Best Probable Diagnosis Of Herpes Simplex Virus-1 Keratitis: Comparison Of Giemsa Stain, Immunofluorescence Assay And Polymerase Chain Reaction.
Published 2024 - 42nd Congress of the ESCRS
Reference: PP06.01 | Type: Free paper | DOI: 10.82333/3qs4-kt54
Authors: Suman Saha* 1 , Jayangshu Sengupta 2 , Archana Khetan 2 , Debapriya Chatterjee 2
1Ocular Microbiology & Molecular Biology Laboratory,Priyamvada Birla Aravind Eye Hospital,Kolkata,India, 2Cornea & Refractive Services,Priyamvada Birla Aravind Eye Hospital,Kolkata,India
Purpose
To evaluate and compare of three diagnostic tests used routinely for detection of Herpes Simplex Virus (HSV) keratitis.
Setting
Tertiary eye care Referal center of Eastern India
Methods
Methods: Corneal scrapings samples from 150 patients from January 2022- December 2023 with clinically typical dendritic corneal ulcer suggestive of HSV keratitis, and 175 patients with clinically viral corneal ulcers, were tested by Giemsa stain for multinucleated giant cells, Immunofluorescence assay (IFA) for HSV-1 antigen, and polymerase chain reaction for HSV-1 DNA.
Results
The positive predictive values of IFA and PCR tests for the diagnosis of HSV keratitis were between 85–93% and Giemsa found low positivity than others. The sensitivity of PCR was 93%, while IFA and Giemsa had sensitivities of 85.7% and 57.1% respectively. The specificity of PCR, IFA and Giemsa were found to be 67.9%, 85.3% and 85.9% respectively. The sensitivity is found higher when diagnostic combination of IFA and PCR used simultaneously.
Conclusions
In the present study, a combination of PCR and immunofluorescence assay appears to be the most suitable choice of tests for diagnosis of HSV-1 keratitis, while detection of MNGC by Giemsa staining procedure may give us a presumptive diagnosis of suspected viral infection.