Method for the diagnosis of specific inflammatory eye diseases

 

(57) Abstract:

The invention relates to medicine, namely to ophthalmology, and is intended for the diagnosis of specific inflammatory eye diseases, such as chlamydia, mycoplasmosis, candidiasis, toxoplasmosis, pneumonia caused by Staphylococcus aureus. Determine the amount of the acid-alkaline balance (pH) on the most damaged surface of the conjunctiva. When it is 8.0-12.0 diagnose acute phase chlamydia, 5.1-6.0 - subacute stage. When the pH 7.43 - acute stage of candidiasis, 6.21 - subacute stage. When the pH value of 8.18 - acute phase of toxoplasmosis, 5.46 - subacute. When the pH value of 3.45 - acute stage of mycoplasmosis, 4.52 - subacute stage. When the pH value 6.0-6.8 - acute stage of inflammation caused by Staphylococcus aureus, 4.75 - subacute stage. The method improves the accuracy of differential diagnosis and the appointment of adequate treatment at the various types of specific inflammatory diseases of the organ of vision.

The invention relates to medicine, namely to ophthalmology, and is intended for the diagnosis of specific inflammatory eye diseases, such as chlamydia, Mycoplasma, Candida, exeperience inflammatory diseases of the organ of vision determines the nature of therapeutic tactics, the problem of increasing the accuracy of diagnosis provided simplicity and accessibility is very important.

There are various indirect methods of determining the presence of microbial agents in the body, in particular, by using enzyme-linked immunosorbent assay, reactions direct immunofluorescence assay, DNA detection of microorganisms (EN 2039986, 20.07.95; EN 2009505, 15.03.94; Witkin S et al. Detection of C. trachomatis by the PCR.Am.J Obstet Gynecol 1993; 5:1438-1442; Gomberg, M. A. - Medicine for all. - 1997. No. 1. - S. 12-14).

The main drawback of all these methods is the inability on the basis of the results of studies using expensive equipment to quickly assign a causal treatment of eye diseases and to identify the stage of the process according to objective criteria. Otherwise antibacterial therapy empirically selected drug can be not only ineffective, but also harmful, because it can enhance the resistance of pathogenic microorganisms and weaken the immune system.

Known culture method for the diagnosis of chlamydial and mycoplasmal diseases, based on the decomposition of certain substances required for growth and reproduction of organisms. An indicator of this is the change in pH and, as a consequence the applications and mycoplasmal diseases. - M., 1995. - S. 194-217).

However, this method has not been used in ophthalmology, in particular, for the diagnosis of specific inflammatory diseases of the organ of vision.

The closest analogue of the proposed method is a method of diagnosis of chlamydial conjunctivitis, consisting in the detection of DNA of chlamydia by polymerase chain reaction (PCR) using oligonucleotide primers (EN, 2205876, 10.06.2003). The method allows for the specific determining in a sample the presence of chlamydia regardless of the type, combinations of species and presence related to chlamydia species. However, the method is complicated and expensive.

The task of the invention is to develop a simple screening method for the diagnosis of specific inflammatory diseases of the organ of vision.

The technical result of the proposed method is to obtain reliable results for the differential diagnosis and the appointment of adequate treatment at the various types of specific inflammatory diseases of the organ of vision.

The technical result is achieved by determining the amount of the acid-alkaline balance of the conjunctiva in the areas of the through cavity in the various specific inflammatory diseases of the organ of vision was experimental studies on frogs in order to study the biochemistry of the eye with the measurement of pH, depending on the illumination of the eye and its temperature (A. Piri and R. van Heyningen. TRANS. from English. HP Zvereva, T. C. Chlopak. Biochemistry of the eye. M, Medicine, 1968, S. 235-237).

We have conducted numerous studies on patients with various inflammatory diseases of the anterior segment of the eye and the obtained data testify to changes in pH, specific to the various types of specific inflammatory diseases of the organ of vision. The data were statistically processed, and the resulting figures of changes in pH depending on the type of infection and disease. The data obtained were verified using specific culture tests on various types of microorganisms. The result concluded that when the pH value 8.0-12.0 diagnose acute phase chlamydia, 5.1-6.0 - subacute stage; when the pH 7.43 - acute stage of candidiasis, 6.21 - subacute stage; when the pH value of 8.18 - acute phase of toxoplasmosis, 5.46 - subacute; when the pH value of 3.45 - acute stage of mycoplasmosis, 4.52 - subacute stage; when the pH value 6.0-6.8 - acute stage of inflammation caused by Staphylococcus aureus, 4.75 - subacute stage.

