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C Monin

Publications and source records attributed to C Monin.

At least 19 recordsLinked to original sources
PubMed2004

[Acute retinal necrosis: clinical presentation, treatment, and prognosis in a series of 22 patients].

PURPOSE: To evaluate the clinical outcome and medical management in a series of patients diagnosed with acute retinal necrosis. MATERIAL AND METHODS: Between 1993 and 2000, 22 patients suffering from acute retinal necrosis were referred to our department. We retrospectively reviewed the clinical course, delay between diagnosis and first clinical manifestation, biological profiles, treatment and complications. RESULTS: All patients had vitreous inflammation; retinitis was seen upon examination in 82% of the cases. Nevertheless, for six patients (27% of the cases), failure to recognize the diagnosis led to delay (mean, 5.5 days) between the first ophthalmological examination and antiviral therapy. Nineteen patients underwent laboratory evaluation, and virological diagnosis was made in 16 of them: varicella zoster virus was found in 11 cases, herpes simplex type 1 in three cases, and herpes simplex type 2 and cytomegalovirus in one case each. Nine patients were treated with a combination of aciclovir and foscarnet and 13 with aciclovir alone. Among the 16 patients who received aciclovir, one did not respond to therapy after 2 days and was cured only after foscarnet was added. Recurrence occurred at the end of treatment in only one patient. Retinal detachment complicated the course for 11 patients and was always associated with proliferative vitreoretinopathy. Among those, seven of the ten patients who accepted surgery were successfully treated. Eleven out of 22 patients had a final visual acuity up to 20/200 and two up to 20/40. CONCLUSION: In our series, acyclovir alone was sufficient to cure the majority of cases. Even with antiviral therapy, the prognosis of acute retinal necrosis remains poor. Retinal detachment is the main complication.

Acyclovir↗
PubMed1998

[Relaxing retinopathies and liquid perfluorocarbons].

PURPOSE: To assess the long term anatomic and functional follow-up of large relaxing retinotomies performed with liquid perfluorocarbon in severe vitreoretinal proliferation surgery. METHODS: A large relaxing retinotomy (more than 90 degrees) was realized in 40 eyes of 39 patients for anterior vitreoretinal proliferation (30 rhegmatogen retinal detachments, 8 intraocular foreign bodies, 2 ocular traumas). Follow-up was always longer than 6 months. Vitreoretinal proliferation secondary to ischemic or inflammatory retinopathy were excluded. The liquid perfluorocarbon was perfluorodecalin and was used for all eyes, as well as final intraocular tamponade by silicon oil ended every intervention. RESULTS: Sixty-seven % of patients had already had a former vitrectomy, and 75% a retinal surgery. Mean size retinectomy was 170 degrees. Nine patients underwent a new vitreoretinal procedure which included in 7 cases a necessary new retinectomy. Silicon oil could be removed in 55%, after a mean period of 6, 5 months. Mean time follow-up was 13 months. At the end of follow-up, 80% of retina were attached. Visual acuity remained low with 25% equal to 1/20 or more; 45% of eyes increased their acuity, 25% remained stable and 30% worsened. Main complications were epimacular proliferation, keratopathy and increased intraocular pressure. CONCLUSION: Relaxing retinotomies provide satisfying anatomic results and allow a preservation of some visual function. The use of liquid perfluorocarbons facilitates their realization. The initial size of retinectomy should be sufficient.

Adolescent↗
PubMed1996

[Responsibility of incomplete retinal photocoagulation in the indication of vitrectomy in proliferative diabetic retinopathy].

