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Qiu JN, Huang FF, Liu CH, Cao WJ, Zhang CR. Atypical stromal herpes simplex keratitis: clinical features and diagnosis. Jpn J Ophthalmol 2023; 67:43-49. [PMID: 36367597 DOI: 10.1007/s10384-022-00963-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 09/22/2022] [Indexed: 11/13/2022]
Abstract
PURPOSE To report atypical clinical features and diagnosis of stromal herpes simplex keratitis (HSK) and to evaluate the diagnostic efficiency of tear HSV-sIgA in atypical HSK. STUDY DESIGN Prospective observational study. METHODS Records of keratitis' patients with tear herpes simplex virus (HSV)-sIgA test results acquired between May 2019 and November 2021 were evaluated retrospectively. Positive tear HSV-sIgA test was used to identify herpes simplex virus (HSV) infection. Patients with typical presentations and histories of HSV keratitis (HSK) were excluded. RESULTS Eleven eyes of 11 patients initially diagnosed as keratitis caused by other etiology were confirmed as having HSV infection by positive results of tear HSV-sIgA. Clinical features of atypical stromal HSK were variable. Antiviral treatment was effective in all patients. CONCLUSION The appearance of an atypical stromal HSK represents a diagnostic challenge. Tear HSV-sIgA test could help provide a quick diagnosis.
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Affiliation(s)
- Ji-Ni Qiu
- Eye Institute, Eye & ENT Hospital, Shanghai Medical College, Fudan University, 83 Fenyang Road, Shanghai, 200031, China.,Laboratory of Myopia, Chinese Academy of Medical Sciences, NHC Key Laboratory of Myopia (Fudan University), Shanghai, 200031, China
| | - Fei-Fei Huang
- Eye Institute, Eye & ENT Hospital, Shanghai Medical College, Fudan University, 83 Fenyang Road, Shanghai, 200031, China.,Laboratory of Myopia, Chinese Academy of Medical Sciences, NHC Key Laboratory of Myopia (Fudan University), Shanghai, 200031, China
| | - Chun-Hong Liu
- Department of Clinical Laboratory, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, 200031, China
| | - Wen-Jun Cao
- Department of Clinical Laboratory, Eye & ENT Hospital, Shanghai Medical College, Fudan University, Shanghai, 200031, China
| | - Chao-Ran Zhang
- Eye Institute, Eye & ENT Hospital, Shanghai Medical College, Fudan University, 83 Fenyang Road, Shanghai, 200031, China. .,Laboratory of Myopia, Chinese Academy of Medical Sciences, NHC Key Laboratory of Myopia (Fudan University), Shanghai, 200031, China.
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Poon SHL, Wong WHL, Lo ACY, Yuan H, Chen CF, Jhanji V, Chan YK, Shih KC. A systematic review on advances in diagnostics for herpes simplex keratitis. Surv Ophthalmol 2020; 66:514-530. [PMID: 33186564 DOI: 10.1016/j.survophthal.2020.09.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 09/21/2020] [Accepted: 09/30/2020] [Indexed: 11/30/2022]
Abstract
Herpes simplex keratitis (HSK) is a significant cause of vision impairment worldwide. Currently, there are no set diagnostic criteria, and popular diagnostic methods, including clinical examination of the eye via slit lamp examination, could lead to false-negatives and misdiagnoses. Molecular testing with polymerase chain reaction (PCR) may lack concordance with clinical findings, posing a great challenge to ophthalmologists. We evaluate recent studies on techniques for the diagnosis of HSK. We included a total of 23 studies published between 2010 and 2020 in English on diagnostic techniques, including in vivo confocal microscopy, polymerase PCR testing, protein detection in tear film with enzyme-linked immunosorbent assay, and various other protein assays. Although PCR has been widely used as one of the current diagnostic methods for HSK, most studies evaluated its efficacy after including alterations to its normal protocol. Tear sample analysis was performed using multiple tools, although corneal scrapings demonstrated a higher positive detection rate. Diagnostic tools identified were able to detect HSK with varying accuracy. Newer diagnostic techniques like multiplex dot hybridization assay and immunochromatographic assays may be considered as the point-of-care preliminary diagnostic tools. More reliable results may be generated by developing a standardized diagnostic protocol.
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Affiliation(s)
- Stephanie Hiu Ling Poon
- Department of Ophthalmology, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Pokfulam, Hong Kong SAR
| | - William Ho Lam Wong
- Department of Ophthalmology, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Pokfulam, Hong Kong SAR
| | - Amy Cheuk Yin Lo
- Department of Ophthalmology, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Pokfulam, Hong Kong SAR
| | - Hao Yuan
- Institute of Applied Mechanics, National Taiwan University, Taipei, Taiwan
| | - Chien-Fu Chen
- Institute of Applied Mechanics, National Taiwan University, Taipei, Taiwan
| | - Vishal Jhanji
- Department of Ophthalmology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Yau Kei Chan
- Department of Ophthalmology, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Pokfulam, Hong Kong SAR
| | - Kendrick Co Shih
- Department of Ophthalmology, Li Ka Shing Faculty of Medicine, the University of Hong Kong, Pokfulam, Hong Kong SAR.