The method is as follows. Glass electrode pH meter with a spherical end with a diameter of 3 mm, specifically what of Sereni has undergone a technical verification and was calibrated with standard buffer solutions, enter in the discharge conjunctival cavity where it contacts the points of maximal hyperemia of the mucous. After amplification of the electrical signal on the electronic scoreboard and fixed pH. Depending on its size diagnose a particular type of infectious disease. When it is 8.0-12.0 diagnose acute phase chlamydia, 5.1-6.0 - subacute stage; when the pH 7.43 - acute stage of candidiasis, 6.21 - subacute stage; when the pH value of 8.18 - acute phase of toxoplasmosis, 5.46 - subacute; when the pH value of 3.45 - acute stage of mycoplasmosis, 4.52 - subacute stage; when the pH value 6.0-6.8 - acute stage of inflammation caused by Staphylococcus aureus, 4.75 - subacute stage.

Example 1. Patient T., 43 years. Sick 6 months. Complains of itching, discharge, redness of both eyes. Objective: there has been a marked swelling and redness of the eyelids, in the corner of the eyes - a collection of Muco-purulent discharge, more to the right. Biomicroscopy: hyperemia and edema of the mucosa of the lower eyelid, hypertrophy of the follicles in the form of beads. Evaluations were carried out using pH-meter HI-8314, glass electrode spherical end was dipped into the cavity of the conjunctiva so that made contact with detachable who remodels in the dynamics of the inflammatory process: in the acute phase pH of 8.04. This indicator is characterized pronounced specific process - ophthalmoplegias. The control exercised by the concentration of inclusions, which was more than 30. After 2 weeks, the inflammatory process has moved in the subacute stage on the background of specific treatment, the pH detachable match of 5.0-6.0, and the number of inclusions of chlamydia decreased by 48%. When the control cure the pH was 3.5, and the concentration of inclusions decreased by 85%.

Example 2. Patient K., 23, ill 1 month. Complaints: irritation, purulent discharge from the eye. During the inspection revealed a large number of discharge and infiltration of the mucous membrane of the eyelids and the eyeball. Produced measurement of pH using glass electrode pH meter HI-8314 immersed in the cavity of the conjunctiva, with the contact points of maximal hyperemia of the mucous. In the acute period, the pH value was 6.0, bakposev was discovered Staphylococcus aureus. Analysis of the intensity of infection was accompanied by control of pH. After specific treatment after three days was a decrease signs of inflammation. The pH value was in the subacute stage of 4.75 cured and the pH was 4,35.

Example 3. Patient 3. Complaints raivi, sticky white discharge, suspected Candida albicans. Using the pH-meter HI-8314, glass electrode, ball end of which is immersed in the discharge cavity of the conjunctiva, with the contact points of maximal hyperemia of the mucous membrane, measured pH of the conjunctival cavity, in the acute stage it was 7.43, in the subacute stage - 6.21. After specific treatment has cured, the pH value was 4.23, no complaints, the patient had no signs of inflammation of the layers of the eyeball.

Example 4. Patient K. Complaints about irritation, discharge. Objective: filmy detachable, mixed infection of the conjunctiva of the eye block. Suspected Mycoplasma. A glass electrode pH-meter HI-8314 immersed in the conjunctival cavity, in contact at points of maximal hyperemia of the mucous membrane, determined pH value equal to 3.45 in the acute stage. Diagnosed and verified mycoplasmosis. After specific treatment subsided stage of inflammation, subacute phase, the pH value amounted to 4.52.

Example 5. Patient A. Diagnosis: toxoplasmosis anterior segment of the eye, acute keratoconjunctivitis. Using the pH-meter HI-8314 glass electrode with a spherical end, placed in the conjunctival band 8.18 in the acute stage. Diagnosis of toxoplasmosis is confirmed. After specific treatment, when the subsidence of the inflammatory process, the pH value in the subacute period equal to 5.46. Recovery - the pH value amounted to 4.35.

Thus, the use of the proposed method to quickly and accurately diagnose specific inflammatory diseases of the organ of vision, and also to determine the type and stage of inflammation to conduct an adequate treatment.

Method for the diagnosis of specific inflammatory diseases of the organ of vision, wherein determining the magnitude of the acid-alkaline balance (pH) on the most damaged surface of the conjunctiva and its value 8,0-12,0 diagnose acute phase chlamydia, 5,1-6,0 - subacute stage; when the pH value 7,43 - acute stage of candidiasis, 6,21 - subacute stage; when the pH value 8,18 - acute phase of toxoplasmosis, 5,46 - subacute; when the pH value of 3.45 - acute stage of mycoplasmosis, to 4.52 - subacute stage; when the value of pH 6,0-6,8 - acute stage of inflammation, caused by Staphylococcus aureus, 4,75 - subacute stage.



 

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