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Purpose: to study the prevalence of various chronic infections, the frequency of their reactivation and characteristic associations of microorganisms in patients with optic neuritis of various etiologies.Material and methods. 13 patients with optic neuritis (ON) and 12 patients with ON and multiple sclerosis were tested for a broad range of infectious agents in their blood serum.Results. All patients were shown to have mixed infections; 64 % of them had an association of 4 or more infectious agents. The patients of both groups were infected with Epstein-Barr virus (100 %), Cytomegalovirus (92 %) and Herpex simplex viruses (92 %) types 1 and/or 2 with serological signs of their reactivation. The combination of Herpes virus reactivation, Toxoplasma and urogenital infection was more often detected in patients with demyelinating ON. In patients with multiple sclerosis, a mutual correlation was detected: the higher the degree of infection (combination of 5 or more pathogens), the lower the visual acuity at the onset of the disease (p < 0.05) and the less favourable the vision prognosis.Conclusion. Possibly, mixed infection may play an important role in the pathogenesis of ON, including that of demyelinating etiology, as a trigger or an aggravating factor.

Introduction. Studies aimed at a direct research of human herpes viruses (HHVs) in the tumor material and eye media have not been carried out so far. Research goal to establish the frequency of detection HHVs DNA in the biomaterial of the eye and blood and to assess the specific humoral immunity to the causative agents of herpes virus infections in patients with uveal melanoma. Materials and methods. 38 patients with the uveal tract tumor were examined for the presence of DNA of HHV types 1 and 2 (HSV-1, 2), Cytomegalovirus (CMV), Varicella Zoster virus (VZV), EpsteinBarr virus (EBV) and herpes viruses 6 and 8 types (HHV-6, HHV-8) in tumor tissue, vitreous body, aqueous humour and blood plasma by real-time polymerase chain reaction; blood serum was studied by enzyme-linked immunosorbent assay (ELISA) for IgG and IgM antibodies to HHVs. Results. EBV DNA was present in tumor tissue in 20.6% of cases, in vitreous body in 4.2%, in blood plasma in 2.7%, and was not found in aqueous humor. Ig G antibodies to HSV-1, 2 and CMV were detected in 97.3% of cases, VZV 94.6%, HHV-6 32.4%, antibodies to HHV-8 were not detected. 20 patients (55.6%) had reactivation of chronic HSV-1, 2 infection, and 14 (38.9%) patients had reactivation of CMV infection. Markers of chronic EBV infection were found in all patients, its atypical reactivation was observed in 2 cases (5.4%). Conclusion. Our findings suggest the possible participation of EBV in the oncogenesis of the uveal tract and emphasize the need for further in-depth study of this problem.

Purpose. To study the possible impact of human herpes viruses (HHV) reactivation: herpes simplex virus type 1 (HSV 1), type 2 (HSV 2), cytomegalovirus (CMV) and Epstein — Barr virus (EBV) on the clinical course of uveitis in Behcet's disease (BD). Material and methods. Serum samples of 106 BD patients (ave. age 39) with uveitis were examined for the presence of antibodies — serological markers of chronic HHV infection and reactivation. Results. In 65 patients (25 with active uveitis (UA), 40 with uveitis remission (UR)), HHV reactivation was detected (mainly HSV 1, less often HSV 2, CMV and EBV — in individual cases), 41 patients had chronic HHV (17 with UA, 24 with UR). Certain clinical symptoms of uveitis were found to depend on HHV activity. Clinical signs of active uveitis (cells in the vitreous body), as well as severe irreversible changes (social blindness and low vision) were significantly more frequently detected in cases of HHV reactivation (p < 0.05) than in chronic HHV. The data obtained allow us to suggest, with some caution, that a subclinical HHV reactivation which stays after the onset of clinical uveitis remission, is an important factor of postuveal complications that are mainly manifested during remission. These complications include epiretinal fibrosis, pronounced optic nerve atrophy, and vasculitis (arterial and venous occlusion). Conclusion. The remission period in patients with subclinical herpesvirus activity is less favorable than in patients without serological markers of HHV reactivation. HHV reactivation that persists after uveitis activity is stopped can contribute to sudden exacerbations of uveitis.

