Fc Gamma receptor IIa polymorphism in Egyptian patients with systemic lupus erythematosus

Systemic Lupus Erythematosus [SLE] is a complex, multifactorial auto-immune disease. Receptors for IgG play an important role in immune complex clearance. Several studies have identified polymorphisms of receptors for the Fc fragment of IgG [Fc Gamma R] as genetic factors influencing the susceptibility and course of such a disease. It has been also suggested that Fc Gamma RIIa polymorphism may be an important risk factor for development of lupus nephritis. This study was done to examine the frequency of Fc Gamma RIIa R/H131 polymorphism among Egyptian patients with SLE, as well as, to determine whether Fc Gamma RIIa polymorphism, represents a risk factor for both SLE susceptibility and lupus nephritis. Patients and Forty four Egyptian patients were diagnosed with SLE according to the American College of Rheumatology Criteria. Both SLE patients and healthy controls were genotyped for Fc Gamma RIIa R/H131 polymorphism using a single step allele PCR based method. No statistically significant difference was found in the frequency of FcyRlla genotypes [H/H, H/R and R/R] between SLE patients and normal controls [p > 0.05]. However, a small excess of R/R allele was seen in the SLE patients but this did not reach statistical significance [total SLE versus controls: OR 1.6, 95% CI 0.69-3.7, p > 0.05]. Moreover, a possible susceptibility to lupus nephritis which may be related to Fc Gamma RIIa R/R allele was suggested in the Egyptian patients, but this also did not reach statistical significance [OR 1.6, 95% Cl0.47-5.3, p > 0.05]. No statistically significant relation was found between Fc Gamma RIIa genotypes and age, age at onset and duration of the disease [p > 0.05]. Also, no statistically significant association between clinical manifestations and Fc Gamma RIIa polymorphism was demonstrated in this study. Serological assessments demonstrated that Fc Gamma RIIa H/H131 allele was significantly associated with double-stranded DNA antibody [OR < 1.95% CI0.27-3.3, p < 0.05], while no statistically significant association was demonstrated with anti-Smith antibody [p > 0.05]. Fc Gamma RIIa polymorphism may possibly constitute a minor determinant that could influence the susceptibility to SLE and lupus nephritis. However, it seems that it does not represent a well recognized genetic risk factor neither for SLE susceptibility nor for the development of lupus nephritis in Egyptian SLE patients

Management of rhegmatogenous retinal detachment with undetected retinal tears

The problem of rhegmatogenous retinal detachment without visible retinal breaks is a challenge to the retinal surgeon. The approach of this problem was described. Instead of the usual blind encircling procedure, pars plana vitrectomy were performed for such cases. Hereby, the study reported the results of this technique that was used in nine eyes where retinal breaks were undetectable preoperative. By this method, there was ability to detect retinal tears in seven eyes and to reattach the retina in these eyes. The advantages of this approach over other approaches were discussed

Intraocular pressure changes following nd-yag laser posterior capsulotomy

Thirty eight with moderately opacified posterior capsules following ECCE were treated with Nd. YAG laser between January 1985 and January 1986. In the first series [20 eyes], a definite rise of I.O.P. was recorded in 50% of cases 4 hours after doing laser. In the second series, [18 eyes], where antiglaucoma treatment was prescribed before and after treatment with laser, no significant rise of I.O.P. was recorded. It is thus advisable to give antiglaucoma treatment and follow up the I.O.P. for variable periods after Nd-YAG laser posterior capsulotomy since a late rise may occur

Vitrectomy for the treatment of retinal detachment due to macular holes

Nineteen consecutive cases of retinal detachment due to macular holes were treated by the modern technique of vitrectomy and air tamponade between Jan.1984. Feb. 1985. In 15 cases the retina remained attached during follow up periods ranging from one to 13 months. This simple technique emphasized the rote of vitreomacular adhesions in the pathogenesis of retinal detachment due to macular holes, It has the advantage of preserving the macula rather than destroying it by previous surgical procedurs

Management of dense membranous after cataract by vitreous cutter through a limbal approach

Twenty six consequetive cases [27 eyes] with dense membranous after cataract had been operated upon; using vitreous cutter through a limbal approach in a period between March, 1984- Dec., 1984. The follow up periods varying between 9 months - 11/2 year. Anatomically, all patients regained a wide clear pupillary area with a quiescent recovery period. Visual acuity was 6/18 or better in 80% of cases. Cases with non improvement of visual acuity were due to pre-existing retinal or macular diseases. Thus in conclusion, vitreous cutter [limbal appraoch] can be a very useful tool against dense membranous after cataract

management of retinal detachment complicating senile retinoschisis

Rhegmatogenous retinal detachment complicating senile retinoschisis is a separate clinical entity. Thirteen cases of retinal detachment complicating pre-existing senile retinoschisis were collected over a period of 2 years [1982-83] and were treated by cryocoagulation of the outer leaf breaks and scleral buckling, which should be broad and central to these breaks. We found that drainage of the subretinal fluid was a must, since it is viscid, almost vitreous-like in consistency and thus can never absorb spontaneously. There was successful attachment of the retina behind the buckle and subsequent recovery of visual acuity in all cases. However,in three cases out of the thirteen there was a residual pocket of fluid peripheral to the buckle, but this was non-progressive over a follow-up period of 2 years