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Biomedical subjects

C Burillon

Publications and source records attributed to C Burillon.

At least 37 records · Page 2Linked to original sources

[Blindness after nitrous oxide anesthesia and internal gas tamponade].

The authors describe the case of a patient with bilateral retinal detachment. Immediately after surgery for the second eye under general anesthesia with nitrous oxide, the patient reported severe visual loss in the first eye successfully treated surgically 2 weeks before, with a residual gas bubble (C3F8) of 50%. In this case, nitrous oxide had rapidly entered the gas bubble and induced a transient expansion of the gas tamponade with a dramatic increase in intraocular pressure. The consequence was a central retinal artery occlusion, which resulted in irreparable ischemic retinal damage and blindness, explaining the severe and sudden visual loss. Nitrous oxide is regularly used but contraindicated if intraocular gas is present, due to its potential threat to visual function. We suggest that patients anesthetized with nitrous oxide carry a card or a bracelet detailing the risks of intraocular gas tamponades combined with nitrous oxide and with travel to high altitudes. This would inform not only patients but also medical personnel caring for these patients.

Anesthesia, General↗

Value of two mortality assessment techniques for organ cultured corneal endothelium: trypan blue versus TUNEL technique.

BACKGROUND/AIM: It is known that trypan blue staining is not a good predictor of loss of corneal endothelial cells (ECs) during organ culture. As it is primarily an indicator of membrane integrity, it would also not be expected to identify ECs undergoing apoptosis. The aim of this study was to determine the ability of the in situ TdT dUTP mediated nick end labelling (TUNEL) technique to detect cell death in the corneal endothelium caused by apoptosis during organ culture, compared with conventional vital staining with trypan blue. METHODS: 31 human corneas were organ cultured at 31C for 3-35 days. Staurosporine was used to induce apoptosis in five control corneas. The endothelium was assessed by trypan blue and by the in situ TUNEL technique. The percentages of trypan and TUNEL positive ECs were compared. Their links with sex, donor age, time from donor death and organ culture, initial and final EC density and cell loss were studied. RESULTS: TUNEL stained ECs were observed in all corneas. TUNEL positive ECs were mostly located either in corneal folds or at the periphery of corneal folds showing central shedding. The mean percentage of cell death at the end of storage, assessed by the trypan blue technique, was 1.47% (SD 2.63, range 0.03-12); assessed by the TUNEL technique it was 12.7% (SD 16.4 range 0.6-65.5). There was a significant correlation between the two techniques (r = 0.7, p<0.001). The percentage of TUNEL stained ECs was correlated negatively with EC density at the end of storage (r = -0.47, p <0.005) and positively with percentage EC loss during storage (r = 0.46, p < 0.05). CONCLUSION: This study demonstrates that organ cultured corneas systematically carry non-viable ECs that are implicated in cell death by apoptosis and go undetected when trypan blue staining is used. Because the in situ TUNEL assay detects earlier events in the cell death process than does trypan blue, it should be used to quantify endothelial viability, especially for experiments with new storage media.

Adult↗

[Conjunctival epithelial carcinoma in a 9-year-old child with xeroderma pigmentosum. Case report].

We report the case of a conjunctival tumor in a 9-year-old patient, suffering from Xeroderma Pigmentosum. Our patient presented a raspberry-colored conjunctival tumor. The tumor was resecked without any additional treatment. The histological study revealed squamous cell carcinoma. A suspicion of relapse appeared two months later of the same location and a new resection was performed. The initial checkup of this tumor was negative. In this disease, ocular localizations are frequent. The conjunctiva, the cornea, the eyelids and, into a lesser extent, the orbit can be involved. Basal cell carcinoma and squamous cell carcinoma are the most frequent tumors observed in Xeroderma Pigmentosum. Their treatment is mainly surgical.

Carcinoma, Squamous Cell↗

[Pain and corneal pathology].

Since the development of photorefractive keratectomy, ophtalmologists are concerned by the mechanisms of corneal pain in order to prevent and reduce it. Corneal epithelium and anterior stroma are widely innervated by nasociliary fibers form ophtalmologic nerve (V). Receptors react to a chemical, mechanical and thermal stimulation by an acute and precisely located pain. This pain is developed by release of inflammatory mediators and neuro transmitters. Pain is different regarding the pathology and the treatment: photorefractive keratectomy, Acanthamoeba keratitis, Mooren's ulcer. Topical non steroidal antiinflammatory drugs have a specific role in controlling corneal pain.

Cornea↗

[Neovascular glaucoma diagnosed following carotid endarterectomy].

