[Reactivation of persistent herpes virus infection as a factor of endogenous uveitis in children].

Two hundred and fifty-five children with endogenous uveitis, aged 2 months to 15 years, were examined. 73-93% of children were chronically infected by different viruses of the human herpes group; mycoplasmal past-infection was detected in only 13% of them and Chlamydia past-infection _ in 3.7% of them. Herpes simplex virus of type 1 reactivated reliably more often versus other types of Herpesviridae. Reactivation of cytomegalovirus infection prevailed in mothers who gave birth to children with intrauterine uveitis. A prolonged active replication of herpes virus was primarily observed in children with a Suppressed cell antiviral immunity component. Uveitis in such children was notable for a severe clinical course and trend towards often relapses.

[Diagnosis and importance of the opportunistic herpes-virus infection in etiology and pathogenesis of different eye diseases]. / Gerpesvirusnaia infektsiia v étiopatogeneze razlichnykh zabolevanii glaz.

A total of 439 patients (adults--184, children--255) with herpetic keratitis as well as with uveitis and choriorenitis of different geneses and localizations were examined. An aggravation of HSV-infection was determined by detecting, in the blood), anti-bodies to the unstructured early viral antigens by using the immune enzyme analysis (IEA). The efficiency of the test was demonstrated during the examination of patients with different ophthalmic pathologies. An active infection was detected in 16-39% of patients with various ocular diseases of non-herpetic etiology. The pathogenetic value of reactivated HSV infection is diverse: it can function as an etiological or trigger factor and it can aggravate the main disease through causing, postoperatively, complications.

[Prevalence and clinical significance of active cytomegalovirus infection in patients with inflammatory ophthalmopathy]. / Rasprostranennost' i klinicheskoe znachenie aktivnoi tsitomegalovirusnoi infektsii u bol'nykh s oftal'mopatologiei vospalitel'nogo kharaktera.

A total of 374 patients with different inflammatory diseases of the eyes were examined (227 children and 147 adults). For detecting active cytomegalovirus (CMV) infection, sera were tested for antibodies to nonstructural intact CMV proteins. Antibodies were detected in 26 of 147 adults (17.7%) and 15 of 227 children (6.6%). Difference in the frequency of detection of active CMV infection in adults and children is statistically significant (p < 0.01). Three groups of patients with active CMV were distinguished: children with congenital diseases, immunocompromised patients, and the most numerous group of patients with isolated ocular diseases without manifest signs of immunodepression. In this latter group active CMV was detected in patients with different clinical diagnoses, including ophthalmic herpes. Russian commercial enzyme immunoassay kit CMV-Control proved to be a highly sensitive, simple, and cheap test for the diagnosis of exacerbations of chronic CMV infection.

[Cytomegalovirus infection in children with endogenous uveitis]. / Tsitomegalovirusnaia infektsiia u detei s éndogennymi uveitami.

A total of 405 children aged 3 months to 15 years with uveitis of different origin and localization and 50 mothers of children with intrauterine uveitis were tested for cytomegaloviruses (CMV). Chronic CMV infection was detected in 79% children and 88% mothers. Active CMV infection was diagnosed in 7.1% children with various clinical forms of uveitis; it was somewhat more frequent in cases with grave posterior uveitis and panuveitis complicated by detachment of the retina and vitreous fibrosis. Anti-CMV IgG antibodies indicate an infection, but their detection is insufficient for identifying the etiology of uveitis. Active CMV infection can be a cause of uveitis or aggravate uveitis of another etiology and favor the development of postoperative complications. In many cases active CMV infection was detected in children during remission without clinical signs of uveitis activity. Individual analysis of clinical laboratory data is needed for each patient in order to evaluate the etiological and pathogenetic role of active CMV infection.

[Use of monoclonal antibodies in the diagnosis of ophthalmic chlamydiosis]. / Ispol'zovanie monoklonal'nykh antitel dlia diagnostiki oftal'mokhlamidioza.

A total of 168 patients with various ocular diseases were tested for Chlamydia. Scrapings off the conjunctiva were examined by the fluorescent antibody technique with monoclonal antibodies. A high diagnostic efficacy of the method in patients with acute and, which is even more important, with the subacute form of ophthalmic chlamydiasis was demonstrated. Moreover, the method effectively diagnosed ophthalmic chlamydiasis in patients with inflammations of the anterior and median segments of the eye of obscure etiology.

[Therapy of stromal herpetic keratitis with a new immunomodulator likopide]. / Novyí immunomoduliator likopid (GMDP) v lechenii gerpeticheskikh stromal'nykh keratitov.