PURPOSE: We report an epidemiologic study about prophylactic photocoagulation of ischaemic diabetic retinopathy in order to avoid proliferative stage and severe vitreous haemorraghe. METHODS: We studied retrospectively 42 eyes of 32 diabetic patients who underwent a vitrectomy in 1993. For each patient several items were analyzed: nationality, sex, age, type, duration and clinical course of diabetes, and other risk factors. Slit lamp and ocular fundus examination were noted; in particular lens, iris and vitreoretinal framework. RESULTS: Almost all patients had an inadequate laser photocoagulation: in 26 eyes (62%) it was insufficient or non-existent, uncomplete in 12 eyes (29%), and non confluent for 18 eyes (43%). Only four eyes have had complete and confluent panphotocoagulation. CONCLUSION: Photocoagulation appears to be the priority therapy to avoid most severe complications of proliferative diabetic retinopathy. Laser photocoagulation must be started from preproliferative retinopathy, confluent on the useless ischaemic retinal areas, and dense elsewhere.

Adult↗
PubMed1996

[Prediction of functional recovery after surgery of macular epiretinal membranes. Value of interferometry using Lotmar's apparatus].

BACKGROUND: The predictability of the measurement of the macular function by white light interferometry was evaluated in a group of patients whose epiretinal membranes had been surgically removed. METHOD: Fifteen patients presenting either primitive or secondary epiretinal membranes were included. We used the apparatus described by W. Lotmar. The main evaluation criteria was the best corrected visual acuity (VA) chosen between the third month and the sixth month examinations. RESULTS: Preoperatively the mean visual acuity was 0.227 +/- 0.105. The mean final visual acuity was 0.507 +/- 0.198. The final visual acuity was predicted within an 0.1 interval in ten cases (67%). In two cases the predicted visual acuity was identical to the pre-operative VA and the final results confirmed the test. No improvement occurred. CONCLUSION: The Lotmar visometer is statistically predictive of the visual outcome after epi-retinal membranes surgery.

Female↗
PubMed1996

[Surgical treatment by vitrectomy and autologous serum of 36 idiopathic macular holes].

PURPOSE: To analyse the surgical results of a second series of full thickness idiopathic macular hole operated with autologous serum as adjuvant therapy, and to compare them to the results of a first series without autologous serum and the results of literature. METHODS: In a series of thirty-six patients, autologous serum has been used as healing adjuvant therapy. The surgical procedure included a posterior and peripherical vitrectomy combined with posterior hyaloid separation, fluid-air exchange, autologous serum injection, and final flushing with 40% sulfur hexafluoride. The patients then maintained strict face-down position post-operatively for a minimum of ten days. RESULTS: Anatomic success was obtained in twenty-nine cases of thirty-six patients (80%), with an anatomic success rate of 100% for the stage 2 holes. Twenty-nine patients had a pre and postoperative measurable visual acuity. Among these twenty-nine patients, median postoperative visual acuity was 20/70, compared with 20/125 preoperatively. Final visual acuity was improved in twenty-seven patients (75%), was stable five times (14%), and declined four times (11%). Among the twenty-nine anatomic successes, twenty-four (85%) improved their visual acuity. Complications were rare, and observed in the same percentage as described in literature. No complication in relation to autologous serum was noticed. CONCLUSION: Autologous serum is an inexpensive, easy to obtain, healing adjuvant therapy. It seems improving the surgical results like the other adjuvants described in the litterature.

Adult↗
PubMed1996

[Hypertensive anterior uveitis of toxoplasmic origin after vitrectomy].

Two cases of vitrectomized congenital chorioretinal toxoplasmosis are presented. During a recurrence, an anterior segment inflammation with hypertony complicated both cases. Hypertony was efficiently controled by a specific antitoxoplasmosis therapy. The role of the vitreous barrier is suggested.

Adolescent↗
PubMed1995

[Search for etiology in 110 cases of uveitis. Value of punctures of the aqueous humor and vitreous body].

