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Lysozyme tear level in patients with herpes simplex virus eye infection.

The lysozyme level in tears of patients with HSV eye infection was examined and correlated with the clinical findings and presence of virus. The concentration of the enzyme in tears of patients during acute attack was 2.83 mg./ml. This value was significantly lower than that in tears from healthy controls (6.1 mg./ml.) and tears from the patient's healthy eye (4.46 mg./ml.). After termination of treatment with either IUDR or poly I:C, the lysozyme level rose to an average of 4.34 mg./ml. During the latent period of the disease the level increased (5.34 mg./ml.), but it remained lower than in healthy subjects who had never suffered from HSV eye infection. This may be an indicator of possible future recurrences.

Acute Disease↗

Herpes simplex eye infections: clinical manifestations, pathogenesis and management.

Herpes infection of the eye may be acquired as the patient's first exposure to the virus (primary infection) or as involvement of a new anatomical site (the eye) in a patient with previous HSV infection. In either case, patients with herpetic eye infection risk recurrent eye disease throughout their lives. The infective lesions of the corneal epithelium (dendritic and geographic ulcers) occasionally develop into noninfective indolent or trophic ulcers, particularly under the influence of cauterizing chemicals or corticosteroids. Inflammation of the corneal stroma may accompany herpetic epithelial lesions or occur independently. Stromal keratitis probably represents the host's immune response to viral antigens filtering down from epithelial lesions or from viral replication in stromal cells. The clinical manifestations of ocular HSV infection are reviewed, pathogenesis and possible pathways of the infection are analyzed, and some practical guidelines for management and prevention are presented.

Adult↗

Secondary amoebic eye infections in mice due to Acanthamoeba sp.

The aim of the present study was to determine the occurrence of eye infections accompanying the infection of the central nervous system and to demonstrate the possible tissue affinity of different strains of amoebae in subsequent infections. The results obtained demonstrate a clear correlation between the occurrence of eye infection and the degree of virulence of the strains. Amoebae isolated from eyeballs and other organs of dead mice did not exhibit any specificity in relation to the organs in subsequent infections. Irrespective of the place of isolation--be it eye or brain--in the subsequent passages, the amoebae were most often found in the brain and lungs, followed only then by the eye of the infected animals.

Acanthamoeba↗

Yeast-like microorganisms in eye infections.

The proportion of yeast species involved in eye infections in 11 patients was examined. The presence of yeast organisms as causative agents of endophthalmitis was found in corneal smears (n = 4), conjunctival swabs (4), and vitreous fluid (3). Altogether 5 strains of Candida albicans, 2 strains of C. krusei and one strain each of C. guilliermondii, C. parapsilosis, C. tropicalis and Cryptococcus neoformans were isolated from the clinical material. The hematogenic origin of endophthalmitis was proved in 7 cases on the basis of positive blood samples and in 2 cases by the isolation of yeasts from the tip of an intravenous catheter. Endophthalmitis-supporting risk factors such as indwelling intravenous catheters, prolonged use of broad-spectrum antibiotics and chemotherapy, surgical intervention, diabetes mellitus, and malignancy were observed in the patients.

Candida↗

Diagnosis of Chlamydia trachomatis eye infection in Tanzania by polymerase chain reaction/enzyme immunoassay.

Detection of Chlamydia trachomatis eye infection is largely unsatisfactory by standard laboratory methods. A polymerase chain reaction/enzyme immunoassay (PCR-EIA) that had previously been successful for diagnosis of genital C trachomatis infection was compared with direct antibody immunofluorescence (DFA) for detection of the organism in conjunctival scrapes. 234 Tanzanian children aged 1-7 years living in a village that had had no previous trachoma control programme were classified clinically as having no sign of trachoma (0) n = 97, follicular trachoma (TF) n = 100, or intense inflammatory trachoma with or without TF (TI +/- TF) n = 37. PCR-EIA detected C trachomatis in 24%, 54%, and 95% of subjects, respectively, compared with elementary body (EB) detection by DFA of 1%, 28%, and 60%, respectively. Overall prevalence of chlamydial eye infection was 22% by DFA compared with 48% by PCR-EIA. Of subjects with chlamydial DNA at pretreatment, 103 (92%) had no detectable chlamydial DNA at the end of 4 weeks of ocular tetracycline. The findings show that PCR-EIA is likely to affect trachoma diagnosis and epidemiology because of the increased sensitivity for detection of C trachomatis in all clinical groups; the less stringent requirements for specimen collection and transport make this method suitable for field use. Moreover, the semi-quantitative aspect of PCR-EIA may be useful for monitoring a decrease in chlamydial DNA after treatment.

Administration, Topical↗

[Role of Staphylococcus epidermidis in outer eye infections].

Coagulase-negative staphylococci (CNS) from 57 patients with outer eye infections and healthy control eyes were isolated according to the Schleifer and Cloos classification and the sensitivity to antibiotics of the isolated CNS was examined. The pathogenicity of CNS in rabbit cornea was studied by direct inoculation of CNS. The results showed that of 57 strains of CNS, 25 strains (43.9%) belonged to S. epidermidis, 22 (38.6%) belonged to non-detectable strains, 4 (7%) belonged to S. capitis, 3 (5.3%) belonged to S. hominis and 2 (3.5%) belonged to S. saprophyticus. Furthermore these CNS were resistant to aminoglycoside and machloride antibiotics which are commonly used as eye drops for ocular infectious diseases. Control rabbit corneas inoculated with CNS almost became clear within 24 hours. Therefore, it was suggested that ocular CNS infections can occur in immunologically compromised host patients.

Adolescent↗

Nosocomial bacterial eye infections in intensive-care units.

