Cytological criteria for assessing the evolution of herpetic keratitis

There were studied 33 patients admitted with clinical diagnosis of superficial herpetic keratitis, typical form of dendritic ulcer. In all these cases there were performed smears from the level of cornea and conjunctiva, that were stained with rapid blue polycrome tanin Dragan staining method. Smears were performed before and during the evolution of the disease, in patients specifically treated with antiviral drugs and also in cases treated unspecifically. There are described some cytological particularities which have a relative specificity for the diagnosis: a high number of lymphocytes with cytoplasmic blebs, giant multinucleated cells, and epithelial cells with degenerative lesions (nucleocytoplasmic inclusions, vacuoles, chromophobe halo around nucleus). Such lesions were not observed in patients with non herpetic keratitis. Modifications noticed in epithelial corneal cells could suggest the diagnosis, which can be associated with clinical examination, in order to administer a specific therapy. Dynamic cytological evolution shows early regression of specific cellular modifications in patients treated by Acyclovir.