PURPOSE: Evaluation of the frequency of each aetiology, comparison with recent and previous publications, focus on less classical pathologies, and interest of some complementary investigations. METHODS: Prospective study of one hundred and ten cases of uveitis, submitted to aetiological investigations, including, when feasible or necessary, an anterior chamber paracentesis and a vitreous paracentesis. RESULTS: An aetiology was identified in 65% of the cases. Toxoplasmosis still remained the most frequent diagnosis (one out of four), followed by viral infection (15%), especially herpes simplex (9%), a notion as yet not mentioned in large statistical surveys, including recent ones. Tuberculosis allergy and rhumatismal diseases (ankylosing spondylitis) represent the two other large groups (5% each). The rest is divided among the other classical causes. These results, particularly toxoplasmosis and viruses, are always based on biological criteria, on the Witmer-Desmonts ratio in aqueous humour, or even the same ratio in vitreous. CONCLUSION: This study confirms the predominant role of anterior chamber paracentesis, the only means of establishing a firm diagnosis for certain categories of uveitis (toxoplasmosis and viruses); it is difficult to conceive how such an investigation can be questioned, to the benefit of a purely biomicroscopic diagnosis, leading to blatant errors, as demonstrated by the results of anterior chamber paracentesis. This study also shows, due to this paracentesis, the increasing role of viruses in the aetiology of uveitis, emphasizing the risks taken when any uveitis is systematically submitted to corticotherapy.

Adolescent↗
PubMed1995

[Acute retinal necrosis syndrome. Retrospective study apropos of 14 eyes in 11 patients].

PURPOSE: The authors present a retrospective study of fourteen eyes of eleven patients suffering from acute retinal necrosis syndrome (ARN) and compare the results with previously published data. MATERIAL AND METHODS: All patients were referred to us between 1985 and 1993. The results of initial examination, the epidemiological and aetiologic data, as well as the clinical course and treatment are summarized in two tables. RESULTS: First clinical examination found a prominent ocular inflammatory reaction, several sites of peripheral retinal necrosis and one retinal vasculopathy. Bilateralisation occurred in 28% of the patients. An optic neuropathy developed in 57% of the cases, and a retinal detachment in 78%. Initial examination and data on the clinical course are discussed and compared with those described in the literature. CONCLUSION: The results of the current study are representative of the various clinical and biological profiles of acute retinal necrosis and are similar to those described in previous publications. Earlier care in specialized departments of ophthalmology should allow a better anatomical and functional prognosis in the future.

Adolescent↗
PubMed1994

[Treatment of coloboma pitS of the optic nerve complicated by serous detachment of the neuroepithelium].

PURPOSE: The pathogenesis of the sensory retinal detachment of the macula associated with congenital pit of the optic nerve remains controversal. Based on our cases and the cases reported in literature, we propose a management plan for macular retinal detachment associated with optic nerve pit. METHODS: In this retrospective study ten eyes were treated for progressive visual loss. Treatment modalities were different depending on the time period: laser photocoagulation (to the juxtapapillary region) alone, laser combined with intraocular gas injection (C3 F8), laser combined with vitrectomy and intraocular gas tamponnade (S F6, C3 F8), laser combined with vitrectomy and temporary silicone oil tamponade. RESULTS: The follow-up period ranged between one and five years (mean follow-up thirty three months). We had eight successes and two definitive failures (an old macular detachment treated only by one laser session, and a young girl who had not kept the prone position after gas injection). In the group of six eyes treated by laser alone, only two retinal treatments were directly successfully treated; in three other eyes, the detachment recurred and was treated with success in a second step by a gas injection; the sixth eye is the first definitive failure (old detachment). In the five eyes treated by laser combined gas injection with or without pars plana vitrectomy (including three failures of laser alone), the retina remained attached in four eyes during the follow-up period; the sixth eye was the second definitive failure (the young girl). In the both eyes treated by vitrectomy and silicon oil injection, the retina has flattened. CONCLUSION: The results suggest that laser photocoagulation alone is not so efficient and that vitrectomy is not necessary with gas injection. Complete resorption of subretinal fluid occurred in eight eyes: two with laser photocoagulation alone, and six with a long term tamponnade combined with a peripapillary laser photocoagulation. In first treatment, this technique (laser with tamponade) is a valuable approach to manage serous macular detachment associated with optic nerve pit.

Adolescent↗
PubMed1994

[Treatment of diabetic macular edema with neuroepithelium detachment combining high-dose corticotherapy and photocoagulation].

