Optimizing etiological diagnostics and improving the efficiency of treating centralized infectious corneal ulcers

Purpose: to study the impact of human herpes viruses (HHV) on the development of infectious corneal ulcers (CU). Material and methods. 43 patients aged 21 to 77 with suspected corneal ulcers of bacterial etiology were examined. Based on the history and ophthalmological examination, the patients were divided into 3 groups: group 1 of 26 patients with herpetic ulcers (HU), group 2 of 13 patients with secondary bacterial ulcers (SBU), and group 3 of 4 patients with primary bacterial ulcers (PBU). Blood (43 samples) and corneal scrapings (29 samples) were examined by nested polymerase chain reaction (PCR) for the presence of DNA of various HHV, including herpes simplex virus (HSV) 1, 2, Epstein - Barr virus (EBV), HHV-6, and HHV-7. Results. HHV was detected in 41.6-53 % of the corneas and in 33.3-50 % of blood samples, depending on the patient group. Clinical patients with the DNA of HHV identified in their cornea had torpid CUs and showed no epithelization following the suppressed purulent process. The addition of antiherpetic drugs resulted in complete epithelialization of the cornea within 3-5 days. Conclusion.The frequent representation of HHV-6 and EBV DNA and less frequently detected HSV DNA in the corneal scrapings indicate the possible involvement of HHV in the etiopathogenesis of SBU. The effectiveness of complex antiherpetic drug therapy supports this conclusion. For citations: Neroev V.V., Slepova O.S., Kovaleva L.A., Krichevskaya G.I. Optimizing etiological diagnostics and improving the efficiency of treating centralized infectious corneal ulcers. Russian ophthalmological journal. 2017; 10 (3): 56-61. doi: 10.21516/2072-0076-2017-10-3-56-61 (in Russian)