Purpose: to study the clinical signs and effectiveness of laboratory diagnostics of fungal corneal ulcer complicated by endophthalmitis aimed at treatment tactics optimization.Materials and methods. 15 patients aged 20–55 with severe monocular fungal ulcer complicated by endophthalmitis were examined by microscopy and culture of corneal scraping on Sabouraud Agar; microscopy and culture of intraocular fluid and corneal fragments, obtained during the surgical treatment. Corneal scrapings from the corneal ulcer and corneal fragments removed during keratoplasty were tested in polymerase chain reaction (PCR) for the presence of deoxyribonucleic acid (DNA) of Candida albicans and total Fungi DNA.Results. Before treatment start, 2.5 hours after the biomaterial was taken, PCR revealed Fungi DNA in all 15 cases. Symptoms of the severe fungal corneal ulcer complicated by endophthalmitis and caused by Aspergillus spp have been identified and described. Conservative therapy and total penetrating keratoplasty (PKP) helped retain the eye in 13 out of 15 patients (86.7 %) and partially restore the visual functions.Conclusion. Rapid laboratory diagnosis of ophthalmomycosis using PCR offers an advantage over the culturing technique: the results are ready within 2.5 hours instead of 10-14 days (culture method); it is highly sensitive and allows identifying the fungi not only in the tissue of the removed cornea, but also in the сorneal scrapings. The effective treatment tactics of fungal corneal ulcer complicated by endophthalmitis combining PKP with pre-operative and long-term postoperative antifungal therapy was proposed.

The aim of the study is to conduct a comparative analysis of percentages for peripheral blood effector lymphocyte subsets in patients with uveal melanoma manifested by recurrent and chronic herpesvirus infection. There were 141 subjects enrolled: 70 patients with uveal melanoma, 38 patients with corneal ulcers and involvement of the uveal tract as well as 33 healthy donors. Immunophenotyping was performed by using laser flow cytometry with panel of monoclonal antibodies to differentiate lymphocyte subpopulations. IgM and IgG antibodies to herpesvirus infections were determined by using enzyme-linked immunosorbent assay on an automatic ELISA analyzer Lazurit (USA) with diagnostic kits of CJSC “Vector-Best” (Koltsovo). The data obtained showed that the absolute number of blood lymphocytes (CD45+) in patients with uveal melanoma did not differ from those in healthy donors. In contrast, patients with corneal ulcers and involvement of the uveal tract had this parameter increased. A decreased relative and absolute count of T cells (CD3+) in uveal melanoma, but increased absolute CD3+ number in inflammation was observed. No difference in relative and absolute content of the CD3+CD4+ helper/inducer subpopulation in patients with recurrent herpesvirus infections was found. Corneal ulcers in cancer patients revealed significantly increased absolute level of CD3+CD4+ helpers/inductor cells. Chronic herpesvirus infection in uveal melanoma patients showed increased relative and absolute number of cytotoxic T lymphocytes (CD3+CD8+). Recurrent herpesvirus infection was featured with decreased relative number of T lymphocytes (CD3+CD8+), upon inflammation, there was noted increased absolute and decreased relative number compared with healthy subjects. Double positive T cells increased in tumor and inflammation. B lymphocytes (CD19+) increased in melanoma and inflammation. The relative number of blood natural killer cells (CD16+CD56+) in uveal melanoma increased upon recurrent infection. Inflammation was coupled to decreased relative level of natural killer cells (CD16+CD56+). Melanoma showed no changes in CD4+/ CD8+ ratio; upon inflammation, its increase was noted in acute and chronic herpesvirus infections (p < 0.05). The suppression of the immune system in uveal melanoma, restricting antiviral defense, was revealed. The data obtained seem to be important for development of personalized approaches to prognosis and treatment of patients with uveal melanoma.

