Biomedical subjects
Publications and source records attributed to A Retout.
Listeria monocytogenes is an uncommon cause infections: to our knowledge this is the seventh case of human endophthalmitis isoleted. An early diagnosis and therapy allowed an excellent functional recovery when compared to the reported cases of the literature.
The authors report one case of blindness occurrence after surgery of strabismus. The clinical description is a posterior ischemic optic neuropathy. We expose the different proceeds of blindness occurrence after ophthalmologic surgery.
This report is concerning a case of bilateral Grave's exophthalmia which underlines that it may appear without hyperthyroidism, and progress in an independent way. The association of diploidy, decrease of the right side view (5/10: P.3) and many episodes of keratitis invited us to use surgery. The surgical technic used, rather similar than Tessier's, consisted of an opening of the external orbital wall with section of the anterior part of the temporal muscle by a half coronal approach, lowering of the orbital floor, and breaking in of the planum bone by an inferior eyelid approach. One year later, the result was rather successful, the esthetics improved, the right exophthalmia decrease (from 27 mm to 23 mm) and the right side view became again normal 10/10e P. 2. Others surgical technics have been used, but we choose and appreciate Tessier's because it was clearly indicated, and concerned the three orbital walls.
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We report the clinical and histopathological features of 2 cases of orbital Rosai-Dorfman disease with lacrimal gland involvement but no lymphadenopathy or cutaneous involvement. The first case was a 7-year-old boy, who was referred to the ophthalmology department with a proptosis in the left eye. The second case involved a 57-year-old African man, who developed oedema of the right upper eyelid over a 4-month period. Ocular involvement in Rosai-Dorfman disease is rare (10%). The diagnosis is histological in combination with immunohistology and is often delicate, especially in extranodal localizations. Histopathologically, normal gland morphology was altered by fibrosis and inflammatory cells. To our knowledge, this is the first report on lacrimal involvement in incomplete, thus uncommon sinus histiocytosis with massive lymphadenopathy.
PURPOSE: To compare the indications, surgical techniques, and operative outcome between two 100-patient populations operated on for evisceration or enucleation with a 10-year interval. METHODS: This retrospective study involved 100 patients operated on between 1987 and 1990 (Group 1) compared with another 100 patients operated on between 1996 and 2000 (Group 2). Group 1 included 64 males and 36 females, mean age 49 years; Group 2 included 60 males and 40 females, mean age 53. RESULTS: In Group 1, 19 eviscerations were performed, versus 55 in Group 2. In both groups, half of the indications for surgery were a painful blind eye. In Group 1, endophthalmia (23%) came second, whereas it was trauma (15%) in Group 2. Sixty-eight patients were implanted in Group 1 (silicone spheres 69%) versus 86 in Group 2 (hydroxyapatite spheres 69%). Twenty spheres (20%) were rejected in Group 1 versus 7% in Group 2. DISCUSSION AND CONCLUSIONS: The proportion of eviscerations increased in 10 years. The number of endophthalmitis-related operations decreased and trauma-related operations increased. The number of implantations increased with hydroxyapatite as the first choice material instead of silicone. This most likely contributed to reducing the number of rejections.
The efficacy and safety of ciprofloxacin ophthalmic solution 0.3% and norfloxacin ophthalmic solution 0.3% in the treatment of bacterial conjunctivitis and blepharitis were compared in a double masked randomised study. A total of 131 patients, 65 treated with ciprofloxacin (42 with conjunctivitis and 23 with blepharitis) and 66 treated with norfloxacin (39 with conjunctivitis and 27 with blepharitis) were enrolled in the study at five centres in France. In the efficacy population, pathogens were eradicated or reduced in 96% (24/25) of patients in the ciprofloxacin group and 89% (24/27) in the norfloxacin group. There was no difference between treatments with regard to eradication of particular pathogens. In the efficacy population, clinical cure or improvement was seen in 96% of the patients (24/25 in the ciprofloxacin group and 26/27 in the norfloxacin group). There were no significant differences between ciprofloxacin and norfloxacin with respect to improvements in four symptoms or ten clinical signs. No serious treatment-related adverse events were reported and both ciprofloxacin and norfloxacin were well tolerated.
Diabetic dyschromatopsia is frequent and is a true complication of diabetes mellitus. Causative factors other than retinopathy have been suggested, but they remain unclear. We have explored the color vision of 100 diabetics aged 16 to 65 (88 insulin-dependent, 12 non-insulin dependent) with Lanthony's D15 desatured panel. Degenerative complications were looked for, especially by fundoscopy and electrophysiological exploration of peripheral nerves using specific scoring. 73% of the diabetics had dyschromatopsia. Dyschromatopsia was significatively more frequent when retinopathy was present (26 out of 30 diabetics with retinopathy versus 47/70 without). We explain the absence of a strict parallelism between dyschromatopsia and retinopathy by the intervention of other factors. Whereas the equilibration of the diabetes was not different between the groups with or without dyschromatopsia, patient age, microalbuminuria, blood pressure and alcohol intake were higher in patients with dyschromatopsia. The greater prevalence of peripheral neuropathy in patients with dyschromatopsia, confirmed by electrophysiology, and independently from the existence of retinopathy, is an indicator of the existence of neuronal disease, whose level remains to be determined. Our results are the indispensible preliminary step to a study of the respective importance of these pathogenic factors.
We studied the risk of sudden loss of visual fields after trabeculectomy on 17 eyes with primary open angle glaucoma and small residual visual fields. We think that it is possible to try to these patients filtering procedures with precautions before and during surgery.
Authors distinguish complete sixth nerve palsies needing a supply procedure and incomplete palsies needing a classic procedure. Results in the second group are satisfactory. In case of complete palsies, the objective consists in obtaining primary gaze rectitude.
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We performed a study in 92 diabetic patients (76 Type 1 and 16 Type 2) without retinopathy to determine the relation between diabetic dyschromatopsia and neuropathy, which has been evoked in previous studies. Color vision was explored with Lanthony's desaturated D 15 panel. Peripheral nervous function was explored with an electrophysiological score which has been beforehand validated. Moreover evoked visual potentials were performed in 38 diabetic subjects in order to determine whether dyschromatopsia was related to an impairment of central optic pathways. Fifty-one among the 92 diabetic subjects had a blue-yellow dyschromatopsia. Among the recorded parameters, only peripheral nervous impairment was significantly more frequent in the group with dyschromatopsia than in the group without. Ten among 38 diabetics had impairment of the evoked visual potentials. Frequency of alteration of evoked visual potentials was not different between the group with and the group without dyschromatopsia. Our results confirm the relationship between dyschromatopsia and the alteration of the nervous function in diabetic subjects. In return, lack of significant modification of evoked visual potentials among diabetic patients with dyschromatopsia and the blue-yellow axis of dyschromatopsia are in opposition with a direct neurological origin of dyschromatopsia. We therefore evoke a common process in the beginning of the diabetic dyschromatopsia and of peripheral neuropathy.