[Chlamydia pneumoniae in the etiology of the keratoconjunctivitis sicca in adult patients (a pilot study)].
OBJECTIVE
In the pilot study the authors refer to the possible connection between the appearance of keratoconjunctivitis sicca (KCS) and Chlamydia pneumoniae (CP) infection.


METHODS
At the Department of Ophthalmology, 10 adult patients older than 45 years were followed up during the period of 5.5-7 years, where in the chronic folicular conjunctivitis caused by CP, the KCS was revealed as the same time.


METHODS
The chlamydial infection diagnosis was established due to the positivity to the familiar (anti-LPS) and species (anti-CP) immunoglobulins (IgG, IgM, and IgA) and to the conjunctival impression specimen, using the indirect immunofluorescence of specific monoclonal antibodies. The patients were treated by means of systemically administered macrolide antibiotics Azithromycine. After the termination of the treatment, the signs of the clinical inflammation of the conjunctival inflammation subsided but the KCS problems remained. After 6 years, the control examinations of the familiar and species antibodies of the CP were performed and the clinical findings of the KCS and its treatment were evaluated.


RESULTS
The decrease of the antibody levels was proved and objective findings and subjective symptoms of KCS in all patients subsided. Altogether 7 patients were without clinical signs of the KCS and without regular application of local artificial tears treatment. At the same time, in two thirds of the patients, the levels of the antibodies decreased or remained unchanged. In the last three patients, the signs of the dry eye decreased, but they didn't disappeared permanently. These patients had to apply artificial tears several times a day. The suspect signs of this serologically active infection persisted despite the antibodies levels' decrease.


CONCLUSIONS
This pilot study until now didn't confirm the direct dependence between the KCS and CP, but it didn't exclude it as well.
Krásný
J
J
Ocní klinika FN Královské Vinohrady, Praha. krasny@fnkv.cz
Hrubá
D
D
Netuková
M
M
Kodat
V
V
Tomásová
Borovanská J
BJ
D000328:Adult; D000368:Aged; D000907:Antibodies, Bacterial / Q000032:analysis; D023521:Chlamydophila Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D016993:Chlamydophila pneumoniae; D005260:Female; D006801:Humans; D007638:Keratoconjunctivitis Sicca / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D008297:Male; D008875:Middle Aged
D000907:Antibodies, Bacterial