Behcet's disease (BD) is a systemic disease underlyed by chronic vasculitis. Hyperactivity of innate and adaptive immunity plays important role in its pathogenesis. Uveitis occurs in 30-70% of the patients, often recurring and reducing visual function. The objective of our work was to study the features of systemic production of immune mediators in BD patients, depending on presence and activity of uveitis. 116 BD patients were divided into 3 groups: (1) 41 patients with active uveitis (UA), (2) 64 subjects with uveitis remission (UR), (3) 11 uveitis-free BD patients (WU). Control group (CG) comprised 34 conditionally healthy people. Detection rate (%) and contents (pg/ml) were measured for IL-1β IL-2, IL-4, IL-5, IL-6, IL-12p70, IL-13, IL-18, IFNγ, CCL2/MCP-1, CCL3/MIP-1α, CCL4/MIP-1β, CCL5/RANTES, CCL11/Eotaxin, СXCL1/GRO-α, CXCL8/IL-8, CXCL10/IP-10, CXCL12/SDF-1α, GM-CSF, TNFα in blood serum by means of multiplex analysis using MAGPIX analyzer (Luminex Corp., USA), Procarta Plex “Human Th1/Th2&Chemokine Panel 20 plex” kits (Bioscience, Austria). TGF-P1, TGF-P2 levels were assayed by ELISA-test (“Vfector-Best”). All the BD patients showed high detection rates of CXCL1/GRO-α (but not its level) in comparison with CG. Detection rate and levels of IL-6, IL-8 were increased in 1st and 2nd BD groups, compared to CG. In UR, unlike UA and WU groups, IL-4 was detected more often than in CG. WU patients showed increased detection rate of only CXCL1/GRO -α. When compared with UA, WU patients had lower serum concentrations of IFNγ, MCP-1, IP-10, MIP-1a, SDF-1α, TGF-β1; UR patients also showed decreased serum levels of IL-18, Eotaxin, GRO-α, RANTES, TGF-β2. Our results indicate the importance of angiogenic and proinflammatory chemokines and cytokines in pathogenesis of BD uveitis, as well as imbalanced production of various immunomediators. Higher detection rates and levels of IL-6 and IL-8 in UA and UR patients may result from weak persistent intraocular inflammation, even upon relief of clinical symptoms, thus, probably, requiring therapeutic correction.

Behcet’s disease (BD) is a systemic autoinflammatory-autoimmune disease (chronic systemic vasculitis) of unknown etiology, almost 70% of patients develop uveitis. BD pathogenesis is complex, human herpesviruses (HHV) play an important role among infectious trigger factors. Ability of herpesviruses to modulate cytokine production and evade host’s immune response is known.Aim of the study was to assess the effect of Herpes simplex virus type 1, Herpes simplex virus type 2, Cytomegalovirus, Epstein-Barr virus on systemic levels of chemokines, pro- and anti-inflammatory cytokines in BD with and without uveitis. Serum samples were collected from 116 BD patients chronically infected with HHV and examined in ELISA-test for markers of HHV reactivation (IgG-antibodies to immediate early HSV antigens 1, 2 and CMV, early EBV antigen). Concentration of IL-1β, IFNγ, MCP-1, IL-2, IL-4, IL-5, IL-6, IL-8, IL-12p70, IL-13, IL-18, TNFα, GMCSF, Eotaxin, GRO-α, IP-10, MIP-1α, MIP-1β, SDF-1α, RANTES detected in multiplex analysis. TGF-β1, TGF-β2 were measured in ELISA-test. Depending on presence and activity of uveitis 3 groups of patients with BD were identified: group 1 – active uveitis, group 2 – remission of uveitis, group 3 – BD without ocular manifestations. After serological study 2 subgroups were highlighted in each group: a) patients with antibody markers of reactivation of at least one HHV, b) patients chronically infected with HHV, without serological signs of reactivation. Mean level and detection rate of cytokines and chemokines in patients with active uveitis (1a, 1b) and in remission (2a, 2b) were compared with patients without eye damage (3a, 3b). Chronic HHV infection (subgroup “b”) was compared with reactivation (subgroup “a”). A significant increase of MCP-1/ CCL2, MIP-1α/CCL3, MIP-1β/CCL4, RANTES/CCL5, IP-10, SDF-1α chemokines in serum, as well as IFNγ, TGF-β1, and TGF-β2 was observed in patients with uveitis (regardless of their activity) and HHV reactivation compared to patients without uveitis. Our data indicate that systemic production of cytokines and chemokines in BD patients and uveitis could be affected by the activity of chronic herpesvirus infections, and the greatest changes are related to chemokines.

