Biomedical subjects
Publications and source records attributed to H Offret.
A new case of neuroendocrine carcinoma (Merkel cell tumor) of the eyelid is reported. Local recurrence, spread to the orbit, led to exenteration and death of the patient. This trabecular carcinoma can be identified by histology, immuno-histochemistry and electron structural microscopy.
A five year old girl with pseudo-tumoral lesion of the inferior right fornix underwent surgical excision. Histology of the lesion showed a granulomatous giant cell inflammation surrounding foreign material, probably related to synthetic fabric fibers.
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7 cases of multifocal choroiditis and panuveitis are reported here (6 females, 1 male). All clinical data were carefully considered. In all cases an aqueous sampling was made for the detection of anti-herpes virus antibodies in aqueous and serum. 3 specificities were tested: herpes simplex (HSV), herpes zoster (HVZ) and cytomegalovirus (CMV). An intraocular synthesis of specific antibodies was found against VZV in 2 cases and against HSV in 1 case. There was another presumptive case for HSV.
Clinical data and histopathologic report of the association of a retinal malignant lymphoma and acute retinal necrosis. Demonstration of virus particle and vitreous herpetic antibodies.
The levels of immunoglobulin E (IgE) in aqueous humor (AH) and serum were determined in 74 uveitis patients and 13 control patients with senile cataract. Uveitis patients' levels ranged from less than 0.06 to 460 IU/ml according to the paper radioimmunosorbent test (PRIST; limit of sensitivity, 0.06 IU/ml). Only one control patient had an AH level higher than the sensitivity limit (0.08 IU/ml). Of the five patients with the highest levels in the AH, four had toxocaral retinitis. The ratio of AH/serum to IgE normalized to the albumin concentration was calculated in 25 uveitis patients and was greater than 0.60 in 13 cases, indicating a possible intraocular IgE synthesis.
About two clinical cases with maculopathy resulting from irradiation with so low dosage as to have been previously considered harmless in most of the literature. The authors suggest that early photocoagulation laser treatment as a mean of preserving a good visual prognosis for these eyes.
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Malignant atrophic papulosis was first described by Degos in 1942. It is an occlusive arteriopathy involving small caliber vessels in the whole organism. Ocular involvement was reported in 35 out of the 105 observations published so far. The ophthalmological symptoms were reviewed and compared to a personal case. They consist of either involvement of the eye tissues with a predominance of the conjunctiva (but also sclera, episclera, retina, choroid and optic nerve), or of neuro-ophthalmological lesions. Up to now, both etiopathogeny and appropriate treatment of the disease remain unknown.
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The authors report a case of sebaceous adenocarcinoma of the eyelid developed in meibomian glands. This tumor grew slowly for several years and was diagnosed three years after an intestinal adenocarcinoma was discovered in the same patient. This case is part of a Torre's syndrome (association of a sebaceous neoplasm and a visceral malignancy). Such an association represents an original example of multiple tumors and shows that the discovery of a sebaceous tumor, benign or malignant, indicates a careful search of an internal malignancy.
The authors report a case of ocular manifestation of a Sipple disease. They discuss, the association with endocrine poly-adenomatosis and the relationship with the APUD system.
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Study of two patients with spontaneous detachment of the choroid. In addition to detachment of the choroid, case 1 had a flat anterior chamber. Corticotherapy gave some improvement but after 3 months, surgical management was necessary. In case 2 enucleation was performed on the basis of positive echographic findings. Histological findings, the main clinical features and the therapeutical approach are discussed.
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We observed in 13 young patients a serous or hemorrhagic paramacular detachment of one third to one half disc diameter size. In eight, we have seen also atrophic choroidal scars. In one patient the serous detachment occured at the site of a previously studied choroidal scar. Our cases resemble the presumed ocular histoplasmin choroiditis described in American literature. In our cases histoplasmosis can be excluded. Visual prognosis is dependent upon proximity of the choroidal lesion to the fovea. In most cases this prognosis is poor. The term juvenile hemorrhagic ocular choroidopathy is suggested for the disease.
The results of argon laser photocoagulation performed on 20 eyes with ischemic or edematous central retinal vein occlusion were analyzed. In patients with ischemic occlusion, neovascularization improved after treatment but they derived no benefit as far as visual acuity is concerned. In the group with enematous occlusion, visual acuity and macular edema improved after treatment. However, 6 of 8 patients of this group had prior urokinase treatment.
Prevention of malignant glaucoma: in first case report lens extraction and trabeculectomy was followed by a malignant glaucoma; in the second case report pars-plana vitrectomy and trabeculectomy was successful. The role of a vitreous posterior blockage is discussed.