Herpes simplex virus keratitis: histopathology and corneal allograft outcomes

Abstract

Molecular biologic studies have elucidated the roles of specific and innate immune responses in the pathogenesis of HSV keratitis. Recent evidence suggests that interference with innate immune mechanisms may reduce the severity of HSV keratitis and its complications. The agents targeting innate immune responses are particularly amenable to translational therapy for patients at risk of complications of HSV keratitis and poor corneal transplant outcomes. Histopathologic evidence of neovascularization or inflammation in tissue removed at the time of corneal transplantation predicts patients who are at risk for allograft rejection or failure. Such patients are prime candidates for close monitoring and intensive therapy. Newer imaging techniques, such as clinical confocal biomicroscopy, might be useful in identifying neovascularization and inflammation that place patients at high risk for poor allograft outcomes prior to corneal transplantation.

Keywords::

• allograft failure
• allograft rejection
• herpes simplex virus
• histopathology
• inflammation
• keratitis
• neovascularization
• penetrating keratoplasty

Financial & competing interests disclosure

The authors have received the following grants from the NIH/National Eye Institute: EY017885 (Roni Shtein), P30EY07003 (Roni Shtein and Victor Elner) and EY09441 (Victor Elner). Victor Elner has received the Senior Scientific Investigator award from Research to Prevent Blindness. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.