Age-related macular degeneration (AMD) and central serous chorioretinopathy (CSC) are diseases targeting the posterior segment of the eye that often lead to lowered visual functions. Pathogenesis of such disorders largely remains unclear. Among the risk factors of developing chronic inflammation, various microorganisms are considered, particularly Cytomegalovirus (CMV ). The study was aimed at analyzing the humoral response to individual viral proteins during chronic and reactivated CMV infection in AMD and CSC patients. Materials and methods. 104 CMV-seropositive patients were enrolled in the study including 75 AMD and 29 CSC subjects. IgM- and IgG-antibodies specific to CMV late viral antigens as well as IgG antibodies against the main non-structural immediate early (IE) antigen were evaluated by ELISA. IgG antibodies to individual CMV phosphoproteins such as the main non-structural immediate early protein (IE), the DNA-binding phosphoprotein pp52, and the tegument phosphoproteins (pp150, pp65, and pp28) were assessed by using Line-Immunoassay: recombinant antigens containing immunodominant protein fragments derived from viral antigens (p52, p150, p65, p28) were used. Positive (bands 2+) and strongly positive (bands 3+) data were only used for analysis. Results. It was shown that in both groups patients with chronic CMV infection had comparable rate of detected antibodies specific to individual antigens. The level of seropositivity to CMV р150 and р65 was significantly higher than that to CMV р52 and р28 (p < 0.05). Patients with AMD compared to patients with CSС had significantly higher moderate positive response (2+) to all the antigens examined. Upon reactivation of chronic CMV infection in AMD patients, the level of seropositivity to all antigens was increased, the number of cases with an intensely positive response to individual antigens was elevated, but patients with moderate positive response still prevailed. However, reactivation of chronic CMV infection was observed only in 6 CSС patients, allowing to perform no comparative analysis between these two groups. Conclusion. The main difference between CMV-chronically infected patients with AMD and CSC was not found at the level of seropositivity to individual CMV recombinant antigens, but rather in magnitude of antibody production so that AMD patients in comparison to CSC patients displayed moderate antibody production (bands 2+). A marked difference was related to the level of antibodies against CMV p150: AMD patients showed moderate antibody response (bands 2+), whereas CSC subjects dominated with strong positive response (bands 3+) (p < 0.05). It seems that moderate antibody production to recombinant CMV antigens examined in AMD patients occurs due to a weak expression of such viral antigens during chronic infection, resulting in long-term maintenance of antigenic stimulation leading to prolonged inflammation.

Fungi implicated in mycotic keratitis include different species. Conventional methods for the diagnosis of fungal keratitis include staining of corneal scarpings, culture medium (Sabouraud agar) for isolating fungi.Purpose. To evaluate the effectiveness of polymerase chain reaction (PCR) for the detection of fungal etiology in comparison with the conventional diagnostic methods in cases with suspected fungal corneal ulcer.Patients and methods. Seven patients with severe corneal ulcers with more than 3 weeks duration. Corneal scarpings and corneal buttons from seven patients who had undergone therapeutic keratoplasty were used for microbiological and PCR analysis. PCR diagnostic kits for the differential detection of Candida albicans DNA and total fungi DNA (DNA Fungi), which allows to identify most pathogenic fungi without determining their species were used. Microbiological methods: microscopy of gramstained smears, culture techniques, including selective for fungi agar Saburo with chloramphenicol.Results. PCR: Fragments of all corneas removed from keratoplasty (6 patients) revealed fungal-common DNA (Fungi DNA) and did not detect Candida albicans DNA, which correlated with sowing results on Saburo medium (mold fungi found in 5 of 6 corneas). Fungi DNA was also detected in the corneal scraps taken prior to surgery; however, growth of fungi during sowing on various nutrient media was not found.Conclusion. Corneal fungal ulcers are a serious disease, often leading to visual disability. The rapid determination of etiology and the correct choice of therapy determines the outcomes of the disease. The advantage of PCR over the culture method: the speed of obtaining results (4 hours instead of 3–7 days); high sensitivity, which allows detecting fungi not only in the tissue of the removed cornea, but also in scrapes from the cornea ulcer of patients who previously received antifungal therapy. The presence of commercial kits for differential detection of fungal-common DNA and DNA of Candida albicans extends the possibilities of PCR in the screening diagnosis of fungal keratitis and the selection of drugs before determining the type of pathogen.