We report a case of bilateral asymptomatic rebeosis iridis related to a bilateral obstruction of the carotid arteries. The iridocorneal angles were closed by a neovascular membrane and intraocular pressures were normal within both eyes (normotensive neovascular glaucoma). After left carotid endarterectomy, the increased perfusion of the ciliary body and the increased secretion of aqueous humor resulted in a sudden bilateral ocular hypertension. Management of ocular neovascularization related to carotid artery obstruction may involve the destruction of areas of retinal ishchemia (laser panretinal photocoagulation or cryotherapy) before carotid surgery.

Carotid Artery Thrombosis↗

Excimer laser photorefractive keratectomy in myopic eyes with corectopia.

Corectopia, the eccentric displacement of the pupil, may be associated with other abnormalities such as axial high myopia or ectopia lentis. We report the case of a patient presenting for surgery to correct bilateral myopia of 6.50 diopters (D) associated with corectopia. Excimer laser ablation was decentered and performed on the center of the abnormal pupils. After a 2 year follow-up, best corrected visual acuity was 20/20 with -1.00 D correction in each eye. To our knowledge, this is the first report of excimer laser photorefractive keratectomy for myopia associated with corectopia. The satisfactory results suggest that in abnormally eccentric pupils, excimer laser treatment of myopia may be successful when it is centered on the deviated pupil.

Adult↗

[Capsular bag distension syndrome after capsulorhexis].

We present one case of capsular bag distension associated with lens phacoemulsification, capsulorhexis and posterior chamber intraocular lens (IOL) insertion. Capsular bag distension is a rare postoperative complication of continuous tear anterior capsulotomy and presents the following characteristics: (1) postoperative myopic over-refraction; (2) shallowing of the anterior chamber associated with anterior shift of the IOL and the iris diaphragm; (3) important posterior distension of the posterior capsule and (4) sealing of the capsule to the anterior surface of the IOL. In our case, recovery of vision was incomplete after cataract surgery although the procedure was uneventful and no other ocular pathology was found. A neodymium: YAG laser anterior capsulotomy peripheral to the edge of the IOL remedied the situation allowing the capsular fluid to regress into the anterior chamber and the IOL to return in a normal posterior position.

Aged↗

[Nummular keratopathy in Crohn's disease. Apropos of a case].

We report an unusual case of nummular keratopathy of the left eye in a 58-year-old woman with active Crohn's disease, presenting colo-anal and joint symptoms. Spontaneously decreased bowel activity and local steroid treatment provided symptom relief and incomplete decrease in volume of subepithelial elevations. We discuss the clinical aspects, the epidemiologic factors, the pathogenic mechanisms and the treatment of keratopathy in Crohn's disease.

Anti-Inflammatory Agents↗

A biometric study of the eye, orbit, and face in 205 normal human fetuses.

PURPOSE: To develop models for assessing the differential growth of the fetal face along its horizontal and vertical axes, as well as of the orbit and the eye. METHODS: Normal human fetuses (n = 205), whose gestational ages ranged from 15.5 to 41 weeks of amenorrhea, were examined. Orbitofacial parameters were as follows: outer canthal distance, inner canthal distance, palpebral fissure length, and oropalpebral distance. Ocular parameters were corneal diameter and axial length. Correlations were tested among all parameters. Linear and polynomial regression analyses of gestational age and the orbitofacial and ocular parameters were used to develop models of growth. Differential patterns of growth in the face were investigated. RESULTS: The best correlation was found between palpebral fissure length and oropalpebral distance. The increase of each of the parameters studied could be accurately described by a linear model. Sex had no detectable effect on these parameters. Compared with the skull, the face had a more rapid growth along the vertical axis. The palpebral fissure developed more rapidly than the eye. CONCLUSIONS: The parameters that were studied in the fetal face, orbit, and eye follow a roughly linear growth curve.

Anthropometry↗

Solid dermoids of the limbus and the cornea.

PURPOSE: To better define the spectrum of limbal and corneal dermoid characteristics and to obtain data on the visual outcome following surgery. METHODS: We reviewed the ocular records of 12 consecutive patients with solid dermoids which underwent surgery in our institution from 1985 to 1993. According to tumor size and location, limbal dermoids can be managed with a simple excision associated with a conjunctival flap or corneoscleral lamellar keratoplasty. RESULTS: Surgical techniques, cosmetic and visual outcomes are documented. Limbal dermoids were more noticeable cosmetically, and they often induced oblique astigmatism. In 6 cases, they could easily be shaved off the cornea and adjacent sclera to improve the appearance of the eye; visual acuity was unchanged. In 3 cases, unfortunately a degree of refractive amblyopia remained after late surgery and visual acuity was inferior to 20/200. In 2 large-diameter limbal dermoids, early corneolamellar keratoplasty allowed to improve best corrected visual acuity. In the corneal dermoid, amblyopia was the indication for early surgical removal. CONCLUSION: We believe that early surgery with simple local resection (combined with a conjunctival flap in order to cover the bare area) may be preferred to lamellar keratoplasty. Nevertheless, corneoscleral lamellar grafts may be required in advanced cases, especially when the whole thickness of the corneal stroma is involved or when the tumor deeply extends around the limbus.

