seventeen (100%) patients with nonbacterial keratitis were PCR negative. Our data suggest that 16S rDNA typing holds promise as a rapid alternative to culture for identifying pathogens in patients with bacterial keratitis.

Adult↗
PubMed2005

Characteristic clinical features as an aid to the diagnosis of suppurative keratitis caused by filamentous fungi.

AIM: To assess whether the presence of characteristic clinical features can be used as a diagnostic aid for suppurative keratitis caused by filamentous fungi. METHODS: Patients presenting with suppurative keratitis in India underwent detailed clinical examination followed by microbiological investigation of corneal scrapes. A partial diagnostic score based upon the strength of the association, as estimated by the odds ratio, between reported clinical features and laboratory confirmed diagnoses was devised and subsequently tested using a case series from Ghana. RESULTS: Serrated margins, raised slough, dry texture, satellite lesions and coloration other than yellow occurred more frequently in cases of filamentous fungal keratitis than bacterial keratitis (p<0.05). Hypopyon and fibrinous exudate were observed more frequently in bacterial keratitis (p<0.05). When incorporated into a backwards stepwise logisitic regression model only serrated margins, raised slough, and colour were independently associated with fungal keratitis; these features were used in the scoring system. The probability of fungal infection if one clinical feature was present was 63%, increasing to 83% if all three features were present. CONCLUSIONS: Microbiological investigations should be performed whenever possible; however, where facilities are not available, a rapid presumptive diagnosis of suppurative keratitis may be possible by scoring clinical features.

Diagnosis, Differential↗
PubMed1999

Microbial keratitis following penetrating keratoplasty.

PURPOSE: To investigate the prevalence of microbial keratitis, predisposing risk factors and treatment modalities in patients who developed keratitis following penetrating keratoplasty (PK). PATIENTS AND METHODS: The records of 285 patients who had undergone PK between January 1991 and December 1995 in a tertiary care center were reviewed. Patients who developed postoperative microbial keratitis were evaluated for predisposing risk factors, microbiological etiology, response to broad spectrum antibiotic therapy and subsequent PK. Patients were mainly treated with fortified topical antibiotics with or without repeat PK. RESULTS: Of the 285 patient records reviewed, microbial keratitis developed in 21 eyes of 21 patients (7.4%). Seventy-one percent of infections occurred within 6 months after grafting. Keratitis initially began from the donor-recipient border in 16 cases (76.2%) and were central or paracentral in 5 patients. Predisposing risk factors included loose or exposed suture (9), suture removal (1), persistent epithelial defect (3), graft failure (3), contact lens wear (1), Stevens-Johnson syndrome (1). Fifteen (71.4%) patients were culture-positive consisting of Streptococcus pneumoniae (7), Staphylococcus aureus (5), Pseudomonas aureginosa (2), and Hemophilus influenzae (1). Forty-three percent of patients were successfully treated with medical therapy only. Seven patients underwent second PK for visual rehabilitation and 4 for tectonic purposes. After medical and surgical therapy, graft clarity was achieved in 17 (81%) of patients. CONCLUSIONS: The microbial keratitis following PK is a major postoperative problem affecting the long term prognosis. Careful selection of patients, and preoperative and postoperative control of risk factors, may decrease the frequency of this complication. Several factors, including loose or exposed sutures, epithelial defects, ocular surface disorders, and graft failure, may predispose patients to develop microbial keratitis following PK.

Adolescent↗
PubMed2000

Macrophage-depletion influences the course of murine HSV-1 keratitis.

