1Sengler U., 1Reinhard T., 2Adams O., 2Krempe C., 1Sundmacher R.

1Eye Hospital and 2Institute for Med. Mikrobiology und Virology, Heinrich-Heine-University, Moorenstr. 5, D-40225 Düsseldorf

Objective: This study is to evaluate the Polymerase-Chain-Reaction (PCR) as a supplementary diagnostic method concerning epithelial, stromal or endothelial keratitis and iritis in case of suspected or obvious herpetic inflammation. Additionally, a second PCR is performed to distinguish between Herpes-simplex-Virus (HSV) type 1 and 2 and to proof or contradict the hypothesis that HSV 1 still is the predominant subtype causing herpetic keratitis.
Methods: In case of epithelial and stromal keratitis corneal swabs were taken with a little brush, suspended in sterile saline and tested for HSV by screening PCR. Samples of aqueous humor were examined in case of endothelial keratitis and iritis. When the screening PCR gave a positive result a second PCR to differentiate between HSV 1 and 2 was performed.
Results: Of 21 corneal swabs 12 were positive for HSV. Only one of these 12 samples was positive for HSV 2 while the other material was positive for HSV 1. Furthermore, 15 samples of aqueous humor were analysed. 6 samples were positive for HSV, in all cases subtyping showed HSV 1.
Conclusion: PCR is a useful supplement to the otherwise clinical diagnostics of herpetic keratitis. Looking at the ratio of the two HSV subtypes HSV 1 is still the far more common cause in ocular involvement.

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