Biomedical subjects
Publications and source records attributed to A Bron.
Ocular infections are still quite common and their clinical presentation is variable; some of them may lead to blindness. In this paper only severe infections like keratitis and endophthalmitis are considered. The rationale for treatment and prophylaxis is based upon bacteriological findings, understanding of ocular barriers and pharmacokinetics of antibacterial agents.
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The multiple-dose twice-daily efficacy of the topical carbonic anhydrase inhibitor MK-927, a racemic compound, was compared with that of its pharmacologically more active S-enantiomer in a four-center, double-masked, randomized, placebo-controlled, parallel study of 1.8% sezolamide hydrochloride (MK-417), 2% MK-927, and placebo, given twice daily to 48 patients with bilateral primary open angle glaucoma or ocular hypertension and morning intraocular pressure greater than 24 mm Hg in both eyes following washout of ocular hypotensive medications. Parallel 10-hour modified diurnal curves were performed before the study and on day 14, with 4-hour curves on days 1 and 4. Both compounds demonstrated significant lowering of intraocular pressure at 8 AM, 12 hours following the evening dose, and through 10 and 6 hours following the 8 AM dose for sezolamide and MK-927, respectively. Morning trough (evening) activity as measured by mean percent change in intraocular pressure from prestudy was -9.2% for sezolamide and -11.1% for MK-927 (-13.5% and -9.6%); peak effect occurred 2 hours after dose administration and was -19.4% and -19.2% for sezolamide and MK-927, respectively. From 2 hours after dose administration, sezolamide consistently demonstrated a slightly greater decrease in intraocular pressure than MK-927; however, these differences were not statistically significant.
A case of primary conjunctival lymphoma is reported herein. A 47-year-old woman presented with an indolent salmon-coloured tumour of the lower epibulbar conjunctiva. Histologically, we found a lymphoid infiltrate in the epithelium and subepithelium consisting of two components. One component was characterized by centrocytic-like cells and the other by lymphocytic, plasmacytoid and plasma cells. An immunohistological study demonstrated a light chain restricted immunoglobulin expression of the tumour cells as well as some residual polytypic follicles exhibiting reticular dendritic cells. Tumour cell proliferation was associated with a T cell reactive population. A comprehensive investigation (in particular an orbital scan) did not demonstrate any other localization of this lymphoma. Such a lesion raised the question of a possible MALT origin, by analog with MALT-lymphomas of the gastrointestinal tract described by Isaacson and colleagues.
The authors have evaluated the interest of sphenoidal electrodes in detection of internal temporal spikes, and intra-orbital electrodes in the detection of orbito-frontal spikes. From a study of 26 patients, 21 with sphenoidal electrodes, 3 with intra-orbital electrodes and 2 with both electrodes, they observed the sensitivity and specificity of such electrodes in detecting spikes with no traduction upon extra-cranial electrodes, or with an unsuspected traduction as spikes at a distance from deep electrodes, or spikes on 2 foci, or bisynchronous discharges. Sphenoidal and intra-oribital electrodes constitute a non-invasive method that provides excellent information in the exploration of the mesiobasal cerebral face. Indications for the use of such a method are complex absences without EEG traduction or with an unsuspected traduction and without abnormalities on CT scan, in the context of functional surgery of epilepsy.
The authors compared the growth of limbal and central explants removed from human cornea. Epithelial growth began on the third day, was greater during the first week and was subsequently slightly invaded by fibroblasts. This study demonstrated that peripheral corneal epithelial cells growth better than central cells. In this study, the cytologic and histologic features of the cells were examined. However, epithelial immunofluorescence staining by anti-cytokeratin antibodies was rather poor. This in vitro system may provide a suitable model for epithelial human corneal cell culture, allowing further biocompatibility studies.
The present paper reports on the case of a 44 year-old woman with progressive facial hemiatrophy associated with bilateral papillitis who developed an acquired complete third nerve palsy on the unaffected side six months later. This Romberg's disease occurred in the context of an immunologic disturbance which was barely improved by steroids and Disulone. Ophthalmic involvement, particularly neurologic involvement, pathogenic hypothesis are reviewed. The responsibility of sympathetic disorder in Parry-Romberg disease is based on frequent association of progressive facial hemiatrophy and Fuch's and Horner's syndromes.
SSPE is a panencephalitis who involves children and who leads to death. It is due to a defective measles virus. Ophthalmologic features are frequent and may be the first manifestation of the disease. The most typical ocular involvement is retinitis which can be misdiagnosed as a toxoplasmosis.
