jjo62(4)_425.pdf 566 KB
Real-time PCR for VZV keratitis
Inata, Kodai Division of Ophthalmology and Visual Science, Faculty of Medicine, Tottori University
Miyazaki, Dai Division of Ophthalmology and Visual Science, Faculty of Medicine, Tottori University Researchers DB KAKEN
Uotani, Ryu Division of Ophthalmology and Visual Science, Faculty of Medicine, Tottori University
Shimizu, Daisuke Division of Ophthalmology and Visual Science, Faculty of Medicine, Tottori University
Miyake, Atsuko Division of Ophthalmology and Visual Science, Faculty of Medicine, Tottori University
Shimizu, Yumiko Division of Ophthalmology and Visual Science, Faculty of Medicine, Tottori University
varicella-zoster virus keratitis
herpes zoster ophthalmicus
Pupose: To determine the efficacy of real-time PCR for the diagnosis and prognosis of varicella-zoster virus (VZV) keratitis.
Study design: Retrospective case series.
Methods: Patients: 545 consecutive patients with keratitis were examined to quantify copy numbers of VZV DNA by real-time PCR. Association of copy numbers of DNA of VZV to clinical signs and disease course was assessed using logistic regression analysis and Cox proportional hazard model.
Results: Of the 545 eyes, 38 eyes (6.9%) were diagnosed as VZV keratitis. The copy numbers of the DNA of VZV (median: 104.19 copy) was significantly associated with diagnosis of VZV keratitis with the highest odds ratio (OR) of 3390 (for median copy) compared to clinical signs. Diagnostic accuracy of the VZV DNA copy indicated good diagnostic value of area under the curve (0.92) by receiver operating characteristic analysis, and detection of unrelated VZV DNA from the cornea was very rare (0.2%). When the VZV DNA copy and clinical signs were assessed for association with the disease course after herpes zoster ophthalmicus, the disease duration was significantly prolonged in VZV keratitis cases with higher numbers of VZV DNA copies, iritis, and history of recurrences. The amount of VZV DNA led to a continuous risk to prolong disease duration until the ocular inflammation subsides (hazard ratio (HR) 0.17, 95%CI: 0.07 - 0.42, for median copies).
Conclusions: Higher VZV DNA copy numbers are associated with the refractoriness of VZV keratitis, and its evaluation may be a clinically useful way to diagnose and manage VZV keratitis.
Japanese Journal of Ophthalmology
|Current Journal Title||
Bulletin of the Tottori University Junior High School
© Japanese Ophthalmological Society 2018
Japanese Journal of Ophthalmology. 2018, 62(4), 425-431 This is a post-peer-review, pre-copyedit version of an article published in Japanese Journal of Ophthalmology. The final authenticated version is available online at: http://dx.doi.org/10.1007/s10384-018-0604-7
Faculty of Medicine/Graduate School of Medical Sciences/University Hospital