PURPOSE: Herpes simplex virus type 1 infection of the cornea induces an immune-mediated disease termed "herpes stromal keratitis" (HSK) that is a major cause of blindness. In this study we investigated the influence of macrophage depletion by Cl(2) MDP encapsulated in liposomes (Cl(2) MDP-LIP) on the course of HSV-1 keratitis. METHODS: The corneas of BALB/c mice were infected with 10(5) PFU of HSV-1 (KOS strain). Mice groups received sub-conjunctival PBS or Cl( 2) MDP-LIP injections 7 and 2 days prior to infection. The eyes were studied clinically, histologically and immunohistochemically with F4/80 antibody at various time points after treatment. Clearance of the virus from the HSV-infected eyes was measured with a standard plaque assay. RESULTS: After subconjunctival Cl(2) MDP-LIP treatment, the HSV-1-induced epithelial keratitis was more severe (P < 0.05). The virus titers were significantly higher after macrophage depletion (day 7, P < 0.005). Stromal keratitis developed in 78.6% of HSV-1 infected PBS treated control mice ( n = 14) by day 14 after infection. By subconjunctival Cl(2) MDP-LIP treatment (n = 14) the incidence of stromal keratitis was reduced to 42.9%, and the keratitis was less severe (P < 0.05). CONCLUSIONS: The data demonstrate an influence of macrophages on the course of HSV-1 keratitis in mice. Macrophage depletion influence the viral replication in the cornea and the immune-mediated process of HSK.

Animals↗
PubMed2001

Fungal keratitis in a daily disposable soft contact lens wearer.

PURPOSE: To report the first case of fungal keratitis in a patient wearing daily disposable soft contact lenses. METHODS: Case Report. A 20-year-old white female in good health developed a corneal ulcer in her lefteye associated with daily disposable soft contact lens wear. There was no history of trauma to the left eye, and she denied overnight wear. Corneal scrapings were taken, and the patient was started on intensive tobramycin 14 mg/mL and cefazolin 50 mg/mL topical therapy for suspected bacterial keratitis. After 3 days of antibacterial therapy, the ulcer worsened. The cultures were negative as were the Gram stain and Gomori's methenamine silver stain. Initial cultures and stains were then repeated with the addition of a culture for herpes simplex virus. The developing clinical picture was suspicious for fungal keratitis. The patient was then started on intensive vancomycin 2%, natamycin 5%, and continued on fortified tobramycin. Three days after the second corneal scrapings were performed, a positive fungal culture was obtained for Fusarium sp. Vancomycin and tobramycin were then discontinued and amphotericin B 0.15% was added to natamycin 5% with the continuation of intensive topical therapy. RESULTS: The patient's keratitis was successfully treated with intensive double antifungal therapy. CONCLUSIONS: Infectious keratitis in daily disposable soft contact lens wear is an unusual occurrence. To our knowledge, there is no previous case of fungal keratitis occurring in patients wearing daily disposable lenses. This case emphasizes the importance of considering fungus in the differential diagnosis for keratitis even in daily disposable contact lens wearers.

Adult↗
PubMed1991

[Recurrent herpetic keratitis in mice].

In order to investigate the mechanism of recurrence in herpes simplex keratitis, it is very important to establish an animal model. As a first step, mice were examined with the slit-lamp biomicroscope to determine whether they spontaneously showed recurrent epithelial keratitis after healing of primary herpetic keratitis. Among 90 eyes of 45 inbred C57BL/6 mice, recurrent epithelial keratitis stained with fluorescein was observed in 10 eyes of 9 mice during the observation period up to 50 days after the primary corneal infection with herpes simplex virus (HSV) type I Amakata strain (virulent strain). Recurrent epithelial keratitis was observed in 17 eyes of 15 mice among 116 eyes of 58 ddy mice infected with HSV-I Ska strain (avirulent strain). The epithelial lesions showed punctate or dendritic patterns and continued for one to 7 days. HSV antigen was detected by the fluorescent antibody technique in the cornea of 5 out of 8 eyes which showed recurrent epithelial keratitis using another ddy mice group tested. It was limited in the epithelium of the cornea. These results show that mice herpetic keratitis recurs spontaneously.

Animals↗
PubMed1991

[An immunofunctional assessment of herpes simplex keratitis patients with T-lymphocyte subsets monoclonal antibodies].

The T-lymphocyte subsets T11, T4, T8, and the T4/T8 ratio in peripheral blood of patients with herpes simplex keratitis (HSK) were determined by means of monoclonal antibodies. The patients included dendritic keratitis 7 cases, geographic keratitis 7 cases, disciform keratitis 7 cases, metaherpetic keratitis 5 cases, necrotic stromal keratitis 5 cases, and inactive herpetic keratitis 11 cases; 21 healthy subjects served as controls. The results showed that the pattern of T-lymphocyte subsets in inactive patients differed little from that of the controls, while in active patients it varied for different clinical types, of which the clinical significance was discussed.

Adolescent↗