Likopide (N-acetylglucosamine-(beta 1-4)-N-acetylmuramyl-alanyl-D-isoglutamine) is a synthetic analog of muramylpeptides, characterized by immunomodulating properties and increasing the nonspecific resistance to infections. Seventy patients with ophthalmic herpes were examined, 35 of these were treated with likopide and 35 were administered placebo. Fifty-two of these suffered from stromal keratitis with ulceration and 18 had no ulcers. The trials were carried out by the double blind test with placebo. Likopide was administered orally in 10 mg tablets twice daily according to the following protocol: 3 days of treatment, 3-day interval, and 3-day treatment. All the patients were administered local specific (acyclovir ointment) and general symptomatic therapy. Immunological studies were carried out before and after therapy. Clinical assessment showed a reliably high therapeutic efficacy of likopide, its total value (excellent and good results) being as high as 88.5%. The mean duration of therapy with likopide was 11.4 +/- 0.4 days versus 15.2 +/- 0.9 days in the placebo group. Judging by the recovery criteria (arrest of inflammation, epithelization of the cornea, resorption of corneal infiltration and edema, resorption of iritis) likopide reliably accelerated healing and ensured a higher increase of vision acuity. Likopide reliably decreased the rate of detection of herpes simplex virus antigen in the involved eye conjunctiva in comparison with the placebo group patients (97.1% of negative cases versus 60%). The drug was well tolerated by the patients, no side effects were observed. Skin allergic tests with likopide showed no drug allergies.

[Assessing the efficacy of DNA hybridization for diagnosis of adenoviral and chlamydial diseases of eyes]. / Izuchenie éffektivnosti metoda DNK-gibridizatsii v diagnostike adenovirusnykh i khlamidiínykh zabolevanií glaza.

Analysis of scrapings off the conjunctiva of patients with suspected adenoviral infection (n = 60) and ophthalmochlamydiasis (n = 132) by different diagnostic tests showed good prospects of using DNA hybridization: the efficacy of detecting adenoviral diseases of the eyes was 35% improved in comparison with the fluorescent antibody method with polyclonal serum and the diagnosis of ophthalmochlamydiasis was 22.8% improved in comparison with enzyme immunoassay.

[Clinical and laboratory assessment of therapeutic efficacy of maxaquin in treatment of chlamydial conjunctivitis]. / Kliniko-laboratornaia otsenka terapevticheskoi effektivnosti preparata maksakvin v lechenii khlamidiinykh koniunktivitov.

Maxaquin (lomefloxacin), a new fluoroquinolone antibiotic, was used in combined therapy of chlamydial conjunctivitis. The results of treatment of 72 patients were assessed by the clinical manifestations and the laboratory time course of Chlamydia trachomatis antigen in smears from the conjunctiva, detected by enzyme immunoassay. Clinical and laboratory findings proved the high efficacy of the drug and its advantages over traditional therapy and other fluoroquinolones.

[Clinical and experimental parallels in children with enterovirus uveitis]. / Kliniko-éksperimental'nye paralleli pri énterovirusnykh uveitakh u detei.

Clinical features of acute and remote periods of experimental enterovirus uveitis were studied. The disease was induced in 22 monkeys by inoculation of ECHO 11 and ECHO 19 strains in the anterior chamber. The animals were followed up for 3 months to 5 years 8 months. The main clinical manifestations of the acute and remote periods of experimental disease were similar to its clinical presentation in children. The developed experimental model can be used to study the pathogenesis of complications of enterovirus uveitis.

[Persistence of ophthalmotropic enteroviruses in ocular tissues after enterovirus uveitis]. / Persistentsiia oftal'motropnykh 'enterovirusov v tkaniakh glaza posle perenesennogo 'eksperimental'nogo 'enterovirusnogo uveita.

Thirteen monkeys were infected with ophthalmotropic strains of ECHO11 and ECHO19 in the anterior chamber of one eye. Echovirus antigens were detected by direct immunofluorescence in the membranes of the infected and paired eyes in various periods after inoculation (from 3 days to 5 years 8 months). Virus antigen was detected both in the infected and intact eyes. During the acute period of uveitis the antigen was detected mainly in the anterior segment of the infected eye, whereas in remote period it was found mainly in the posterior segment. Long persistence of the virus antigen in various ocular membranes may explain many of the late complications observed in children with enterovirus uveitis.

[Significance of autoimmune reactions in the development of postoperative uveitis in patients with artificial lenses]. / Znachenie autoimmunnykh reaktsii v razvitii postoperatsionnykh uveitov u bol'nykh s artifakiei.