Coronaviruses (CoV) are a large group of RNA viruses that are pathogenic to animals and humans. Until the end of the 20th century, human CoV were known as pathogens of seasonal mild respiratory diseases. In the last 20 years new CoVs caused three outbreaks of severe acute respiratory diseases with a predominant lesion of the lower respiratory tract: SARS-CoV — the causative agent of the severe acute respiratory syndrome (SARS) in 2002–2003; MERS-CoV that induced Middle East respiratory syndrome (MERS) in 2012 and SARS-CoV-2 the causative agent of the coronavirus disease-19 (COVID-19), a pandemic of which began in China in late 2019 and is ongoing. The review presents current data on SARS-CoV-2, ways of contagion, transmission routes, detection time in the body, the role of asymptomatic virus carriers in the epidemic process. Advantages and disadvantages of the main laboratory methods of COVID-19 diagnosis are described: polymerase chain reaction (detection of viral RNA) and serological tests (detecting IgG-and IgM-specific antibodies). The data on conjunctivitis, the main currently known ocular symptom of COVID-19, are summarized. The role of the tear and eye discharge as a possible source of infection is discussed, as well as the role of the eye as the entrance gate of the virus with the subsequent development of respiratory infection. The high professional risk of ophthalmologists being infected through close contact with the patient during the examination is outlined. A system of complex protection of ophthalmologists against contagion during examination of patients, proposed in some countries, is presented.

Conjunctival lymphomas are predominantly extranodal B-cell non-Hodgkin’s lymphomas (NHL), most of them are MALT-lymphomas originating from the mucosa-associated lymphoid tissue. Manifestations of the conjunctival NHL are very diverse, and often imitate the appearance of other ocular diseases, which makes their clinical diagnosis difficult and significantly lengthens the time from the first visit to the ophthalmologist until the diagnosis is verified. The article presents the case histories of two young patients who were treated for a long time at the place of residence as acute chlamydial conjunctivitis (in one case — 3, in the other — almost 5 months). A comprehensive laboratory study to detect specific blood antibodies, DNA of the pathogen in conjunctival scrapings and the cytological picture of the conjunctiva did not confirm the chlamydial etiology of the process. A pronounced lymphoid reaction mainly due to small lymphoid cells was found in both patients in scrapings from the conjunctiva of the eyelid, which was the basis for referring patients for consultation to oncologist. Histological examination of conjunctival biopsy specimens also revealed proliferation of lymphoid tissue: patients with suspected MALT lymphoma were referred to onco-hematologists. A PCR analysis of the biopsy material revealed HHV-8 DNA in one patient and Epstein-Barr (EBV) DNA in another, although no pathogen genomes were detected in the conjunctiva scrapings. Immunohistochemical analysis in one patient confirmed the conjunctival MALT-lymphoma, in another one diagnosed hyperplasia of the conjunctival mucous-associated lymphoid tissue, caused by prolonged antigenic stimulation (EBV DNA was detected in the biopsy). The follicular appearance of the lymphocyte hyperplasia in conjunctiva may imitate the clinical picture of infectious diseases. For differential diagnosis of chlamydial conjunctivitis and MALTlymphoma, especially in young patients with refractory follicular conjunctivitis, it is advisable to include a set of serological, molecular biology and cytological methods.

