A systematic review on advances in diagnostics for herpes simplex keratitis
Journal
Survey of Ophthalmology
Journal Volume
66
Journal Issue
3
Pages
514-530
Date Issued
2021
Author(s)
Abstract
Herpes simplex keratitis (HSK) is a significant cause of vision impairment worldwide. Currently, there are no set diagnostic criteria, and popular diagnostic methods, including clinical examination of the eye via slit lamp examination, could lead to false-negatives and misdiagnoses. Molecular testing with polymerase chain reaction (PCR) may lack concordance with clinical findings, posing a great challenge to ophthalmologists. We evaluate recent studies on techniques for the diagnosis of HSK. We included a total of 23 studies published between 2010 and 2020 in English on diagnostic techniques, including in vivo confocal microscopy, polymerase PCR testing, protein detection in tear film with enzyme-linked immunosorbent assay, and various other protein assays. Although PCR has been widely used as one of the current diagnostic methods for HSK, most studies evaluated its efficacy after including alterations to its normal protocol. Tear sample analysis was performed using multiple tools, although corneal scrapings demonstrated a higher positive detection rate. Diagnostic tools identified were able to detect HSK with varying accuracy. Newer diagnostic techniques like multiplex dot hybridization assay and immunochromatographic assays may be considered as the point-of-care preliminary diagnostic tools. More reliable results may be generated by developing a standardized diagnostic protocol. ? 2020 Elsevier Inc.
Subjects
cell protein; antibody response; antigen detection; clinical protocol; confocal microscopy; cornea; corneal scraping; diagnostic accuracy; diagnostic error; diagnostic procedure; dot hybridization; English (language); enzyme linked immunosorbent assay; false negative result; herpes simplex keratitis; human; immunoaffinity chromatography; immunofluorescence; in vivo study; intrarater reliability; microbial keratitis; point of care testing; polymerase chain reaction; priority journal; protein analysis; protein determination; reliability; Review; slit lamp microscopy; tear film; vision
Type
review