Impression membrane for the diagnosis of microbial keratitis

Kaye, Stephen B.; Sueke, Henri; Romano, Vito; Chen, Jern Yee; Carnt, Nicole; Tuft, Stephen; Neal, Timothy

doi:10.1136/bjophthalmol-2015-307091

Cited by 21 publications

(31 citation statements)

References 25 publications

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“…Impression cytology using a CIM, however, removes epithelial cells thus enabling the detection of intracellular microorganisms such as HSV-1. In addition, impression cytology has been shown to be useful for the diagnosis of a variety of infectious and non-infectious corneal conditions, including viral (15), fungal (26), acanthamoeba (27) and microbial keratitis (16), as well as for ocular surface neoplasia (17), keratoconjunctivitis sicca (18), vitamin A deficiency (28), and atopic keratoconjunctitivits. (29) In cases of suspected bacterial and acanthamoebic keratitis, a CIM has been shown to have higher sensitivity than more invasive methods and to be easy to use.…”

Section: Discussionmentioning

confidence: 99%

“…(29) In cases of suspected bacterial and acanthamoebic keratitis, a CIM has been shown to have higher sensitivity than more invasive methods and to be easy to use. (16) Importantly, the detection of human DNA extracted from corneal epithelial cells using a CIM and then amplified by the internal amplification control PCR, may be used as an indicator of sample quality.…”

Section: Discussionmentioning

confidence: 99%

“…A CIM is easy to use and may therefore be suitable for use by non-ophthalmologists or where less sophisticated biomicroscopes are available, such as in resource poor settings. In a recently published study (16) we compared the microbial detection rates of a corneal scrape to that using a CIM made from PTFE. The results using a CIM were significantly better than using a blade to detect bacteria and acanthamoeba from corneal ulcers in cases of suspected microbial keratitis.…”

Section: Discussionmentioning

confidence: 99%

“…(15-18) As has been shown in cases of suspected bacterial, acanthamoeba and fungal keratitis, use of a CIM has several practical advantages over conventional methods using swabs or sharp instruments with good isolation rates. (16) This technique is easy to perform, less traumatic and invasive for the patient and if needed, can be sized to cover the entire ulcer. (16)…”

Section: Introductionmentioning

confidence: 99%

“…(16) This technique is easy to perform, less traumatic and invasive for the patient and if needed, can be sized to cover the entire ulcer. (16)…”

Section: Introductionmentioning

confidence: 99%

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Use of a corneal impression membrane for the detection of Herpes Simplex Virus type-1

Brunner

Somerville

Corless

et al. 2018

Preprint

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24Purpose 25To investigate the use of a corneal impression membrane (CIM) for the detection of Herpes 26Simplex Virus type 1 (HSV-1) in suspected Herpes Simplex Keratitis (HSK). 27 Materials and Methods 28In the laboratory study, swabs and CIMs made from polytetrafluoroethylene were spiked with 29 different concentrations of HSV-1. DNA was extracted and real time PCR undertaken using 2 30 sets of primers. In the clinical study consecutive patients presenting with suspected HSK 31 were included. For each patient, samples were collected from corneal lesions with a swab 32 and a CIM in random order. Clinical details were collected using a standardised clinical form 33 and patients were categorized into probable, presumed and possible HSK. 34 Results 35There was no difference in the performance of both primer sets for all HSV-1 dilutions 36 (p=0.83) or between a CIM and a swab (p=0.18). 110 patients were included. Seventy-three 37 patients (66.4%) had probable, 20 patients (18.2%) presumed, and 17 patients (15.5%) 38 possible HSV-1 keratitis. The HSV-1 detection rate was significantly higher using a CIM 39 (40/110, 36.4%) than a swab (28/110, 25.5%) (p=0.004). In the probable HSV keratitis group, 40 the detection rate using a CIM was 43.8% compared to 27.4% for a swab (p=0.004). The Cp 41 values obtained for the conjunctival swabs were higher than those obtained for the CIMs 42 (p<0.001). 43 Conclusions 44In suspected HSK, a CIM is a useful alternative to a swab and more likely to detect the 45 presence of HSV-1. 46 47 Keywords 48Herpes simplex keratitis, corneal impression membrane, detection of HSV-1 DNA, real time 49 PCR 50

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