[Results of enzyme-linked immunoassay of the blood serum in patients with infectious and inflammatory diseases of the anterior segment of the eye]. / Rezul'taty immunofermentnogo analiza syvorotki krovi pri infektsionno-vospalitel'nykh zabolevaniyakh perednego segmenta glaza.

PURPOSE: To evaluate the clinical significance of the data obtained during enzyme-linked immunosorbent assay (ELISA) of the blood serum of patients with inflammatory diseases of the anterior eye segment compared to a group of healthy volunteers. MATERIAL AND METHODS: A retrospective analysis of the results of serum ELISA of 200 patients with chronic keratoconjunctivitis and keratouveitis was performed using the solid-phase IFA method in order to detect the presence of antibodies to herpes simplex viruses of 1 and 2 types (HSV 1, 2), cytomegalovirus (CMV), Chlamydia trachomatis and Toxoplasma gondii. The control group consisted of 34 healthy volunteers with no signs of inflammation of the eye tissue. RESULTS: There were no significant differences in the frequency of detection of both «acute-phase¼ IgM and «chronic¼ IgG to HSV and CMV between patients of the main group and healthy volunteers (ρ≥0.05). The levels of IgG to Toxoplasma gondii in the study group were three times higher than in the control group (ρ≤0.05). A comparative analysis of the frequency of detection of antibodies to Chlamydia trachomatis showed statistically significant differences between the groups and more frequent detection of immunoglobulins classes A, G and M in patients with inflammatory eye diseases (ρ≤0.05). CONCLUSIONS: The absence of statistical differences with the control group in the frequency of detection of active HSV and CMV infections in patients with inflammatory diseases of the anterior eye segment when using ELISA allows to recommend the use of additional methods of examination such as polymerase chain reaction (PCR) and real-time PCR (RT-PCR) with identification of pathogen genetic material in the available biological secretions. The increase in IgG titers to toxoplasma in patients of the main group apparently indicates a cross-stimulation of antibody synthesis against the background of a chronic inflammatory process. Significant differences in the frequency of detection of all types of antibodies to chlamydiae suggests a significant etiological role of this pathogen in the development and maintenance of chronic inflammation in the anterior eye segment.

[Clinical presentations of Herpes Zoster Ophthalmicus (diagnosis and therapy)]. / Klinicheskie proyavleniya Herpes Zoster Ophthalmicus (diagnostika i terapiya).

Approximately a quarter of the world's population at some point in life is at risk of developing shingles (Herpes Zoster). In 10-20% of cases the first branch of the trigeminal nerve gets involved (Herpes Zoster Ophthalmicus, HZO). Ophthalmic complications of HZO are able to cause a significant reduction in visual function. AIM: To study and summarize clinical features of HZO (including the rate of complications and their nature) and to determine the relationship between clinical and laboratory data from these patients. MATERIAL AND METHODS: The study included 133 patients with ophthalmic and neurological complications of HZO (group 1 (n=28) - retrospective analysis of outpatient records for the period 1995-2005; group 2 (n=95) - a prospective study for the period 2005-2015), who received a course of conservative treatment in either the Botkin City Hospital, branch № 1, or in the ophthalmic department of the Moscow herpes centre (Gerpeticheskiy Tsentr Ltd.). Laboratory tests were performed only in patients from group 2 and included: examination of biological fluids for six types of herpes viruses by polymerase chain reaction, examination of tears and urine for DNA of Chlamydia, Mycoplasma, and Ureaplasma, and serological blood testing for markers of herpes virus infection. Patients from group 1 were prescribed topical antiviral, antibacterial, and anti-inflammatory therapy, in rare cases - acyclovir per os. In group 2, the treatment included systemic antiviral medications and immune correction therapy. Anti-inflammatory therapy consisted of local and systemic non-steroidal agents (NSAIDs). RESULTS: The most common ophthalmic complications of HZO in both groups were stromal keratitis and keratoiridocyclitis, neurological - III and VI cranial nerves palsies. The duration of the disease in the first group ranged from 2 months to 3 years; in the second group, patients were divided into two subgroups: subgroup A with the disease duration of no more than one month (n=81) and subgroup B with the disease duration from 1.5 to 9 months (n=14). Varicella-zoster virus (VZV) DNA was present in tears and/or other biological fluids of patients from group 2 in more than 70% of cases (n=67). Particularly, in 27.4% of cases the virus was isolated in two fluids and in 7.4% of cases - in three fluids. The duration of virus production in tears and other biological fluids (saliva, blood, and urine) ranged from 10 days to 4 months. CONCLUSION: Topical non-steroidal anti-inflammatory drugs and systemic etiological treatment in case of intraocular inflammation in HZO patients may reduce the risk of severe consequences of VZV reactivation and help avoid recurrences later in life.

[Herpesviruses in ophthalmology].

The article presents the current data on seven main human herpesviruses, capable of causing ocular inflammation. Features of intraocular production and anterior segment involvement associated with each of the viruses and modern aspects of antiviral therapy for herpetic keratitis are discussed.