Child↗

[Ophthalmologic signs in children with autism].

PURPOSE: Autism is a clinical entity defined by characteristic association of a lack of social interactions and communications, beginning before three years of age. The purpose of this study was to screen ophthalmologic findings in autistic children. MATERIALS AND METHODS: Ten autistic children, 6 girls and 4 boys, underwent a complete ophthalmologic examination in the Department of Pediatric Ophthalmology at the Hospital La Timone, Marseilles, France. Their age ranged from 1 to 14 years (mean = 8.5 +/- 3.8). RESULTS: Refraction showed hypermetropia in 7 cases (70%), astigmatism more than 1 diopter in 6 cases (60%), bilateral astigmatism in 4 cases (40%) and unilateral astigmatism in 2 cases (20%). Astigmatism axis was oblique for 8 eyes, with the rule for 6 eyes and against the rule for 2 eyes. Strabismus was present in 6 cases (60%) including 4 cases of exotropia. Fundus examination found pallor of the optic disc in 4 cases. CONCLUSION: Ophthalmologic findings in autistic children appear to be mainly unilateral or bilateral astigmatism and binocular vision troubles. They can lead to amblyopia with the risk of functional loss of vision. Early diagnosis of visual problems in autistic children is also essential in order to be able to propose adequate psychological and educational cares for the children and their family.

Adolescent↗

Human corneal fibrillogenesis. Collagen V structural analysis and fibrillar assembly by stromal fibroblasts in culture.

PURPOSE: The stroma of the developing cornea is a highly organized extracellular matrix formed essentially by uniform, small-diameter collagen fibrils with constant interfibrillar spacing. Unlike the fibrillogenesis of chicken cornea, the assembly and maturation of human corneal fibrils have been poorly investigated. In the current study, the authors aimed to ascertain the heterotypic organization (collagens I and V) of the human corneal fibrils at the supramolecular level. To gain more insight into the molecular structure of collagen V, its cellular source, and its role in fibrillogenesis, the authors used cultured human corneal fibroblasts. METHODS: The structure of human corneal stroma after brief homogenization of the tissue was analyzed by immunogold labeling using specific polyclonal antibodies and rotary shadowing. Biochemical, electron microscopic, and immunolabeling approaches were used to investigate the collagen fibril formation and the extracellular matrix synthesis using human corneal fibroblasts grown in culture as a model system. RESULTS: The authors showed that in human corneal stroma, collagen I is distributed uniformly along the striated fibrils, in contrast to collagen V, which could be identified only at sites at which the fibrils partially were disrupted. Rotary shadowing observations of the homogenate revealed that collagen VI, a major component of the human cornea, was associated closely with the collagen fibril surface. Corneal fibroblasts synthesize and deposit a collagenous matrix with fibrils resembling those of the human cornea in appearance and collagen composition. Biochemical data indicate that a high concentration (20% to 30%) of collagen V is synthesized by stromal fibroblasts and that collagen V molecules are processed similarly to matrix forms in which the extension peptides are retained on the molecules. CONCLUSIONS: The heterotypic nature (collagens I and V) of human corneal fibrils was determined. Results indicate that human corneal fibroblasts synthesize the major collagen types in human cornea (collagens I, V, and VI) and express all the posttranslational equipment for correct collagen molecular assembly and processing in a manner that closely resembles the situation in situ, offering the opportunity for more detailed study of this process, which is essential for optical transparency.

Adult↗

[Corneal manifestation of histiocytosis X].

A 15-year-old girl had bilateral corneal infiltration associated with diabetes insipidus which has been treated for 8 years. The correct diagnosis of histiocytosis X was obtained after histopathological examination. The strict correlation between pathological anatomy and clinical status favoured Hand-Schuller-Christian disease.

Adolescent↗

[Multifocal choroiditis associated with herpes zoster ophthalmicus. Apropos of a case].

We describe a patient with multifocal choroidal lesions affecting the midperipheral fundus, with an atrophic and scattered punched-out pale aspect. Lesions were discovered seven months after an ipsilateral herpes zoster ophthalmicus. Fluorescein angiography findings exhibited a delay of choroidal injection and late moderate staining during the venous phase. The etiological arguments refer to a previous herpes zoster infection. The pathogeny would involve an occlusion of posterior ciliary arteries, lesions of posterior ciliary nerves and/or direct cytopathogenic involvement of chorioretina by neurotropic virus from ciliary ganglion.

Adolescent↗