Endogenous uveitis (EU) in children is a multifactorial sight-threatening disease that reduces patient’s quality of life. Proliferative syndrome (PS) coupled to developing adhesions, opacity of vitreous body, epiretinal and preretinal membranes is one of the most serious EU complications, with yet-unknown pathogenesis. Among the numerous trigger factors, a role for infections, particularly human herpes group-driven, is proposed. The goal of the study was to assess a potential role of Herpes simplex viruses type 1 (HSV-1), Herpes simplex viruses type 2 (HSV-2), Epstein–Barr virus (EBV) and Cytomegalovirus (CMV) played in the PS pathogenesis in children with endogenous uveitis. 112 patients aged 3–17 years (mean age 10 years) with (93 patients)/without PS (19 children) were examined. IgM and IgG antibodies (markers of chronic and active infection) against HSV-1/2, EBV and CMV were detected by ELISA. A significantly increased PS rate in infected vs. uninfected children was revealed solely for EBV infection (p = 0.03), but not for HSV-1/2 (p > 0.05) or CMV-positive patients (p > 0.05). However, PS emergence in EBV-negative patients also suggests that some factors might contribute to proliferation in intraocular inflammation. In addition, level of serum IL-8 and IL-6 were assessed by multiplex analysis in 28 children. It was found that IL-8 was detected in all patients, with great individual fluctuations (5.6–2743 pg/ml). Enhanced systemic IL-8 level tended to rise in patients with more prominent proliferation and serological markers of EBV reactivation. However, serum IL-6 was detected by about 2-fold less often reaching up to 55% cases (variation of individual indices 1.3–35.5 pg/ml). A correlation between PS severity, EBV infection activity and systemic IL-6 level was not observed. Further studies evaluating a role of EBV infection in PS pathogenesis pediatric endogenous uveitis are necessary, as it may underlie a rationale for including antiherpetic drugs into a combination therapy.

Purpose: to study the role of human herpesviruses (HHV) in the pathogenesis of prolonged bacterial corneal ulcers. Patients and methods. 117 patients with bacterial corneal ulcer were examined. Two groups were identified: a favorable course-with duration of bacterial corneal ulcer epithelialization for 17 days (62 people) and a prolonged course with a persistent ulcer more than 17 days (55 people). Blood samples (n = 117) and scrapes from corneal ulcer (n = 117) were investigated in polymerase chain reaction (PCR) for the presence of deoxyribonucleic acid (DNA) of Herpes simplex virus (HSV1, 2), Epstein-Barr virus (EBV), Human herpesvirus type 6, 7 (HHV-6, HSV-7). Results. The HSV1, 2 and EBV genomes were detected in the cornea significantly more often in BCU of prolonged course compared with a favorable course (HSV1, 2 p = 0.012; EBV p = 0.012), and HHV-6 was detected not only in the cornea (p = 0.000), but also and in blood (p = 0.007). In patients with HHV DNA in corneal scarps and/or blood, after resorption of purulent infiltrate, corneal epithelialization was absent, and the use of antiherpetic drugs allowed to reduce the completion time of BCU epithelialization. Conclusion. The role of HHV-6, EBV, HSV 1, 2 in the pathogenesis of bacterial corneal ulcer of protracted course was revealed. The expediency of examination of patients with bacterial corneal ulcer on HHV is shown, a method of treatment is proposed, including antiherpetic therapy, which makes it possible to prevent the development of a protracted course.

Purpose: to describe the characteristic clinical signs and to study the causes of the development of an unfavorable prolonged course of bacterial corneal ulcers of central localization, and to improve treatment effectiveness. Material and methods. A total of 289 patients with central bacterial corneal ulcers were examined. Two types courses of bacterial corneal ulcer were distinguished: favorable (acute and subacute) and unfavorable (prolonged subacute and prolonged chronic forms). Blood (122 samples) and scrapings from corneal ulcers (110 samples) were examined in a nested polymerase chain reaction (PCR) to detect deoxyribonucleic acid (DNA) of simple herpes virus (HSV) 1 and 2 types, virus Epstein–Barr (VEB), human herpes virus (HHV)-6, and HHV-7. To detect autoimmune sensitization to the corneal antigens, migration inhibition reaction of leukocytes (MIRL, 215 samples) was used. Results. In patients with unfavorable course of the disease, blood and corneal HHV DNA was detected in 88.7 % of cases, while with a favorable course only 10 % of cases showed the presence of HHV DNA (р < 0.002). In all patients, HHV type 6 was predominating. Autosensitivity to corneal antigens was detected in 8 (10.4 %) out of 77 patients at the end of the first week of the disease, and as the disease progressed, the number of patients with an autoimmune component increased to reach 63.2 % (48 of 76). The inclusion of antiviral and immunosuppressive drugs into the routine treatment plan led to complete epithelialization of the cornea within 5–10 days. Сonclusion. The protracted course of bacterial corneal ulcers was found to be caused by a mixed herpes-bacterial infection, which is corroborated by the effectiveness of the modified treatment tactics.