The clinical course of background diabetic retinopathy in its oedematous form (macular and diffuse posterior pole edema), leads to serous macular retinal detachment. At this stage, even if the laser burns are observed on the retinal pigment epithelium, laser photocoagulation is unsuccessful in such a serous detachment, because retinal neuroepithelium is far from the retinal pigment epithelium. We have previously noticed that high doses of oral steroid drug (one milligram per kilo a day) for fifteen days may allow a partial or complete macular flattening. This flattening is only correctly evaluated by contact glass biomicroscopy, and often associated to a visual improvement. Favourable outcome was observed in 76% of the fifty-eight eyes, which have been laser treated. When laser photocoagulation was successful, the results were stable with an improvement of two or four lines. If flattening did not occur, laser photocoagulation was not performed. Oral steroids treatment for long-term insulin treated diabetic patients required a very close daily diabetic or/and internist survey. At our institution, it was possible because the internist was at the patient's bed once or twice a day: for this reason, this technique seems to be the first study in the literature. Some very unexpected visual improvements incite us to use classic laser treatment as early as possible for macular or diffuse posterior pole oedema, before a serous retinal detachment occurs and renders treatment impossible excepted with the help of high doses steroids.

Administration, Oral↗
PubMed1994

[Prevention of retinal detachment in Wagner-Stickler disease. Comparative study of different methods. Apropos of 22 cases].

Prophylactic treatment in patients presenting Wagner-Stickler disease has not been yet well defined. We retrospectively studied twenty-two patients who had a retinal detachment on the first eye. Among the ten patients treated by peripheral confluent laser photocoagulation, five had a retinal detachment after a mean follow-up of fifteen months; with a 42% rate of spontaneous retinal detachment bilateralization, we can conclude that laser therapy has not been efficient. Four patients treated by focal or circular laser photocoagulation, cryotherapy or vitrectomy developed retinal detachment. Eight eyes treated by a preventive encircling scleral buckle did not develop retinal detachment, with a mean follow-up of twenty-one months. This follow-up is still too short, but greater than the mean bilateralization delay. Per and postoperative complications had no consequences.

Adolescent↗
PubMed1993

Effect of altered loading conditions during haemodialysis on left ventricular filling pattern.

Changes in the circulating volume associated with haemodialysis result in modification of left ventricular loading conditions. To determine the influence of haemodialysis on Doppler indices of left ventricular filling, 12 patients (mean age 40.8 +/- 2.7 (SEM) years) with renal insufficiency but without overt heart disease were studied by Doppler-echocardiography immediately before and after haemodialysis. Haemodialysis resulted in a decrease in body weight from 68.0 +/- 3.8 kg to 65.0 +/- 3.7 kg (P < 0.01). Heart rate and blood pressure did not change significantly during haemodialysis. Left ventricular diastolic dimension (M-mode) decreased from 53.5 +/- 1.1 mm to 49.5 +/- 1.9 mm (P < 0.05), whereas the shortening fraction did not change. Haemodialysis elicited marked changes in the early diastolic rapid filling wave (E wave) recorded by pulsed Doppler at the level of the mitral annulus. Peak velocity of the early rapid filling phase (peak E) decreased significantly from 95.3 +/- 8.2 cm.s-1 to 63.0 +/- 5.7 cm.s-1 (P < 0.001) and mid-diastolic deceleration of transmitral velocity decreased from 437.3 +/- 54.2 cm.s-2 to 239.7 +/- 54.4 cm.s-2 (P < 0.01). The peak filling velocity during atrial contraction (peak A) did not change (79.7 +/- 6.3 cm.s-1 vs 74.1 +/- 4.7 cm.s-1; P = NS). The ratio peak E/peak A decreased from 1.19 +/- 0.06 to 0.85 +/- 0.04 (P < 0.01) during haemodialysis. The results provide further evidence for the pronounced preload-dependence of Doppler indices of left ventricular diastolic function.

