Direct fluorescent antibody assay and polymerase chain reaction for the detection of Chlamydia trachomatis in patients with vernal keratoconjunctivitis

OBJECTIVES: To identify Chlamydia trachomatis via polymerase chain reaction and a direct fluorescent antibodyassay in patients with vernal keratoconjunctivitis while comparing the efficacies of both tests for detectingChlamydia trachomatis in these conditions. METHODS: Conjunctival scraping samples were obtained from 177 patients who were divided into two groups: avernal keratoconjunctivitis group (group A) and a control group (group B). The polymerase chain reaction and adirect fluorescent antibody assay were performed. Sensitivity, specificity, receiver operating characteristic curves,and areas under the curve were calculated for both tests in groups A and B. Receiver operating characteristic curveswere plotted using a categorical variable with only two possible outcomes (positive and negative). RESULTS: Statistical analysis revealed a significant association between vernal keratoconjunctivitis and Chlamydia trachomatis infection detected by a direct fluorescent antibody assay with high sensitivity and specificity. Allpatients in group A with positive polymerase chain reactions also presented with positive direct fluorescentantibody assays. CONCLUSION: The association between vernal keratoconjunctivitis and Chlamydia trachomatis infection wasconfirmed by positive direct fluorescent antibody assays in 49.4 percent of vernal keratoconjunctivitis patients and bypositive polymerase chain reactions in 20 percent of these patients. The direct fluorescent antibody assay detectedChlamydia trachomatis in a higher number of patients than did the polymerase chain reaction. Although thediagnosis of trachoma is essentially clinical, the disease may not be detected in vernal keratoconjunctivitis patients.Due to the high frequency of chlamydial infection detected in patients with vernal keratoconjunctivitis, we suggestconsidering routine laboratory tests to detect Chlamydia trachomatis in patients with severe and refractory allergicdisease.

Microbiota conjuntival em pacientes com alergia ocular / Conjunctival microbiota in patients with ocular allergy

OBJETIVO: Avaliar a presença de microbiota aeróbia da conjuntiva de portadores de alergia ocular e comparar a um grupo controle. MÉTODOS: Foram examinados 133 pacientes no período de abril a junho de 2001 divididos em 2 grupos. O grupo A foi composto de 63 portadores de conjuntivite alérgica (sem uso de medicação) e o grupo B de 70 pacientes do ambulatório geral (controle). Foram coletadas amostras do fundo de saco conjuntival do olho direito de todos os pacientes e o material foi semeado em meios sólidos de cultura (ágar sangue, chocolate e Sabouraud). RESULTADOS: No grupo A, 30 culturas (47,7 por cento) foram positivas e no grupo B, 6 (8,6 por cento). Sete bactérias foram isoladas no grupo A e 4 no B. A análise estatística revelou associação significante entre a positividade dos cultivos e conjuntivite alérgica. CONCLUSÃO: Microbiota bacteriana foi mais freqüentemente encontrada nos pacientes com alergia ocular.

Penicillium keratitis in vernal Keratoconjunctivitis.

We report a case of penicillium keratitis in vernal shield ulcer in the absence of corticosteroid use. This report illustrates super-added infection in vernal shield ulcer by an organism which is otherwise innocuous and forms a part of the normal ocular flora.

Giant papillary conjunctivitis A clinical, bacteriological and cytological study

Giant papillary conjunctivitis [GPC] is one of the most important complications of soft contact lenses [SCL] wear. Twenty cases [37 eyes] of GPC associated with soft contact lens were examined thoroughly using slit lamp biomicroscopy with high magnification, 2% sodium fluorescein eye drops and cobalt blue light. Cultures from conjunctival cul de sac and cytological examination of conjunctival scrapings were performed. The severity of GPC was found to be related to duration of lens wear, chemical method of disinfection and the presence of deposits on the lenses. The cultures were sterile in 94.5% of cases. The non-sterile cultures showed the presence of Proteus, Stap. epidermidis and diphtheroids. Few polymorphonuclear of sterile cultures proved that this inflammatory condition was not due to bacterial infection, while the presence of eosinophils proved its allergic nature

Las conjuntivitis recidivantes / Recurrent conjuntivitis

Entre las causas condicionantes de conjuntivitis recidivantes por fracaso fármaco-terapéutico, hay que tomar en cuenta la presencia de procesos infecciosos mixtos del tipo bacteria-bacteria o bacteria-hongos, así como la existencia de un proceso exudativo conjuntival de tipo alérgico. La evaluación citobacteriológica de estos exudados cumple un papel orientador sobre la probable etiología del proceso desde el primer dia de consulta. La presencia de una flora "saprofítica" en dichas afecciones, debe ser tomada como patógena oportunista de acuerdo a la clínica y a la evaluación microbiológica del proceso