[Pseudo-exfoliative glaucoma in eastern Algeria. Clinical study]

The authors present the results of a study concerning 656 patients, over 40 years old, presenting a glaucoma, or a Capsular pseudoexfoliation, or both. These patients have been admitted at the Annaba Ophthalmology Clinic between September 1st, 1984 and September 1st, 1987. Frequency, age, sex, glaucoma-CPE association, opening and pigmentation of the iris-cornea angle, as well as the level of intraocular pressure, are studied. It turns out that the pseudoexfoliative glaucoma represents 53% of all glaucoma, that it is a particular form of primitive glaucoma, generally with open angle, of severe evolution, but that it can be controlled with an adequate treatment, often surgical.

[Epiretinal membrane and photocoagulation with argon laser. Discussion of 3 cases]

The unexpected arrival of a preretinal membrane after Argon L.A.S.E.R. photocoagulation is reported about three observations. Literature brings physiopathogenic mechanisms of the membrane proliferation to light the study of risk factors lead to precise the importance of the preventive treatment of retinal detachment.

[Interocular accommodative disparities: asymmetry and/or paresis?]

Description of interocular accommodative disparities about 3 cases of young patients, whose occupations require an excellent stereopsis in near vision. Is is a paresis, an asynergy or a constitutional asymmetry? In order to delimit this pathology, the accommodative power of each eye has been measured on a reference population including 100 subjects aged 20 to 35 years. The suitable correction of this anomaly, allows an exact compensation and the recovery of a normal functional comfort.

[Intra-ocular implantation and traumatic cataract]

Discussion of the indications of the correction of post-injury aphakia intraocular lens. The immediate infectious danger by perforation, the unavoidable inflammatory reactions, the potential retinal risk and the so often alteration of the posterior chamber by synechias, are leading to advice, in the majority of cases, the secondary anterior chamber lens implantations.

Effect of the 5-lipoxygenase inhibitor piriprost on superoxide production by human neutrophils

The effect of 6,9-deepoxy-6,9-(phenylimino)-delta 6,8-prostaglandin I1 (Piriprost) on the oxidative response was studied in human neutrophils stimulated by N-formyl-methionyl-leucyl-phenylalanine (fMLP), phorbol 12-myristate, 13-acetate (PMA) or opsonized zymosan. Piriprost inhibited the stimulatory effect of fMLP on superoxide anion (O2-) generation, at concentrations higher than those which depress leukotriene B4 (LTB4) formation. This inhibition was overcome by increasing the concentration of fMLP. Neither exogenous LTB4 nor indomethacin were able to reverse the inhibitory effect of piriprost on fMLP action. In contrast, piriprost did not inhibit the stimulation of O2- production induced by PMA or zymosan. Piriprost behaves thus as a specific and apparently competitive antagonist of fMLP: this action does not seem to involve lipoxygenase inhibition and might be exerted at the level of the fMLP receptor or its associated mechanisms of transduction.

Pregnancy and humoral immune response in mice chronically infected by Trypanosoma cruzi

The effect of pregnancy on the humoral immune response induced by Trypanosoma cruzi was studied in groups of chronically infected and pregnant mice (IP) or chronically infected and nonpregnant mice (INP) of strain BALB/c. Groups of noninfected and nonpregnant mice (NINP) or noninfected and pregnant mice (NIP) served as controls. The pregnant mice were killed on day 17 of pregnancy. Anti-T. cruzi immunoglobulin G (IgG) and IgM antibodies, detected by immunofluorescence or enzyme-linked immunosorbent assay or both, underwent a pregnancy-associated decrease of 20 to 40%, whereas complement-mediated lytic antibodies were unaffected by pregnancy. Immunoblotting analysis indicated identical specificities of the anti-T. cruzi antibodies in IP and INP groups. The levels of all the immunoglobulin isotypes (particularly IgG2a and IgG3), circulating immune complexes, rheumatoid-like factor, and anti-DNA antibodies were considerably increased during chronic infection (NINP versus INP), which could be related to the high degree of polyclonal B-cell activation occurring in T. cruzi infection. However, pregnancy significantly decreased (by 20 to 60%) such parameters. IgG levels were particularly affected (by 40 to 60%), and the decreases could be ordered as follows: IgG3 greater than IgG2a greater than IgG1 greater than IgG2b for IP versus INP. Comparisons between the noninfected groups indicated differences only in IgG levels. These results indicate the following. (i) The specific humoral anti-T. cruzi immune response is weakly affected by pregnancy, which is not sufficient to modify the course of the mother's infection. (ii) Pregnancy does not modify the expression of the anti-T. cruzi antibody repertory. (iii) Pregnancy reduces the polyclonal B-cell activation, particularly the levels of the IgG isotypes undergoing the greatest activation.

