[Sub-tenon steroid treatment in choroidal neovascularization caused by serpiginous choroiditis. A case report]. / Esteroides subtenonianos en neovascularización coroidea secundaria a coroiditis serpinginosa. Presentación de un caso.

CASE REPORT: We present a report of a patient suffering from serpiginous choroiditis complicated by choroidal neovascularization (CNV). Sub-tenon steroid treatment, added to the usual immunosuppressive therapy, resolved the CNV, improving visual acuity in one eye. DISCUSSION: Choroidal neovascularization is a sight-threatening complication of posterior uveitis. Our case suggests that sub-tenon steroid treatment, added to systemic immunosuppressive therapy, may accelerate the CNV resolution in posterior uveitis.

Esteroides subtenonianos en neovascularización coroidea secundaria a coroiditis serpinginosa. Presentación de un caso / Sub-tenon steroid treatment in choroidal neovascularization caused by serpiginous choroiditis. A case report

Caso clínico: Se presenta el caso clínico de una paciente con coroiditis serpiginosa y neovascularización coroidea (NVC) activa en ambos ojos. Tras tratamiento con terapia inmunosupresiva sistémica junto con inyección sub-Tenon posterior de esteroides, conseguimos la resolución de la NVC en ambos ojos, mejorando la capacidad visual en uno de los ojos. Discusión: La NVC es una complicación de las uveítis posteriores, cuya presencia amenaza de forma importante la visión. El presente caso sugiere que los esteroides subtenonianos añadidos a terapia inmunosupresiva sistémica, pueden acelerar la resolución de NVC tras uveítis posteriore (AU)

Case report: We present a report of a patient suffering from serpiginous choroiditis complicated by choroidal neovascularization (CNV). Sub-tenon steroid treatment, added to the usual immunosuppressive therapy, resolved the CNV, improving visual acuity in one eye. Discussion: Choroidal neovascularization is a sight-threatening complication of posterior uveitis. Our case suggests that sub-tenon steroid treatment, added to systemic immunosuppressive therapy, may accelerate the CNV resolution in posterior uveitis (AU)

Strong association of HLA class II sequences in Mexicans with Vogt-Koyanagi-Harada's disease.

Vogt-Koyanagi-Harada's syndrome (VKH) is an autoimmune disease prevalent in Mongoloids with evident participation of HLA. The aim of this study was to identify the class II DNA sequences involved in the etiopathogenesis of VKH in Mexican Mestizos. This study included 46 VKH patients and 170 controls. 75% were females (mean age at onset of 33.5 years). The disease evolved to chronicity (68%) and 25% of the patients were unresponsive to corticotherapy. DNA typing of HLA-DRB1, DQA1 and DQB1 was done following the 12th International Histocompatibility protocols. VKH was strongly dependent of DRB1 gene; DRB1*04 was found in 78.2% of the patients vs. 50.6% of the controls (p = 0.001). No particular DRB*04 subtype was significantly increased, suggesting that residues E-9 V-11; H-13; H-33 and Y-37 shared by all DR4s are implicated in susceptibility to VKH. However DRB1*0101 (p = 0.009, OR = 4.2) was clearly associated. This allele shares the motif LLEQRRAAG located at position 67-74 and 86 of DRB1 with *0405 associated in Japanese. Two HLA associated mechanisms may be triggering the autoimmune phenomena. One involving critical polymorphic residues expressed in different alleles. Secondly, some peptides may anchor to the conserved residues leaving other sequences to bind to the T cell receptor.

Independent Associations of the HLA-B27 Antigen and the Complement Haplotype SC21 in Chronic Anterior Uveitis.

There is evidence of an association between major histocompatibility complex (MHC) genes and acute anterior uveitis; here the authors report the frequency of class I and class III MHC phenotypes in 32 Mexican mestizo patients with chronic anterior uveitis and compared them to those present in 100 ethnically matched healthy controls. Results showed in patients statistically significant increased frequencies of HLA-B(27) antigen (pC=0.02, OR=6.33, 95+ CI:1.63-26.47) and the complotype SC(21) (pC=0.04, OR=4.5, 95+ CI:1.40-14.67); the authors found a decreased frequency of HLA-B(35) (p=0.006, OR=0.10, 95+ CI: 0.00-0.65) as compared to normal controls. None of the individuals bearing the SC(21) complotype were positive for HLA-B(27), suggesting independent roles of the class I and class III antigens in the genetic susceptibility to chronic anterior uveitis.

[Gastric secretion after vagotomy at different levels]. / Secreción gástrica después de vagotomía a diferentes niveles.

It is well known that all the different procedures of vagotomy have a great variability in the clinical results and a high incidence of positivity in the Hollander's tests, this probably due to the arrangement of the vagus nerves in the low third of the esophagus and its connection with the mienteric plexus. In a group of ten dogs with a gastric fistula we obtained first a sufficient number of assays with vagal stimulation, later on vagotomy was done at the level of the esophago-gastric union (EGU), getting a decrease in the gastric secretion of hydrochloric acid of 64%, afterwards a second section of the vagus nerves was practiced, five centimeters above the EGU having an inhibition of 90% and finally 95% was attained when the vagotomy was done 15 centimeters above the EGU. It is concluded that it is needed a long vagal resection of the last ten centimeters, instead of the classic section of the nerve at the gastroesophagic union; it is the same case with a parietal cell mass vagotomy.