The levels of antibodies to native and denatured DNA in the blood were measured before and in the first days after extracapsular cataract extraction with implantation of intraocular lenses. Before surgery anti-DNA antibodies were appreciably more incident in patients with complicated cataracts in comparison with patients with senile cataracts (p < 0.01). A relationship was revealed between increased titers of anti-DNA antibodies before the operation and the development of "sterile" uveitis after it. On the whole, 50% of patients with increased titers of anti-DNA antibodies developed postoperative "sterile" uveitis. In patients with normal preoperative levels of these antibodies uveitis was observed in only 1.8% (p < 0.01). "Sterile" uveitis was arrested with steroids; if therapy was discontinued before antibody levels normalized, uveitis recurred.

[Use of siflox (ciprofloxacin) in paratrachoma and assessment of its effectiveness by immunoenzyme analysis]. / Primenenie preparata sifloksa (tsiprofloksatsina) pri paratrakhome i otsenka ego éffektivnosti metodom immunofermentnogo analiza.

The possibility of using an antibiotic ciprofloxacin quinolone (siflox) in combined therapy of paratrachoma was investigated. Fifty patients with acute and subacute paratrachoma were included in the study. The drug efficacy was assessed by clinical results and laboratory findings: by the time course of the levels of Chlamydia trachomatis antigen in smears from the conjunctiva, measured by enzyme immunoassay (EIA) using the Abbott kit. The results indicated a high efficacy of siflox in combination with local application of tetracycline ointment; such treatment helped shorten the treatment period. EIA proved to be not only a highly sensitive and effective method for the diagnosis of chlamydial infection of the eyes, but permitted assessment of changes in the levels of the antigen over the course of treatment and, hence, helped assess the treatment efficacy.

[The development of early complications after cataract extraction with IOL implantation in patients with an elevated level of antibodies to deoxyribonucleic acid]. / Razvitie rannikh oslozhnenii posle ékstraktsii katarakty s implantatsiei IOL u bol'nykh s povyshennym urovnem antitel k dezoksiribonukleinovoi kislote.

The immune system of the eye is closely connected with the immune system of homeostasis regulation of the body. The present research was aimed at the detection of the correlations between blood serum levels of autoantibodies to native and denatured DNA and the clinical course of the postoperative period after IOL implantation to cataract patients. Increased titers of both antibody types were found prognostically valuable. If only one parameter is increased (antibody titer to one DNA), the prognostic value of the test is reduced by 30%.

[Role of circulating immune complexes in the development of postoperative complications after cataract extraction]. / Rol' tsirkuliruiushchikh immunnykh kompleksov v razvitii posleoperatsionnykh oslozhnenii u bol'nykh pri ékstraktsii katarakty.

Physical and chemical parameters of immune complexes were studied in cataract patients before and after surgery with laser nephelometry. The authors suggest a possible uveitogenous role of the circulating immune complexes of medium size (from 7 to 21 IgG) and high concentration (over 1.2 mg/ml) in the development of postoperative complications of an inflammatory nature.

[Characteristics of the clinical course of epidemic keratoconjunctivitis]. / Osobennosti klinicheskogo techeniia épidemicheskogo keratokon"iunktivita.

Clinical picture of epidemic keratoconjunctivitis was studied in 232 patients. The patients were divided into 3 groups. Group I included 147 patients with a monoinfection: Group 2 consisted of 70 epidemic keratoconjunctivitis patients after surgery for cataracts and glaucoma; Group 3 included 15 patients with epidemic keratoconjunctivitis and ophthalmic herpes. Some differences in the relative incidence of clinical signs and in the course of the condition were detected in the patients after surgery. Clinical course of epidemic keratoconjunctivitis paralleled by ophthalmic herpes was not characterized by a clear-cut staged pattern. Adenoviral ophthalmic infection coursed less severely than usual.

[Diagnosis of toxocariasis in uveitis in children]. / Diagnostika toksokaroza pri uveitakh u detei.

Seventeen children aged 2 to 13, suffering from uveitis of unknown etiology, were screened for chronic infections, toxocariasis included. Antibodies to Toxocara canis were detected in the blood of two children with negative results of tests for toxoplasmosis, tuberculosis, herpetic and cytomegaloviral infections. One of these two suffered from panuveitis, the other from granulomatous chorioretinitis. Both the clinical forms are characteristic of ocular toxocariasis.

[Monoclonal antibodies in the diagnosis of paratrachoma]. / Monoklonal'nye antitela v diagnostike paratrakhomy.

The efficacy of Chlamyset antigen (Orion, Finland) in the diagnosis of paratrachoma was studied; this test system is based on immunofluorscent method with anti-chlamydial monoclonal antibodies. Examinations of scrapings off the conjunctiva, obtained from 120 patients with suspected paratrachoma, have demonstrated that in contrast to the routine cytoscopic method for detection of Rickettsia prowazekii, this test system improves the efficacy of etiologic diagnosis of paratrachoma by 22.1 percent.