Role of herpes simplex virus in the immune stromal keratitis

Background: Herpes simplex virus (HSV) infection of the cornea is a leading cause of blindness in occidental countries and a common recurrent manifest ation of it is the immune stromal keratitis (ISK). However, it is not known whether active viral replication occurs during the acute phase of the dise ase, because isolation of the virus by conventional culture techniques has not been accomplished. Aim: To establish the presence of HSV in patients wi th ISK. Material and methods: Fourteen corneal swabbing samples, from activ e diseased eyes of patients with clinical diagnosis of ISK, were submitted to Herpchek (R) and PCR for the identification of HSV antigens and genome. Results: All ISK samples were negative by both techniques. Conclusions: It was not possible to identify HSV antigens nor their genome by the methodolo gy used. It is likely that, they can't be detected in corneal superficial l ayers or probably there is no viral replication at this stage of the diseas e, so antiviral therapy should be reconsidered.