Herpes simplex virus PCR in 2230 explanted corneal buttons

Abstract

Purpose To determine herpes simplex virus (HSV) DNA prevalence and mean cycle threshold of polymerase chain reaction (PCR) in corneal tissue of patients with penetrating keratoplasty (PKP), with (HSK+) and without (HSK−) previous clinical herpetic keratitis history. Methods Retrospective review of recipient corneal buttons which were explanted through PKP between March 2010 and September 2018 at the Department of Ophthalmology, Saarland University Medical Center in Homburg/Saar, Germany. Corneal tissue samples were analysed by real‐time PCR for the presence of HSV DNA. For each subject, clinical data, including patients’ demographics and clinical diagnoses, were collected. Results In total, 2230 corneal samples (age at the time of the surgery 57.3 ± 19.2 years) of 1860 patients were analysed. HSV PCR was positive in 137 (6.1%) corneal samples, with a 30.57 ± 6.01 (range 14–39) mean cycle threshold (Ct) value. Two hundred ninety‐eight (13.4%) corneas of 266 patients were clinically HSK+, and 1932 (86.6%) corneas of 1600 patients were clinically HSK−. HSV DNA was detected significantly more frequently (p < 0.0001) in HSK+ corneal samples (108 corneal samples; 36.2%), than in HSK− corneal samples (29 corneal samples; 1.5%). Ct value was significantly lower in HSK+ than in HSK‐ corneal samples (29.8 ± 5.8 versus 32.6 ± 5.9; p = 0.008). Conclusion Our data demonstrate that a positive clinical history of HSK is related to HSV PCR positivity in about every 2.8th patient. In addition, about every 66th explanted corneal tissue is HSV PCR‐positive despite the lack of clinical suspicion. These patients may need additional local/systemic antiviral treatment to avoid newly acquired HSK following penetrating keratoplasty.

Trends in Corneal Transplantation and Characteristics of Donors in the Chongqing Eye Bank, China: A Retrospective Study, 1999–2018

“…However, our findings are similar to those reported in an earlier survey in Germany, whereby younger age was found to be associated with a negative attitude toward corneal donation and a positive attitude was correlated with increasing age, which may be explained by the fact that compared with young people, older individuals have had a greater opportunity to reflect on their deaths (20). In particular, we found that people with higher education levels were more willing to donate, which is consistent with many previous reports from other countries and the north of China (17,21,22). A higher education level might lead to a better understanding of (1999-2003, 2004-2008, 2009-2013, and 2014-2018).…”

“…htm), were more willing to donate corneas compared to other counties, suggesting that economic development may influence corneal donation. This result is in line with reports showing that lower economic levels are a practical obstacle to corneal donation (21,23). Among participants of different socioeconomic sectors, employees working in medical sectors have a relatively lower willingness to donate their corneas than employees working in non-medical settings (20).…”

“…In our study, the proportion of fungal cases increased obviously, and treating fungal keratitis was always a challenge. A recent report has found that 5% of fungal keratitis cases without any suspicion of herpes simplex virus (HSV) displayed a positive HSV PCR test and this complicated infection increased the difficulty to manage these patients (21). We believe that one of the reasons why fungal keratitis increased that much (up to 30%) was due to the abuse of glucocorticoids and antibiotics (23).…”

Transplantatversagen nach PKP und DMEK: Was ist die beste Option?

“…), the DMEK donor is marked during harvesting with 3 asymmetric semicircles at the margin according to Bachmann, Cursiefen, and Kruse, in order to be able to determine unequivocal graft orientation in the anterior chamber [15]. ▪ The removed Descemet membrane containing the inferior endothelial cells is always sent to virology along with an aqueous humor aspirate for viral PCR (HSV, VZV, CME, and EBV) [11]. ▪ Care is taken to center the DMEK graft as well as possible within the PKP graft.…”

“…Ursache des Transplantatversagens nach PKP sind häufig eine endotheliale Immunreaktion 5 , 6 , ein chronisch nicht regulierter Augeninnendruck, insbesondere bei der Grunderkrankung Buphthalmus 7 , transplantierte Guttae aus der Hornhautbank bei bis zu 15% aller PKPs 8 , 9 , eine herpetische Endotheliitis als Reaktivierung einer vorbestehenden, schlummernden Herpesinfektion im Bereich der Wirtshornhaut oder aufgrund einer transplantierten Herpesinfektion, die sich im Extremfall auch als Hornhautulkus manifestieren kann 10 , 11 . Insbesondere bei vorbestehender pseudophaker bullöser Keratopathie als Ursache für die Keratoplastik kann nach vielen Jahren – auch ohne akutes Ereignis – eine chronische Transplantatermüdung auftreten.…”