Cytomegalovirus (CMV) contamination is very common: in several countries, the number of seropositive people reaches 90% among the adult population. It is a latent infection able to affect any human organs and tissues that assumes special importance in severe immunosuppression cases. Cytomegalovirus retinitis is a disabling disease, and often leads to blindness. The article deals with some issues of epidemiology, clinical course, clinical presentation characteristics of cytomegalovirus eye disease in the context of HIV-infection. A special attention is given to detection methods, problems of diagnosis against the background of immune reconstruction syndrome, treatment approaches in clinical practice, and existing recommendations.
According to statistical studies in recent decades, there has been an increase of allergic diseases in most countries of the world. Predisposing factors are the deterioration of the environmental situation, the total “chemicalization” of life and the forced use of drugs. Twenty years ago, the World Health Organization called the new century “the century of allergies” and the disease itself as an “epidemic”. As time has shown, these forecasts have come true: from 2001 to 2010, the number of allergic people in the world increased by 20 % and many of these patients suffer from ophthalmic manifestations of the pathology: the eyes are involved in the process in almost every second case. This is due to the fact that the eyes are directly exposed to the environment and a variety of external allergens. The most common disease of an eye-allergic nature is allergic conjunctivitis: approximately 15 % of the total population of economically developed countries suffer from it. Allergic blepharitis, eyelid dermatitis, keratitis, iritis, uveitis, retinitis and optic neuritis are much less common. The following manifestations are typical for allergic conjunctivitis: burning, lacrimation, pruritus, hyperemia of the eyelids and conjunctiva, photophobia. In the case of a transition to a chronic form, pronounced tissue changes are observed. Therefore, timely diagnosis and effective treatment certainly have a positive effect on the quality of life of the patient and the course of the disease. The treatment of patients with allergic conjunctivitis, first of all, consists in the maximum possible restriction of contact with the allergen. During desensitizing therapy, local and general drugs are used. Numerous studies have proven the advantage of targeted and effective antiallergic local therapy compared with systemic exposure. Currently used local ophthalmic antiallergic drugs belonging to various groups. The tactics of their use is determined by the acuity, severity and etiology of the process. When choosing a drug, in some cases, you should focus on the presence of substances that provide a double mechanism of action: a pronounced antihistamine activity in combination with the stabilization properties of mast cells, which has a quick and long therapeutic effect. This study evaluated efficacy of Vizallergol (olopatadin 0.2 %) application in cases of allergic conjunctivitis in 239 patients was evaluated. The medication arrested the symptoms of allergic conjunctivitis in 89 % of patients, at that the mean period of treatment made 10.7 ± 0.3 days. In the treatment of allergic conjunctivitis, the therapeutic efficacy of Vizallergol 0.2 % was comparable to opatanol 0.1 % and was found to be more comfortable for most patients due to the convenience of a single use.
BACKGROUND: Cytomegalovirus damage to the eye is the leading cause of loss of visual functions associated with HIV. Effective treatment of HIV-infected patients has changed the understanding of the clinical picture of cytomegalovirus uveitis (CMV-uveitis). AIM: The aim of the work is to determine the prevalence, the structure of clinical forms and to evaluate visual functions in HIV-infected patients with CMV-uveitis. MATERIALS AND METHODS: The study group consisted of 66 HIV-infected patients with CMV-uveitis (97 eyes), of which there were 27 men (40.9%), 39 women (59.1%). The average age was 39.6 3.91 years. All patients had stage 4B of HIV infection according to V.V. Pokrovskys classification (2006). During the work, visometry, perimetry, biomicroscopy, ophthalmoscopy were used. RESULTS: The main form of the disease is chorioretinitis, diffuse and generalized forms of the disease are diagnosed in 68.0% of cases. In predicting visual acuity, the leading regression criterion was the clinical form of the disease. CONCLUSIONS: Diffuse and generalized forms of the disease prevailed in clinical practice. Localization of the chorioretinal process of a predominantly diffuse nature predetermined visual acuity, which in more than a third of cases met the criteria for blindness according to the WHO classification (1977).
The article deals with the problem of ditofilariasis - the only facultative for the human in Russian Federation zoonotic parasitic helminth. Over the last years, there is a pronounced tendency to increased number of animals and humans dirofilariasis cases in the temperate climate area. The spread of the disease (which until quite recently was considered as endemic for tropical climate countries and southern regions of our country) is related to a wide causative agent circulation in the environment and to the spread of the great number of stray dogs and lack of adequate measures aimed on detection and treatment of infected animals. Moreover, there is a year-round risk of infection caused by «basement» Culex mosquitoes and in an urban setting. Herewith, the problem of dirofilariasis caused by Dirofilaria repens and Dirofilaria immitis nematodes is poorly known and there are no sufficient data on its true prevalence in our country. In the article, clinical cases of ocular dirofilariasis caused by Dirofilaria repens are presented, diagnosed in Ural and North-Western Regions of the Russian Federation. Upon larvoscopic examination, Dirofilaria repens immature female was identified in all four cases. The article contains short literature review of dirofilariasis problem in Russia and morbidity prognosis. The need for thorough epidemiological anamnesis and use of ultrasound, laboratory and larvoscopic examination for clinical diagnosis of ocular dirofilariasis is reviewed. The main aspects of conservative and surgical treatment of parasitic infection are presented. The late diagnosis of dirofilariasis caused by absence of pathognomonic symptoms at early stages of the disease requires wider awareness and clinical suspicion of this pathology.
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