Association of HSV-1 antigen distribution in the cornea with clinical characteristics of herpetic stromal keratitis.

PURPOSE: To investigate whether the clinical characteristics of stromal herpetic simplex keratitis (HSK) are associated with herpes simplex virus type 1 (HSV-1) antigens distribution in the pathologic cornea.

MATERIALS AND METHODS: Pathologic corneal buttons from 8 eyes were obtained during keratoplasty at the Shandong Eye Institute from 2006 to 2009. Immunohistochemical examination was performed to detect the distribution of HSV-1 antigens, including position, depth, and load in the cornea.

RESULTS: Each of the 8 pathologic corneal buttons was positive for HSV-1 antigen by immunohistochemical staining, and HSV-1 antigen was detected in the corneal stroma but not in the corneal epithelium or endothelium. Combined with the clinical characteristics, it was found that the distribution depth of HSV-1 antigen in the cornea was partly related to the disease course, and the load was related to the delay time for treatment. Furthermore, HSK could be effectively cured by deep anterior lamellar keratoplasty (DALK).

CONCLUSIONS: The distribution characteristics of HSV-1 in HSK corneal stroma supports the theory of HSV-1 latency in the cornea and guides the selection of DALK, rather than penetrating keratoplasty (PKP), for clinical stromal HSK treatment.