Treatment of hairy-cell leukemia with recombinant alpha 2-interferon

Eleven patients with hairy-cell leukemia (eight with progressive and three with non-progressive disease) were treated with low dose recombinant human alpha 2-interferon. After a 3-month treatment period, nine patients showed an improvement and one patient a partial remission. By then, transfusions were not required any more and serious infections were no longer encountered. Four patients were further treated: three for a total period of 9 months and one for 6 months; all of them reached a partial or complete remission. The treatment was equally effective in patients with both progressive and non-progressive disease. Previous absence of response to splenectomy did not preclude a positive effect of IFN therapy. In two patients, IFN dose reduction was necessary due to unremitting flu-like symptoms.

[Course and prognosis of serous detachment of the retinal pigment epithelium]

In a 15-year retrospective study the spontaneous evolution of serous detachment of the pigment epithelium was investigated functionally, by perimetry, biomicroscopically, and angiofluorographically, in order to identify the manifestations of this syndrome and determine its prognosis. Serous detachments of the retinal pigment epithelium are generally associated with senile macular degeneration, central serous chorioretinopathy, diffuse pigment epitheliopathy, or are idiopathic. The patients studied were divided into two groups: 45 patients under 55 years old (64 eyes), kept under observation for an average of 70 months, and 42 patients over 55 years old kept under observation for an average of 38 months. These two groups were compared with a group of cases of isolated colloidal degeneration. The good prognosis for the first group is emphasized. Stabilization or improvement of visual acuity was normal. In the second group, complications included subretinal neovascularization in 29% and tears in the retinal pigment epithelium in 3.5% of the cases. Visual acuity deteriorated in one-third of the cases. Factors which adversely affected prognosis were an initial detachment larger than the diameter of the optic disk, macular location, and contralateral neovascularization. However, the results with spontaneous evolution were not worse than those in laser-treated cases reported in the literature.

Impairment of phagocyte oxidative metabolism in hemodialyzed patients with iron overload

In order to study the influence of iron overload on the polymorphonuclear leucocyte (PMN) metabolism of patients on chronic hemodialysis, generation of superoxide anion (O2-) by PMN in whole blood was compared in two groups of hemodialyzed patients: group A consisted of twenty-one individuals with serum ferritin levels above 1000 ng/ml and group B of nineteen individuals with serum ferritin levels below 1000 ng/ml. Whereas basal production of O2- was similar in the two groups (6.3 +/- 4.6 vs 11.5 +/- 8.3 nmoles O2- 10(6) granulocytes-1 15 min-1) (mean +/- s.e.m.), PMN response to opsonized zymosan was significantly lower in group A as compared with group B (86.5 +/- 6.3 vs 120.4 +/- 8.2 nmoles O2- 10(6) granulocytes-1 15 min-1) (p less than 0.01). Superoxide anion generation induced by the dialysis procedure was reduced in eight patients from group A (89.2 +/- 32.1) as compared with eight patients from group B (374.3 +/- 100.0 nmoles O2- 10(6) granulocytes-1 15 min-1) (p less than 0.05). These data suggest that iron overload may be involved in the impairment of neutrophil phagocytosis in patients on chronic hemodialysis.