Differential effects of HSV-1 and HCMV infection on adhesion molecule expression on human corneal keratocytes.

PURPOSE: Previous studies have shown that keratoplasty buttons obtained at surgery from patients with herpes simplex virus-1 (HSV-1) keratitis have elevated localized expression of the adhesion molecule ICAM-1, which plays a critical role in the initiation and amplification of an immune response. We performed studies to determine whether changes in expression of ICAM-1 and HLA class I are direct effects of productive infection of human corneal fibroblasts with HSV-1. METHODS: Immunocytologic and flow cytometric analyses were performed to analyze the ability of HSV-1 to induce ICAM-1 and HLA class I expression in a primary cornea-derived keratocyte cell line, E-2. Positive controls for these experiments were E-2 cells infected with human cytomegalovirus (HCMV), which has been shown to increase ICAM-1 expression in selected cells, and E-2 cells treated with IFN-gamma, which upregulates both ICAM-1 and HLA class I expression in most cell types. RESULTS: Kinetic cytometric analysis indicated decreased ICAM-1 expression 3 hours following HSV-1 infection of E-2 cells. In contrast, HCMV led to detectable increases in ICAM-1 expression starting 6 hours after infection. Infections with either HSV-1 or HCMV resulted in reduced HLA class I expression on E-2 and SF cells. CONCLUSIONS: These studies suggest that increased ICAM-1 expression seen on corneal stromal cells during clinical HSV-1 infection is not a direct result of productive viral infection, but of other mechanisms such as cytokine release by infiltrating mononuclear cells.

Improving the sensitivity of the OKP visual field screening test with a blue stimulus on a dark background.

The standard oculokinetic perimetry test (OKP) was modified to present a light blue stimulus on a dark background (MOKP) to determine whether the sensitivity and specificity for detecting glaucomatous visual field loss could be improved. Thirty-five adult glaucoma patients (70 eyes) self-administered both tests and the results were correlated with the loss of retinal sensitivity on the Octopus IV program 38. The MOKP detected 18% more true scotomatous loci (more than 15 dB loss of attenuation) than the standard OKP (p < 0.0001). The gain was due to 37% fewer false negatives (p < 0.0001), but with a doubling of the false positives rate (p < 0.049). With a disease prevalence of approximately 2%, the MOKP and OKP would respectively miss 15% or 30%, and include 14 or 9 normals for each diseased individual. This relatively simple modification may further improve the OKP for detecting glaucoma.