XXXX . Polymerase chain reaction detection of viral DNA and a role for antiviral therapy.

@entity1 @entity6435 @entity4091 @entity1800 @entity9358
BACKGROUND: The late-onset pseudodendrites, delayed @entity9358 , of herpes @entity6435 are reported to be of mechanical or immune origin and to be worsened by antiviral therapy. OBJECTIVE: To study pseudodendrites to ascertain a viral presence in the lesions and their response to antiviral therapy. DESIGN: Prospective clinical study. SETTING: Outpatient and inpatient hospital-based corneal specialty referral practice; molecular virology laboratory. @entity1 : Six @entity1 , aged 33 to 89 years, four with delayed herpes @entity6435 pseudodendrites and two with herpes @entity6435 neurotrophic ulceration. One @entity1 was immunosuppressed. MAIN OUTCOME MEASURES: Findings from clinical evaluation; polymerase chain reaction assays of lesions and tear film of six @entity1 ; polymerase chain reaction and light and electron microscopy of the corneal button from one @entity1 ; and the clinical response of four @entity1 to various antiviral drugs. RESULTS: In contrast to reports in the current literature, delayed pseudodendrites may also be infectious, as they are positive for zoster DNA by polymerase chain reaction and appear responsive to certain antiviral therapy. The corneal button from an immunosuppressed @entity1 had mature and immature viral particles in the basal cells within 2 weeks of transplantation. CONCLUSIONS: To our knowledge, this is the first report of viral DNA in delayed @entity4091 . Recurrent @entity1800 may play a role in this form of @entity4091 and warrant antiviral therapy.