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Xie X, Chen C, Sun T, Mamati G, Wan X, Zhang W, Gao R, Chen F, Wu W, Fan Y, Lv X, Wu G. Rapid, non-invasive screening of keratitis based on Raman spectroscopy combined with multivariate statistical analysis. Photodiagnosis Photodyn Ther 2020; 31:101932. [PMID: 32717454 DOI: 10.1016/j.pdpdt.2020.101932] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 06/29/2020] [Accepted: 07/17/2020] [Indexed: 02/07/2023]
Abstract
This study proposes a multivariate statistical analysis method based on Raman spectroscopy and different dimensionality reduction methods combined with the support vector machine (SVM) algorithm for rapid, non-invasive, high-accuracy classification of keratitis screenings. In this experiment, tear samples from 19 subjects with keratitis and 27 healthy subjects were detected, Raman spectra of the two groups of subjects were compared and analysed, and we found that their spectral intensities were different at 1005 cm-1 and 1155 cm-1 Principal component analysis (PCA) and partial least squares (PLS) were used for feature extraction, which greatly reduced the dimensionality of the high-dimensional spectral data. Then, the above two feature extraction methods were used as input to an SVM to build the discriminant diagnosis model. The average accuracy obtained from the PCA-SVM and PLS-SVM models was 77.86 % and 100 %, respectively. Our results suggest that tear Raman spectroscopy combined with multivariate statistical analysis has great potential in screening for keratitis. We expect this technology to could lead to the development of a portable, non-invasive and highly accurate keratitis screening device.
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Affiliation(s)
- Xiaodong Xie
- People's Hospital of Xinjiang Uygur Autonomous Region, 91 Tianchi Road, Ophthalmology, Urumqi 830001, China
| | - Cheng Chen
- School of Information Science and Engineering, Xinjiang University, Urumqi 830046, China
| | - Tiantian Sun
- School of Information Science and Engineering, Xinjiang University, Urumqi 830046, China
| | - Gulinur Mamati
- People's Hospital of Xinjiang Uygur Autonomous Region, 91 Tianchi Road, Ophthalmology, Urumqi 830001, China
| | - Xinjuan Wan
- People's Hospital of Xinjiang Uygur Autonomous Region, 91 Tianchi Road, Ophthalmology, Urumqi 830001, China
| | - Wenjuan Zhang
- People's Hospital of Xinjiang Uygur Autonomous Region, 91 Tianchi Road, Ophthalmology, Urumqi 830001, China
| | - Rui Gao
- School of Information Science and Engineering, Xinjiang University, Urumqi 830046, China
| | - Fangfang Chen
- School of Information Science and Engineering, Xinjiang University, Urumqi 830046, China
| | - Wei Wu
- School of Software, Xinjiang University, Urumqi 840046, China
| | - Yangyang Fan
- School of Software, Xinjiang University, Urumqi 840046, China
| | - Xiaoyi Lv
- School of Software, Xinjiang University, Urumqi 840046, China.
| | - Guohua Wu
- School of Electronic Engineering, Beijing University of Posts and Telecommunications, Beijing 100876, China.
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Landis ZC, Pantanelli SM. Corneal and Conjunctival Infectious Disease Diagnostics. Int Ophthalmol Clin 2018; 57:1-11. [PMID: 28590277 DOI: 10.1097/iio.0000000000000182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Qiu J, Huang F, Wang Z, Xu J, Zhang C. The evaluation of diagnostic efficiency for stromal herpes simplex keratitis by the combination of tear HSV-sIgA and HSV-DNA. Graefes Arch Clin Exp Ophthalmol 2017; 255:1409-1415. [DOI: 10.1007/s00417-017-3653-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 03/12/2017] [Accepted: 03/20/2017] [Indexed: 11/30/2022] Open
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Ma JX, Wang LN, Zhou RX, Yu Y, Du TX. Real-time polymerase chain reaction for the diagnosis of necrotizing herpes stromal keratitis. Int J Ophthalmol 2016; 9:682-6. [PMID: 27275421 DOI: 10.18240/ijo.2016.05.07] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2015] [Accepted: 07/28/2015] [Indexed: 11/23/2022] Open
Abstract
AIM To design, optimize and validate a rapid, internally controlled real-time polymerase chain reaction (RT-PCR) test for herpes simplex virus (HSV) in the diagnosis of necrotizing herpes stromal keratitis. METHODS Tears alone or together with corneal epithelium scrapings from 30 patients (30 eyes) suspected of necrotizing herpes stromal keratitis were tested for HSV DNA by RT-PCR. The samples were collected during the first visit and then on the subsequent 7, 14, 28, 42, and 56d. The symptoms of the patients were scored before treatment to determine the correlation between HSV concentration in the corneal epithelium scrapings and clinical scores. RESULTS The positive rate (46.4%) in the corneal epithelium group before the therapy was significantly higher than that (13.3%) in the tears group (P=0.006). There were 13 positive HSV patients before the therapy, the concentration of HSV DNA in corneal epithelium scrapings group was significantly higher than that in the tears group (paired t-test, P=0.0397). Multilevel mixed-effects model analysis showed that the difference between the corneal epithelium scrapings group and the tears group was statistically significant (P=0.0049). The Spearman rank correlation analysis indicated a positive correlation between the HSV concentration in the corneal epithelium scrapings and clinical scores before the treatment (r=0.844, P<0.0001). CONCLUSION RT-PCR appears to be a powerful molecular tool for the diagnosis of necrotizing herpes stromal keratitis.
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Affiliation(s)
- Jun-Xin Ma
- Department of Ophthalmology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, Jiangsu Province, China
| | - Lin-Nong Wang
- Department of Ophthalmology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, Jiangsu Province, China
| | - Ru-Xia Zhou
- Department of Ophthalmology, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, Jiangsu Province, China
| | - Yang Yu
- Department of Clinical Nuclear Medicine Center, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, Jiangsu Province, China
| | - Tong-Xin Du
- Department of Clinical Nuclear Medicine Center, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, Jiangsu Province, China
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