HHV-8 (Kaposi’s sarcoma associated herpesvirus) is considered as the etiological agent of Kaposi’s sarcoma (KS), primary effusion lymphoma, multicentric Castleman’s disease (MCD), POEMS-syndrome, and HHV-8 inflammatory cytokine syndrome (HHV-8-KICS). Eye diseasesmay be the initial or the only manifestations of KS and MCD or be combined with systemic pathology. We discuss the role of HHV-8 in the pathogenesis of lymphomas of the orbit, the eye, and the conjunctiva. In the pathogenesis of KS and MCD, HHV-8 inflammatory cytokine syndrome plays an important role due to the unique ability of HHV-8 to produce viral cytokine IL-6, homologous to human proinflammatory IL-6 // Russian Ophthalmological Journal, 2016; 4: 91-6. doi: 10.21516/2072-0076-2016-9-4-91-96.

The paper summarizes current data on HHV-6: prevalence, modes of transmission, clinical manifestations of the primary infection and the reactivation of chronic infection, the role played in the pathogenesis of lymphoproliferative diseases, malignant tumors, CNS, DRESS-syndrome, inflammatory diseases of the eye (keratitis, uveitis, retinitis, optic neuritis) in children and adults, the methods of laboratory diagnosis and treatment // Russian Ophthalmological Journal, 2016; 1: 98-104.

Purpose: to study the impact of human herpes viruses (HHV) on the development of infectious corneal ulcers (CU). Material and methods. 43 patients aged 21 to 77 with suspected corneal ulcers of bacterial etiology were examined. Based on the history and ophthalmological examination, the patients were divided into 3 groups: group 1 of 26 patients with herpetic ulcers (HU), group 2 of 13 patients with secondary bacterial ulcers (SBU), and group 3 of 4 patients with primary bacterial ulcers (PBU). Blood (43 samples) and corneal scrapings (29 samples) were examined by nested polymerase chain reaction (PCR) for the presence of DNA of various HHV, including herpes simplex virus (HSV) 1, 2, Epstein - Barr virus (EBV), HHV-6, and HHV-7. Results. HHV was detected in 41.6-53 % of the corneas and in 33.3-50 % of blood samples, depending on the patient group. Clinical patients with the DNA of HHV identified in their cornea had torpid CUs and showed no epithelization following the suppressed purulent process. The addition of antiherpetic drugs resulted in complete epithelialization of the cornea within 3-5 days. Conclusion.The frequent representation of HHV-6 and EBV DNA and less frequently detected HSV DNA in the corneal scrapings indicate the possible involvement of HHV in the etiopathogenesis of SBU. The effectiveness of complex antiherpetic drug therapy supports this conclusion. For citations: Neroev V.V., Slepova O.S., Kovaleva L.A., Krichevskaya G.I. Optimizing etiological diagnostics and improving the efficiency of treating centralized infectious corneal ulcers. Russian ophthalmological journal. 2017; 10 (3): 56-61. doi: 10.21516/2072-0076-2017-10-3-56-61 (in Russian).

Results of comprehensive ELISA tests of blood serum for the presence of IgM-, IgA-, and IgG-antibodies to herpes simplex virus types 1 and 2, cytomegalovirus, Epstein-Barr virus, human herpesvirus 6, human herpes virus 8 type, Chlamydia trachomatis in 38 patients with uveal melanoma are presented. The polymerase chain reaction was used to detect DNA of these pathogens in tumor biopsies, vitreous body of 10 enucleated eyes, as well as in plasma IgG-antibodies to HHV 6 were revealed in 50% of patients; IgG-antibodies to HHV 8, in 5.3% of patients. Among the 16 patients with uveal melanoma at advanced stages, 6 patients had antibodies indicative of EBV reactivation (1.2-3.3). Chlamydia trachomatis genome was detected in both biopsies; in one of them, in conjunction with EBV and CMV DNA . Tissue samples from the identified infectious agents were related only to the spindle-cell histologic type AB of uveal melanoma. In plasma, genomes of pathogens were not determined. The results indicate the presence of infectious agents in patients with uveal melanoma and require further study of the pathogenetic role of infections in the pathogenesis of uveal melanoma.