PDF(Pubmed)
Abstract：
The impact of viral keratitis (VK) on individuals and society is notable. Early diagnosis and treatment are crucial in managing viral keratitis effectively. Timely intervention with antiviral medications and supportive care can help mitigate the severity of the infection and improve visual outcomes. We examined the prevalence of varicella-zoster virus (VZV), herpes simplex virus type 1 (HSV-1), adenovirus (AdV) and herpes simplex virus type 2 (HSV-2) in patients suspected for ocular infections. Patients included in the study exhibited various clinical manifestations indicative of ocular pathology, such as infectious keratitis, corneal scar, endogenous endophthalmitis, panuveitis, endothelitis, stromal edema, and other relevant conditions. Four different types of tear fluid, corneal samples epithelium, aqueous humor and vitreous humor were taken. After genome extraction, multiplex real-time PCR was used for diagnosis of viruses. 48 (29.6%) out of the total of 162 (100%) eye specimen were positive. The dominant prevalence was VZV (12.3%) and HSV-1 (11.7%) followed by AdV (4.9%) and HSV-2 (0.6%). There were 4 (8.3%) coinfections within the samples (HSV-1 and VZV). Aqueous humor samples demonstrated superior virus detection ability and our only HSV-2 positive sample was from aqueous humor. The utilization of multiplex real-time PCR assays in differential diagnosis of VK holds promise for expeditious diagnoses while also preventing unwarranted antibiotic prescriptions. Moreover, the aqueous humor appears to be a more sensitive site for detecting viral keratitis.
摘要：
病毒性角膜炎(VK)对个体和社会的影响是显著的。早期诊断和治疗对于有效治疗病毒性角膜炎至关重要。及时干预抗病毒药物和支持性护理可以帮助减轻感染的严重程度并改善视力。我们检查了水痘-带状疱疹病毒（VZV）的患病率，单纯疱疹病毒1型（HSV-1），疑似眼部感染患者的腺病毒（AdV）和单纯疱疹病毒2型（HSV-2）。包括在研究中的患者表现出指示眼部病理的各种临床表现，如感染性角膜炎，角膜瘢痕,内源性眼内炎，全葡萄膜炎,内皮细胞炎,间质水肿,以及其他相关条件。四种不同类型的泪液,角膜上皮样本，取房水和玻璃体液。基因组提取后，多重实时PCR用于病毒的诊断。在162例(100%)眼样本中,48例(29.6%)为阳性。主要患病率为VZV（12.3％）和HSV-1（11.7％），其次是AdV（4.9％）和HSV-2（0.6％）。样品中存在4种(8.3%)共感染(HSV-1和VZV)。房水样品表现出优越的病毒检测能力，我们唯一的HSV-2阳性样品来自房水。在VK的鉴别诊断中使用多重实时PCR测定法有望快速诊断，同时还可以防止不必要的抗生素处方。此外，房水似乎是检测病毒性角膜炎更敏感的部位。