Adult↗
PubMed1993

Effects of dialysate composition during hemodialysis on left ventricular function.

To determine the effects of dialysate composition during hemodialysis on left ventricular systolic and diastolic function, 12 patients treated by chronic hemodialysis (mean age 40.8 +/- 2.7 years), without overt heart disease, were studied by Doppler-echocardiography successively before and after acetate hemodialysis (AHD), bicarbonate hemodialysis (BHD), and acetate-free biofiltration (AFB). The three types of hemodialysis resulted in a comparable decrease of the body weight. Mean arterial blood pressure decreased by 5 mm Hg (NS), 8 mm Hg (NS) and 10 mm Hg (P < 0.05) during AHD, BHD and AFB, respectively. There was a significant increase of the heart rate and the shortening fraction of the left ventricular diameter after AHD, but not after BHD and AFB. Mean total systemic resistance increased by 20% after AHD, 18% after BHD and by 7% after AFB (all changes NS). During each type of hemodialysis there was a significant reduction of the peak velocity of the early diastolic rapid filling wave (peak E) without change of the peak filling velocity during atrial contraction (peak A). During AHD and BHD the pressure half-time of the early filling phase (TP/2) increased, and the velocity-integral of the early diastolic filling phase (E-area) decreased. However, TP/2 and E-area did not change significantly after AFB.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetates↗
PubMed1993

[Prevention of non-traumatic retinal detachment by surgical cerclage. Apropos of 20 cases].

Prophylactic retinal detachment with laser photocoagulation is ineffective for some vitreo-retinopathies in which vitreous traction is predominant (non traumatic giant retinal tears, Wagner Stickler's syndrome, Marfan's syndrome...). Twenty eyes were operated by prophylactic episcleral circular buckling. In eighteen cases, the fellow eyes had previously presented a retinal detachment. We performed two types of encircling buckle. We only observed minor operative complications, without any functional consequences, attesting to the innocuity of this type of treatment. But we have to wait for vitreous detachment to know the efficacy of this prophylactic treatment. This detachment occurs at different time in each vitreoretinopathy, but with a specific rate of retinal detachment for each pathology.

Adolescent↗
PubMed1993

[Failures of the surgical treatment of rhegmatogenous retinal detachment].

The surgical treatment of rhegmatogenous retinal detachment, has considerably improved. But there are still a lot of failures, at least after the first surgical procedure. Out of a group of 320 retinal detachments, a one stage surgical procedure allowed the retina to reattach in 84% of cases. Out of the 51 failures, we defined 2 subgroups: the early recurrences were mainly caused by undiagnosed breaks or insufficient scleral buckling, and the delayed recurrences by a vitreo-retinal proliferation or a new tear. Though a second operation increased the success rate to 97%, it is certainly desirable to lower the failure rate of the first surgical procedure.

Adult↗
PubMed1991

[Surgical treatment of non-traumatic retinal detachment in children under 15 years of age].

Etiological and clinical features of 151 retinal detachments in childhood are studied and discussed. Results of surgical management of 92 of them, after at least a 6 month follow-up, especially after ablation of silicon oil when used temporarily, are described. Clinical aspects of the contralateral eyes and their prophylactic treatment is also studied. Though surgical techniques have done great strides, prognosis of retinal detachment in childhood is still desperately poor. Proliferative vitreo-retinopathy, frequent, early and very progressive, is the leading complication and cause of failure in surgical of these retinal detachment. In this series of 151 retinal detachments, only 38% have achieved long term retinal reattachment because of it. If high grade (C-D) proliferative vitreo-retinopathy is associated 14.5% only achieved long term reattachment though 86% it when proliferative vitreo-retinopathy was moderate or absent. It is for this reason that we wish to emphasize the need to inform practitioners and "at risk" families. Strict and systematic follow-up of the "at risk eye" is essential. The most complete surgery at the outset seems to be the best way of managing high-grade proliferative vitreo-retinopathy associated with retinal detachments.

Age Factors↗