27 consecutive cases of non freeze myopic keratomileusis (using Barraquer Krumeich Swinger Set) were performed by one surgeon on 22 patients in a retrospective study. 4 per operative complications were noticed. Visual acuity with and without correction, astigmatism before and after surgery were reviewed preoperatively, at 1 week, 1 month, 3 months, 6 months and 1 year postoperative. The preoperative myopia (mean +/- standard deviation) was -15.55 +/- 5.46 D, the average postoperative residual myopia was: at 1 week -0.43 +/- 3.58 D, at 1 month -1.18 +/- 4.15 D, at 3 month -4.44 +/- 4.80 D, at 6 month -5.43 +/- 5.51, at 1 year -6.95 +/- 4.81 D. Visual acuity without correction was always better postoperatively. The best visual acuity (with correction) was preoperatively 0.38 +/- -0.22 at 1 week postoperative 0.21 +/- 0.09, at 1 month 0.35 +/- 0.16, at 3 month 0.31 +/- 0.15, at 6 month 0.32 +/- 0.15, at 1 year 0.34 +/- 0.17. Further investigation is monitoring to assess the predictability and stability of non freeze keratomileusis.
Ocular toxoplasmosis is uncommon in the natural course of AIDS. We report here in a case of a 27 year old man with cerebral toxoplasmosis involvement with neurological signs and coma. After an initial improvement with a sulfadiazine and pyriméthamine treatment, we noticed a foveal chorioretinitis with hyalitis in the right eye which deeply decreased the visual acuity (less than 20/400) strongly suggesting a toxoplasmic etiology. Then specific aspects such as serology, acquired or congenital toxoplasmosis, treatment are reviewed.
27 consecutive cases of non freeze myopic keratomileusis were performed on 22 patients in a retrospective study. 4 per operative complications were noted. Visual acuity with and without correction, keratometry, astigmatism, pachymetry, esthesiometry before and after surgery were reviewed at 1 week, 1 month, 3 months, 6 months and 1 year post operatively.
Choroid osteoma was described for the first time by GASS in 1978. Today only 53 cases were reported in 39 patients. Using 3 new cases recently discovered in our region, we try to assess with the help of the already published data, the main points of the disease and its diagnostic.
The term "pre-equatorial syndrome" covers post-traumatic involvement of the anterior segment and of the pre-equatorial retina, due to a frontal distension mechanism. In a retrospective study, we studied 582 cases of ocular contusions from 1973 to 1986 in patients who required a brief hospitalisation in our clinic because of the severity of the initial injury. The aim of the study was to assess the occurrence of this syndrome, its clinical features and evolution. 59 complete pre-equatorial syndromes were found in this sample (10.2% of all the ocular contusions). The follow up ranged from one to 168 months. Games and sports injuries in children and work injuries in young men were most commonly found causes (2/3 of the cases). Hyphema and angle recession were the most frequently observed lesions (69%). All hyphemas disappeared spontaneously without surgical drainage. Subluxation of the lens was present in 10.6% and late post traumatic cataract occurred in four cases; all eyes were operated on by intracapsular extraction, three of them in the first year following the traumatism and the last twelve years latter. Intraocular pressure was high in 15.3% (but was easily controlled) and was very low in 5.1%. Retinal edema and haemorrhages were the most common involvement of the peripheral retina. Retinal dialysis was noticed in 13.6% especially in the upper nasal area: buckling surgery was performed in these cases with good results. Anterior and peripheral retinal damages was situated on the same meridian in 80% of the cases, five eyes showed a 180 degrees opposite setting while there was no obvious alignment in 15 of the cases. This syndrome did not impair final visual function alone, whereas severe associated ocular contusions of the posterior pole gave a very low visual outcome in 16 cases. This retrospective review emphasizes the main characteristics of this syndrome. Accurate examination of the irido-corneal angle and peripheral retina is of paramount importance in every ocular contusion.
Authors have studied the penetration of ciprofloxacin in the aqueous humor of 30 patients (30 eyes). The concentration in the anterior chamber was on average 0.73 mg/l (33% of serum level), from 1.30 hours after a single oral dose (1000 mg) till the 5th hour after this dose. The samples were assessed by a microbiological method. These results are over the minimal inhibitory concentration for many bacterial agents found in endophthalmitis. So this antibiotic may be proposed in the treatment of endophthalmitis, with further investigations assessing the safety of this procedure.
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Automated perimetry was performed on 32 eyes of 31 patients with posterior chamber intraocular lens. Visual field and retinal sensibility were studied a week and three months after surgery for each eye. Decreased retinal sensibility in the foveal area was observed in 75% of the eyes. Such a deficiency was also noted in the nasal visual field from 30 to 45 degrees, and within 60 degrees in the temporal area. Further investigation is mandatory to assess our hypothesis about this phenomenon.
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