A cluster of ten nosocomial eye infections occurred in three intensive-care units during an 18-month period. Nine of the ten patients were intubated, all were obtunded, and all had copious sputum production. The bacteria isolated from the patients' sputum samples and from the eyes were identical in nine cases. Pseudomonas aeruginosa caused six of the infections, including all those with complications (three corneal ulcers, two hypopyon, one opaque cornea, two corneal rupture). Three patients lost their sight. Only the left eye was infected in nine cases. In a prospective study of bacterial dispersion during tracheal suctioning of twenty intubated patients, patients with copious secretions had significantly higher bacterial colony counts on settle plates than those without. Colony counts were higher on the side opposite to the hand the nurse used to withdraw the catheter than on the same side. Nurses tended to withdraw the catheter diagonally across the patient's face, which may explain the selective involvement of the left eye.

Adolescent↗

[B-lymphocytes in chronic herpetic and adenovirus eye infections].

Concentrations of serum immunoglobulins and the number of B-lymphocytes in the peripheral blood were determined in herpes and adenovirus infections of the eyes. In severe forms of ophthalmic herpes the level of IgM was found to be high at the peak of the disease. In ophthalmic adenoviral infection and level of IgA was decreased. At the peak of the disease, the relative and absolute number of B-lymphocytes was decreased in severe forms of herpetic and adenovirus infections of the eyes. In the period between relapses the number of B-lymphocytes is completely restored.

Adenoviridae Infections↗

Detection of experimental Chlamydia trachomatis eye infection in conjunctival smears and in tissue culture by use of fluorescein-conjugated monoclonal antibody.

The immunofluorescent staining of conjunctival cytology smears with an antichlamydial monoclonal antibody is a new method for the detection of chlamydial eye infection. Using a monkey model of chlamydial eye infection, we compared the monoclonal antibody staining cytology with the established methods of Giemsa-stained cytology and chlamydial culture with cycloheximide-treated McCoy cells. Compared with either culture or monoclonal antibody-stained cytology, Giemsa cytology had a low sensitivity (30 and 24%, respectively) but was highly specific (100% in each case). Compared with culture, monoclonal antibody-stained cytology was highly sensitive (94%) but appeared to lack specificity (70%). However, examination of the changes in identification rates with time suggested that monoclonal antibody-stained cytology may be even more sensitive than culture and detect lower levels of infection. This study showed that monoclonal antibody-stained cytology of conjunctival smears might be a rapid, efficient, and inexpensive method of diagnosing ocular chlamydial infection.

Animals↗

[Glycolytic metabolites and adenosine triphosphoric acid in the herpes-infected eye].

In the tissues of the herpes-infected eye of a rabbit the content of adenosine triphosphoric acid (ATP), glucose and pyroracemic acid decreases and the level of lactic acid rises, i.e. anaerobic glycolysis prevails over the aerobic decomposition of glucose. A sharp decrease in the amount of ATP in the cornea and the iris in herpetic keratitis is due to the increased consumption of ATP for the synthesis of DNA and polypeptides of herpes simplex virus, as well as to disturbances in the oxidation transformations of glucose linked with the increased proportion of anaerobic glycolysis.

Adenosine Triphosphate↗

Ocular distribution of lomefloxacin 0.3% after a single instillation in the infected eye of pigmented rabbits.

We investigated the distribution of lomefloxacin, a fluoroquinolone, in the infected eye of pigmented rabbits after one instillation of 50 microliters lomefloxacin 0.3% eye drop, and compared tissue concentrations with therapeutic levels. Infection was induced by 6 instillations of Pseudomonas aeruginosa inoculum 6 x 10(5) bacteria) on centrally scratched cornea of 32 pigmented rabbits. Fifty microliters of 14[C] lomefloxacin 0.3% were instilled 24 hours after infection and animals were sacrificed 0.25, 0.5, 1, 2, 4, 8 and 12 hours later. Ocular structures, tear fluid, whole blood and plasma were then sampled, and tissue levels over time, Tmax, Cmax and area under the curve (AUC) were calculated. Lomefloxacin rapidly penetrated into the ocular structures: tear (Tmax 0.25 hours, Cmax 366 micrograms/ml, AUC 360 micrograms/ml x hour), corresponding value were for: eye lids (0.25, 7, 33), conjunctiva (0.25, 11, 7), cornea (0.25, 56, 70), aqueous humor (1, 8, 14), iris ciliary-body (4, 34, 252), lens (1, 0.2, 0.6). Tear levels remained high for many hours and were 34, 48, 1 and 27 micrograms/ml at 1, 2, 4 and 8 hours following a single instillation. Elimination from ocular structures was rapid. Therapeutic levels were achieved after a single instillation (mainly in the external ocular structures) when compared with MIC 90% values (1-10 micrograms/ml).

Administration, Topical↗

Detection of Pseudomonas aeruginosa eye infections by ultraviolet light.

Pseudomonas aeruginosa elaborates several pigment fractions that fluoresce in ultraviolet light. This fact has been used by surgeons in burn units so that treatment of subclinical P aeruginosa infections may be initiated promptly. We have determined the minimum in vitro concentration of two strains of this organism that exhibit ultraviolet light fluorescence and have applied this principle to the early detection of P aeruginosa eye infections.

Animals↗

Topical chloramphenicol for eye infections.

Topical chloramphenicol has been widely used in the treatment and prevention of superficial eye infections due to its broad spectrum of activity and low cost. The use of this drug has decreased considerably in the United States since the first case of aplastic anaemia associated with topical chloramphenicol was reported in the 1960s. This medication, however, is still widely used in many other countries. This paper evaluates the evidence for and against the use of topical chloramphenicol in ocular diseases.

Administration, Topical↗