Abstract
Purpose :
Red eye (RE) is one of the most common ophthalmic disease induced by various factors as: bacteria, fungi, viruses or environmental conditions. The treatment of RE should be focused on an elimination of the primary cause and a reduction of symptoms. Topical antibiotics are prescribed in many cases of RE without a clear evidence on a bacterial etiology what can be a reason of an antibiotic resistance. During the inflammatory process caused by bacteria neutrophilic leucocytes are activated and release a leucocyte esterase enzyme (LE). The purpose of the study was to evaluate an activity of LE in the conjunctival sac of patients with acute RE.
Methods :
The study was performed on 17 eyes of patients with subjective (itching, tearing, foreign body sensation, discharge) and objective (conjunctival redness and edema, discharge color, eyelid edema) symptoms of the acute RE. The discharge was collected from the lower conjunctival sac by a sterile swab and used for an assessment of LE activity and bacteria identification in microbiological cultures. LE activity was measured in a color chemical reaction with pyrrole amino acid ester and diazonium salt. An intensity of the pink-purple color of the reaction was divided into six grades (0 – lack of any color, 1 – light pink, 5 - dark purple).
Results :
The activity of LE was the highest (grade 4-5) in 3 eyes and it corelated with the presence of the purulent discharge. Staphylococcus aureus was found in 2 of those eyes. There were not purulent discharges and any bacteria in 11 eyes with grade 0-1 of LE activity. There were 3 eyes with grade 3 of LE activity and without purulent discharge. Staphylococcus aureus was identified in 1 eye and Staphylococcus epidermidis in 2 eyes.
Conclusions :
LE can be a useful marker for the identification the bacterial cause of ocular surface inflammations. LE activity measurement seems to be a quicker, easier and more precise diagnostic method in RE than bacterial culture. It can help to choose a proper treatment and reduce the usage of topical antibiotics in non-bacterial RE.
This is a 2021 ARVO Annual Meeting abstract.