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Biomedical subjects

A C Martenet

Publications and source records attributed to A C Martenet.

At least 19 recordsLinked to original sources
PubMed1992

[Ocular complications of AIDS. Diagnostic problems].

Presentation is made of the ocular complications of AIDS which were observed in the ophthalmologic clinic of the University Hospital in Zurich from 1986 to 1991. Besides cotton-wool spots, CMV-retinitis is the most frequent and best known infectious complication. In all other infections, diagnosis is most difficult, because it could never be supported by histological examination. Presentation is made of some cases of acute retinal necrosis, toxoplasmosis, cryptococcosis, candida, and of some cases of uveitis with unknown etiology. Furthermore we present one intraocular non-Hodgkin lymphoma, some suspicions of Kaposi's sarcoma and some neurologic disturbances of central origin.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Unusual ocular lesions in AIDS.

Presentation of 5 patients with acquired immune deficiency syndrome and unusual ocular complications. The first case appears as a non-specific, intermediate uveitis, the others as complications due to various infectious agents.

Acquired Immunodeficiency Syndrome↗
PubMed1990

[Cyclophotocoagulation with the Nd:YAG-laser].

Hopeless glaucoma cases fluctuate between excessive pressures and phthisis. Due to the underlying disease (neovascularization in the chamber angle, chronic inflammation, dysgenesis, aphakia) the customary surgical pressure-lowering operations often fail and medication is also useless. As a "last-ditch" measure, there remains only destruction of the ciliary body. In the Zurich eye department, noninvasive cyclophotocoagulation has been performed since 1987. The present paper reports on the first cases with long-term follow-up.

Adolescent↗
PubMed1989

[Sense and nonsense of examinations in hematogenous and exogenous intra-ocular infections].

Diagnosis of intraocular inflammations can be difficult, particularly if the patient is suffering from immunodeficiency. Among the endogenous inflammations this applies mainly to cases of hyaloretinitis caused by Candida or other fungi, often presenting as an acute hyalitis with sudden onset; the various ocular complications of AIDS, especially those due to toxoplasmosis (rare) and cytomegalovirus, and lyme disease, which can occasionally cause chronic panuveitis. Among the exogenous cases it applies to postoperative and posttraumatic endophthalmitis. In all these cases the diagnosis has to be established clinically if possible, since, as a consequence of the immunodeficiency, serology is hardly helpful, and only biopsy (of the vitreous) may provide additional information. Rapid diagnosis is very important because of the urgent need for therapy.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Classical immunosuppressive agents].

Immunodepressive or immunoregulatory drugs might be indicated among the therapeutic possibilities in uveitis and associated diseases, especially in those cases, which resist to specific treatment and steroids, and in those in which disorders of the immune system play a pathogenetic role. Classical cytostatic drugs mainly act by a reduction of the amount of circulating lymphocytes. The most useful seem to be the alkylating drugs (chlorambucil, cyclophosphamide) and antimitotics (procarbazine, colchicine), or antifolic (methotrexate), while the antipurines (azathioprine) seem to us less effective. Such therapy requires the full consent of the patient. The dosage of the drug has to be well established in order to keep the total amount of leucocytes between 4,000-5,000/mm3. Side effects can be hair loss, sterility, rarely hemorrhagic cystitis, and, mostly only in the initial therapy period, nausea and vomiting. Teratogenic risks seem non-existent. Since the therapeutical effect comes rather slowly, a local steroid therapy can be added. Absolute indications for such therapy are Behçet and sympathetic ophthalmitis, while all severe chronic uveitis forms are relative indications. Acute iritis and chorioretinitis are contraindications. The results with procarbazine and cyclophosphamide run around 40% full successes (healing of inflammation and improvement of function) and 30% satisfactory results (healing of inflammatory signs, without improvement of function). Failures amount to 17% and 13% of the patients cannot be thoroughly controlled. With regard to the failures, alternative treatment might be attempted with cyclosporin A, plasmapheresis or perhaps immunostimulation.

Alopecia↗
PubMed1989

[Intermediate uveitis].

Intermediate uveitis defines the group of diseases formerly called pars planitis or chronic cyclitis. Its frequency amounts to 10-20% of all uveitis cases. The anamnesis is vague. The clinical symptoms mainly involve the vitreous. The visual acuity is variable, depending of the involvement of the retina. A slight inflammation of the anterior chamber is possible, but no synechiae are present. The vitreous shows a positive Tyndall and cells, snow balls, eventual plaques on the pars plana. Serious cases are complicated by a retinal vasculitis, which often leads to cystic macular edema and papillary edema. Schisis and retinal holes are more seldom. A complicated cataract can develop. The most valuable complementary tests are fluorescein angiography and electroretinography, useful to detect retinal damage. Aetiological investigations give mostly poor results and are not very useful. Differential diagnosis has to be made, among others, from Fuchs' heterochromic cyclitis and from acute cellular infiltration of the vitreous in case of retinochoroiditis or candida endophthalmitis. Treatment of intermediate uveitis can be only local and discrete when only the vitreous is involved. If the retina is damaged, systemic steroids or immunodepressive cytostatic drugs might be indicated. Despite the duration of the disease, its prognosis remains rather good. Only about 15% of the cases end up with visual impairment to 1/10 or less, while more than half of the cases maintain a visual acuity higher than 0.6, even after three years of disease progress.

Diagnosis, Differential↗
PubMed1976

Nonspecific immune parameters and hepatitis B antigens in patients with uveitis.

In the sera of 217 patients with uveitis the immunoglobulins IgG, IgA, IgM as well as beta1A (a measurable metabolic product of the third component of complement) were measured by radial immunodiffusion. IgG was below normal levels in 12% of the patients, IgM was increased in 12%, while reduced beta1A concentrations could be found in 28%. 95 sera were also tested for the presence of antibodies against cell nuclei, smooth muscle and thyroglobulin. There was no significantly increased incidence of any of these antibodies. The data were interpreted as not being in favor of the hypothesis that autoimmune phenomena play a key role in the pathogenesis of uveitis. An unexpected finding was the high frequency of hepatitis B antigen (13%) and corresponding antibodies (23%) in sera of uveitis patients compared to other hospitalized patients and blood donors. At present, there is no explanation for this phenomenon.

Antibodies, Antinuclear↗