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Biomedical subjects

D Hannouche

Publications and source records attributed to D Hannouche.

At least 37 records · Page 2Linked to original sources
PubMed1997

Efficacy of proton therapy in circumscribed choroidal hemangiomas associated with serious retinal detachment.

OBJECTIVE: The purpose of the study is to evaluate the efficacy and safety of proton therapy in complicated circumscribed choroidal hemangiomas. DESIGN: The study design was a retrospective review. PARTICIPANTS: Studied were 13 patients (13 eyes) who had circumscribed choroidal hemangioma associated with serous retinal detachment. Of these, four eyes previously underwent laser unsuccessfully. INTERVENTION: Proton therapy including a total dose of 30 Cobalt-Gray-Equivalent was administered to each eye. MAIN OUTCOME MEASURES: Patients were controlled for initial and final best-corrected visual acuity, slit-lamp examination, intraocular pressure, fundus examination, fluorescein angiography, and tumor thickness on B-scan ultrasonography. RESULTS: The mean follow-up period was 26 months (range, 9-48 months). Retinal reattachment was obtained in all cases after a mean period of 52 days. The tumor height decreased in all cases. Visual acuity improved to two lines or more in eight eyes (62%) and reached 20/200 or more in nine eyes (69%). No radiation complication was detected during follow-up. CONCLUSIONS: Proton radiation seems to be effective and safe in the management of choroidal hemangioma associated with serous retinal detachment. It may be useful when photocoagulation can not be performed.

Adult↗
PubMed1997

Systemic cyclosporine A in severe atopic keratoconjunctivitis.

OBJECTIVE: Atopic keratoconjunctivitis (AKC) is a potentially blinding disease. It is usually associated with atopic dermatitis that has been managed successfully with systemic cyclosporine A (CSA) in some severe forms of the disease. In this study, the authors evaluated systemic CSA therapy in patients with severe AKC. DESIGN: Cohort Retrospective study. PARTICIPANTS: Four patients aged 31 to 64 with severe AKC and atopic dermatitis refractory to or dependent on steroid therapy. INTERVENTION: The patients received oral CSA. MAIN OUTCOME MEASURES: Ocular inflammation, skin condition, CSA treatment methods (dosage, duration), CSA-related side effects. RESULTS: Daily dosage of oral CSA was 3 to 5 mg/kg and mean duration of treatment was 37 months (range, 22-48 months). Ocular inflammation was controlled totally in three patients. One patient responded only partially to treatment. Side effects included renal toxicity in one patient. Reduction of CSA dosage resulted in normalization of serum creatinine level. CONCLUSIONS: This report suggests that systemic CSA represents an interesting alternative therapy in severe AKC.

Administration, Oral↗
PubMed1997

Management of viral retinitis-associated retinal detachment in AIDS.

We retrospectively reviewed the results of surgery in 27 cases of retinal detachment related to viral necrotising retinitis in acquired immune deficiency syndrome (AIDS). Vitrectomy and silicone oil tamponade were performed in all cases. Scleral buckling was applied to 9 eyes. Silicone oil was left in the eye in all cases. Mean follow-up period was 13 weeks. Post-operative flattening of the retina at the posterior pole was achieved in 89% of the eyes. Anatomical results were not related to the intraoperative use of an encircling procedure. Visual acuity improved by 2 Snellen lines or more in 40% of cases and 67% of the eyes retained a post-operative ambulatory vision. Phacosclerosis and optic atrophy developed in 29% and 22% of cases, respectively. Vitrectomy and silicone oil tamponade without scleral buckling are effective in the management of retinitis-associated retinal detachments. This procedure is short and can be performed under local anaesthesia.

AIDS-Related Opportunistic Infections↗
PubMed1997

Management of silicone-induced cataract in AIDS patients treated for viral retinitis-associated retinal detachment.

BACKGROUND AND OBJECTIVE: To evaluate the outcome of cataract surgery for patients with acquired immunodeficiency syndrome (AIDS) who underwent vitrectomy and silicone tamponade for viral retinitis-associated retinal detachment. PATIENTS AND METHODS: The authors retrospectively reviewed the data of five AIDS patients (five eyes) who had cataract within a mean period of 4 months following vitrectomy and silicone oil tamponade for viral retinitis-associated retinal detachment. Phacoemulsification and implantation of a poly-methylmethacrylate posterior chamber intraocular lens were performed. The mean postoperative follow-up was 3 months. RESULTS: Neither silicone oil loss nor retinal redetachment were reported postoperatively. Visual acuity improved in two eyes and remained unchanged in one eye. Total blindness occurred in two eyes. CONCLUSION: Although cataract surgery in these eyes is a relative easy procedure and does not interfere with the retinal status, visual outcome remains poor because of possible postoperative optic atrophy.

AIDS-Related Opportunistic Infections↗
PubMed1997

[Triple procedure with phacoemulsification prior to grafting].

We report a surgical technique which combines phacoemulsification and posterior chamber in the bag intra-ocular lens implantation before penetrating keratoplasty. This combined technique can only be performed in eyes with clear cornea. This technique seems to be safer during cataract extraction. We compared this combined procedure with the classical technique which associates manual extracapsular extraction and posterior chamber intra-ocular lens implantation and penetrating keratoplasty.

Corneal Diseases↗
PubMed1997

[Self-sealing sclerotomies in pars plana vitrectomy].

