muramidase and Eye-Infections

Topics: Corneal Ulcer; Eye Infections; Humans; Immunodiffusion; Immunoglobulins; Muramidase; Tears

Ophthalmologic examinations were performed on the 176 eyes of 88 bedridden patients with severe dementia. There were some pathologic changes in the external and anterior segments of 93 eyes. We observed infectious external and anterior segment eye diseases in 80 of these 93 eyes (86.0%). Fundus diseases were found in 34 eyes, but treatment was not necessary. Infectious eye diseases appeared to be the most prevalent ocular problem in these patients. Cultures of conjunctival swabs commonly demonstrated Staphylococcus aureus. No differences were noted in tear secretion rate or lysozyme concentrations in tears between eyes with and without infection. The blinking frequency was significantly reduced in infected eyes compared to normal eyes. Failure of the lacrimal drainage system was observed more often in infected eyes than in normal eyes. This study demonstrated that bedridden patients with severe dementia develop infectious eye diseases easily, to which stasis of tear flow seems to predispose. In caring for bedridden patients with severe dementia, ophthalmologists must be concerned with controlling infectious eye diseases.

Topics: Adult; Aged; Aged, 80 and over; Dementia; Eye Infections; Female; Hospitalization; Humans; Lacrimal Apparatus Diseases; Male; Middle Aged; Muramidase; Tears

Low levels of tear lysozyme were observed in patients with infective corneal ulcers, when compared with controls. Lowest levels were seen in patients with bacterial corneal ulcers. The levels of tear lysozyme showed a corresponding decrease with the increase in Schirmer test values; meaning thereby, that in ocular conditions associated with increased rate of tear flow, the lysozyme content in tears tends to be low.

Topics: Adult; Corneal Ulcer; Eye Infections; Eye Infections, Bacterial; Eye Infections, Fungal; Eye Infections, Viral; Female; Humans; Male; Middle Aged; Muramidase; Tears

Accurate diagnosis of uveitis is of great importance since the treatment for the various uveitis entities may differ considerably. In a large number of cases the clinical picture is sufficient to make an adequate diagnosis. There are cases in which the diagnosis cannot be made on clinical grounds alone and support is needed from laboratory tests. Only a limited number of tests have been proven to be useful as a diagnostic or prognostic aid. These include HLA-B27 typing in patients presenting with anterior uveitis and testing for angiotensin converting enzyme and lysozyme in case of suspected sarcoid uveitis. Toxoplasma serology is only useful to exclude the diagnosis and a positive test has very low specific value. Analysis of local intraocular antibody production is a valuable tool to confirm a suspected clinical diagnosis in uveitis. It is now possible to analyse paired serum and aqueous samples for the presence of specific antibodies against toxoplasma, cytomegalovirus, herpes simplex virus and varicella zoster virus using commercially available kits. Of the patients retrospectively diagnosed as having toxoplasma chorioretinitis 75% were shown to have a positive antibody coefficient indicating specific intraocular antibody production. Local antibody production in the eye directed against CMV confirmed the suspected diagnosis of CMV retinitis in 50% of the AIDS patients investigated. Until now we have not been able to measure local antibody production against herpes simplex virus (26 samples tested). Two of three patients with acute retinal necrosis had a positive antibody coefficient against varicella zoster virus. Both of these patients even had a higher titre in the aqueous than in serum. Since the choice of treatment, in infectious uveitis, depends on the causative organisms, it is very important to confirm a suspected clinical diagnosis with aqueous humor analysis.

Topics: Antibodies, Protozoan; Antibodies, Viral; Antibody Specificity; Aqueous Humor; Cytomegalovirus; Cytomegalovirus Infections; Eye Infections; HLA-B27 Antigen; Humans; Muramidase; Peptidyl-Dipeptidase A; Toxoplasmosis, Ocular; Uveitis