HSV-1 latent rabbits shed viral DNA into their saliva.

BACKGROUND: Rabbits latent with HSV-1 strain McKrae spontaneously shed infectious virus and viral DNA into their tears and develop recurrent herpetic-specific corneal lesions. The rabbit eye model has been used for many years to assess acute ocular infections and pathogenesis, antiviral efficacy, as well as latency, reactivation, and recurrent eye diseases. This study used real-time PCR to quantify HSV-1 DNA in the saliva and tears of rabbits latent with HSV-1 McKrae. METHODS: New Zealand white rabbits used were latent with HSV-1 strain McKrae and had no ocular or oral pathology. Scarified corneas were topically inoculated with HSV-1. Eye swabs and saliva were taken from post inoculation (PI) days 28 through 49 (22 consecutive days). Saliva samples were taken four times each day from each rabbit and the DNA extracted was pooled for each rabbit for each day; one swab was taken daily from each eye and DNA extracted. Real-time PCR was done on the purified DNA samples for quantification of HSV-1 DNA copy numbers. Data are presented as copy numbers for each individual sample, plus all the copy numbers designated as positive, for comparison between left eye (OS), right eye (OD), and saliva. RESULTS: The saliva and tears were taken from 9 rabbits and from 18 eyes and all tested positive at least once. Saliva was positive for HSV-1 DNA at 43.4% (86/198) and tears were positive at 28.0% (111/396). The saliva positives had 48 episodes and the tears had 75 episodes. The mean copy numbers ± the SEM for HSV-1 DNA in saliva were 3773 ± 2019 and 2294 ± 869 for tears (no statistical difference). CONCLUSION: Rabbits latent with strain McKrae shed HSV-1 DNA into their saliva and tears. HSV-1 DNA shedding into the saliva was similar to humans. This is the first evidence that documents HSV-1 DNA in the saliva of latent rabbits.

Considerations for a Retained Foreign Body in the Posterior Orbital Apex.

Orbital foreign bodies must be approached with complex considerations involving their precise location and composition in order to adequately guide management. Physicians must carefully weigh the advantages and risks of surgical and medical intervention compared to conservative management. We present a case of a male patient with penetrating trauma to the eye that resulted in open globe injury and orbital foreign body, presumed metallic, at the posterior orbital apex near the optic nerve. As such, despite the uncertainty of the exact composition of the object, the medical team and patient agreed to conservative management given its high-risk anatomical location.

Highly Accelerated Onset of Hydroxychloroquine Macular Retinopathy.

BACKGROUND: Hydroxychloroquine (HCQ, Plaquenil) is often prescribed in lieu of other sulfate antimalarials to treat rheumatologic diseases because of its pharmacologic efficacy and few reported side effects. However, a known potential side effect of HCQ is retinal toxicity. CASE REPORT: A 61-year-old black female presented for screening of ophthalmic disease 2 months after initiation of HCQ for the treatment of polyarthralgia with a positive rheumatoid factor. At the time of the examination, she had taken a cumulative total of 19.8 g of HCQ and was found to have bilateral bull's-eye retinopathy. The patient had no known risk factors for HCQ toxicity. HCQ was discontinued, and the patient was prescribed ibuprofen for her polyarthralgia symptoms. The ophthalmic effects of HCQ toxicity were permanent. CONCLUSION: Known major risk factors for HCQ retinal toxicity include drug loads >300 mg/day (5 mg/kg/day), use for >5 years, a cumulative dose >1,000 g, underlying retinal disease or retinopathy, tamoxifen use, and renal disease. Despite not having any of these risk factors and having a reduced drug load during the treatment period, our patient developed the signs and symptoms of HCQ toxicity. This case suggests underlying mechanisms for HCQ toxicity other than those previously reported and a need for additional screening tests to prevent HCQ toxicity.

The antimicrobial agent C31G is effective for therapy for HSV-1 ocular keratitis in the rabbit eye model.

The amphoteric C31G solution contains equimolar alkyl dimethlyglycine and alkyl dimethyl amine oxide buffered with citric acid. C31G acts as a broad spectrum antiviral and an antibacterial. No previous in vivo studies have been done to test C31G in an animal model of HSV-1 ocular keratitis. We assessed the anti-herpetic activity of C31G in the rabbit eye model using three treatment groups: (1) 1% trifluorothymidine (TFT); (2) 0.25% C31G plus 0.5% hydroxypropyl methylcellulose (HPMC); and (3) vehicle, 0.5% HPMC. Scarified rabbit corneas were inoculated with the HSV-1 strain McKrae. On post inoculation (PI) day 3, rabbits were placed in three balanced groups based on slit-lamp examination (SLE) scores. Treatment began on PI day 3, five times a day for five consecutive days. In addition to the daily, masked SLE scoring, the eyes were assessed daily for stromal opacity, scleral inflammation, neovascularization, eyelid inflammation, inflammatory discharge, and epiphora. C31G and TFT were very effective in reducing the lesions and pathogenesis associated with HSV-1 ocular keratitis. The vehicle control scores were significantly higher and did not effectively treat HSV-1 keratitis. C31G has the potential to be used to treat herpetic keratitis as well as other herpetic topical lesions in humans.