PURPOSE: To study a technique of self-sealing sclerotomies, recently described. METHODS: After conjunctival peritomy, a tunnel incision is performed with a crescent knife, 2 mm posterior to the intended site of entry. Then a 20G microvitreoretinal blade is used to enter the vitreous cavity. From November 1996 to April 1997, 99 primary vitrectomies were prospectively studied. RESULTS: 292 sclerotomies were performed with this technique. Self-sealing sclerotomies were observed in 270 cases (92.5%). In 22 cases, leakage of fluid required closure with 8-0 nylon sutures. Leakage was related to multiple instruments used through the sclerotomy, or more frequently to a thin scleral wall. In 1 case, transient hypotony was observed. Ocular pressure spontaneously returned to normal. CONCLUSIONS: Self-sealing sclerotomies are difficult to perform if the sclera is thin, and leakage can be observed if multiple instruments have to be used through the same sclerotomy. But this technique prevents vitreous and retinal herniation through the sclerotomy, and ocular hypotony. It also reduces the operative time, and prevents irritation related to nonabsorbable sutures.

Humans↗
PubMed1996

Ocular involvement in Epstein-Barr virus-associated T-cell lymphoma.

PURPOSE: To determine if serous retinal detachment may occur in a case of Epstein-Barr virus-associated T-cell lymphoma. METHODS: We examined a 51-year-old man who had recent loss of vision and poor general health. RESULTS: Ocular involvement consisted of bilateral serous retinal detachment and choroidal infiltrates. The diagnosis of lymphoma was made by liver biopsy. The course of the disease was fulminant. Postmortem histologic examination disclosed a massive infiltration of the choroid and hematopoietic organs by pleomorphic large T cells. Epstein-Barr virus was detected by in situ hybridization. CONCLUSION: Ocular involvement, including choroidal infiltrates and serous retinal detachment, may occur in Epstein-Barr virus-associated T-cell lymphoma.

Choroid Neoplasms↗
PubMed1996

Autologous platelet concentrate as an adjunct in macular hole healing: a pilot study.

PURPOSE: A pilot study was undertaken to assess the efficacy of autologous platelets in macular hole healing. PATIENTS AND METHODS: Eight eyes of eight patients with stage 3 or 4 macular holes, two of which had failed to heal after previous vitrectomy and gas tamponade, were included. The procedure consisted of pars plana vitrectomy with removal of posterior cortical vitreous, stripping of associated epimacular membranes, 15% perfluoroethane-air tamponade, and instillation of autologous platelet concentrate onto the posterior pole. Strict postoperative facedown positioning was observed for 12 days. Postoperative evaluation included visual acuity measurement, biomicroscopic macular appearance and scanning laser ophthalmoscope examination. The follow-up period ranged from 3 to 13 months (mean, 7 months). RESULTS: Of eight eyes, flattening of the surrounding retina and closure of the hole were achieved in seven (87.5%). Visual acuity improved two lines or more in four eyes (50%) Four eyes (50%) reached a postoperative visual acuity of 20/50 or more. Increased nuclear sclerosis was observed in six eyes (75%), and retinal detachment occurred in two eyes (25%). CONCLUSIONS: Autologous platelet concentrate administered peroperatively in full-thickness macular holes seems to be a safe and effective adjunct to vitrectomy with removal of posterior hyaloid and gas tamponade. A larger multicenter randomized prospective study is underway to verify these encouraging results before advocating the use of autologous platelets in macular hole surgery.

Aged↗
PubMed1996

[Technique of peribulbar anesthesia].

A new technique of peribulbar anesthesia using a short needle has been applied on 3,691 patients. Complications previously reported with the use of a long needle are thus avoided.

Anesthesia, Local↗
PubMed1995

Systemic lupus erythematosus with choroidopathy and serous retinal detachment.

Systemic lupus erythematosus associated ocular manifestations usually consist of cotton-wool spots and retinal hemorrhages. The authors report one case of lupus choroidopathy revealed by bilateral serous retinal detachment, occurring 4 months after a systemic flare-up of the disease. An immune complexes-mediated phenomenon is involved in these manifestations, which are usually controlled by systemic corticosteroids and immunosuppressive agents. Plasma exchanges were successfully applied in this case, resulting in a disappearance of the retinal detachment in one month.

Adult↗
PubMed1995

[Uveitis with hypopyon in patients with acquired immunodeficiency syndrome, treated with Rifabutin].

BACKGROUND: Iridocyclitis has been identified as a dosage-dependent side effect in patients with the acquired immunodeficiency syndrome who are treated for Mycobacterium avium complex infections with systemic Rifabutin. We reviewed cases of acute hypopyon uveitis occurring in patients with AIDS to establish whether there was an association or not. METHODS: All patients were referred by an infection disease specialty service for complete ophthamological evaluation and ancillary laboratory. Six patients with AIDS, aged from 29 to 65 years, presented with acute unilateral hypopion. RESULTS: At the time of presentation, all six patients were receiving treatment for MAC infection with Rifabutin (dosage range, 300-600 mg/d) and four received Fluconazol. Results of microbiological investigations were negative. Hypopyon developed in the second eye of two patients. Hypopion resolved rapidly with intensive antibiotherapy without corticosteroids. CONCLUSION: Concomitant use of Rifabutin and Fluconazol may precipitate hypopyon uveitis. The cause of the uveitis is less certain, but the possible role of a microbiological agent cannot be ruled out.

AIDS-Related Opportunistic Infections↗
PubMed1995

[Orbital Erdheim-Chester disease].

Erdheim-Chester disease is related to a tissue infiltration of foamy histiocytes. Results of immunoperoxydase stains for S-100 and T6 protein, the Langerhans cells antigen, is negative. It is a multisystemic disease, and it particularly involves bones and orbit. The visual prognosis is threatened, and the disease may lead to a fatal issue. Treatments have poor effects on the disease. Patients sometimes have good symptomatic response to corticotherapy. This case was revealed by headaches and diabetes insipidus. The orbital infiltration was asymptomatic.

Adult↗