DETECTION OF VARICELLA-ZOSTER VIRUS-DNA IN KERATECTOMY SPECIMENS BY USE OF THE POLYMERASE CHAIN-REACTION

Objective: To study the correlation of clinical findings, histopatholo gic features, and detection of varicella-zoster virus (VZV) DNA in ker atectomy specimens. Materials and Methods: Fourteen corneal buttons fr om patients with a confirmed history of herpes tester ophthalmicus wer e examined by use of light microscopy and the polymerase chain reactio n. The polymerase chain reaction techniques included gel electrophores is and hybridization for the detection of VZV DNA. Results: Seven (50% ) of the 14 specimens were positive for VZV DNA. The positive findings in the specimens correlated with the clinical findings of uveitis (3/ 3) and the histopathologic features of chronic stromal keratitis (4/4) . Patients with stromal scarring, granulomatous keratitis, and neurotr ophic ulcers had negative findings. The largest interval between the i nitial appearance and detection of viral DNA was 51 years. Conclusions : The results suggest that VZV DNA is not detectable in the cornea in every patient and at every stage of tester keratitis. This may be due to the low number of VZV particles present in the cornea or the lack o f viral DNA in the keratocytes. It remains unclear whether the VZV-rel ated keratopathy is caused by an immunologic response to a viral antig en, the viable virus itself, or both.