[Choroid metastases].
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Choroid Neoplasms↗
Biomedical subjects
J-C Quintyn
Publications and source records attributed to J-C Quintyn.
[Comparison of two surgical techniques for the treatment of superior oblique palsy].
AIM: To compare two surgical techniques for the treatment of superior oblique palsy. PATIENTS AND METHODS: Retrospective study involving 32 patients operated on at the Rouen Teaching Hospital for superior oblique palsy. Group 1 patients were treated by surgical reinforcement of the superior oblique muscle and group 2 patients were treated by surgical loosening (or weakening) of the antagonist muscles. One-year follow-up explored head tilt, diplopia, vertical deviation and cyclotorsion. RESULTS: Functional results (presence of diplopia or stiff neck) were positive in both groups but better in group 1. Only 12.5% of patients required a second operation. Cyclotorsion amounted to less than 2% in group 1 and was still greater than 8% in group 2; on the other hand, vertical deviation had improved more in group 2, where it decreased to 2.1 diopters versus 3.1 in group 1. DISCUSSION: and conclusion: Only reinforcing the superior oblique adequately corrects cyclotorsion, which is the main cause of asthenopia and diplopia, despite an often insufficient height correction that is otherwise clinically well tolerated. We suggest reinforcing the superior oblique as a first intent rather than weakening hyperactive muscles, and in case of excessive postoperative height, we would carry out additional treatment of one of the hyperactive muscles later.
Adolescent↗
[Retinal detachment by inferior tear: a poor prognosis?].
AIM: To determine whether a lower location of retinal wounds is a factor for poor prognosis in retinal detachment. PATIENTS AND METHOD: This retrospective study involved 248 medical records of patients who were operated on for retinal detachment in 2001 at the Toulouse-Rangueil Hospital Ophthalmology Department. We excluded retinal detachment of very short-sighted patients, diabetic patients and detachment secondary to trauma or relapses. We compared the incidence of surgical failure according to various parameters: condition of the crystalline lens, operative technique, operator, vitreoretinal proliferation, retinal wound location, patient age and the operative side. Thirty-six patients presented with lower wounds; 17 patients obtained incomplete results and relapsed within 1 year of surgery. RESULTS: Vitreoretinal proliferation and inferior location of the retinal detachment were found to be poor prognostic factors. No significant differences were found between the other parameters studied. DISCUSSION: A variety of prognostic factors of retinal detachment surgery are now clearly identified (vitreoretinal proliferation, old detachment). A lower location of the detachment constitutes an additional difficulty for retinal applications. Indeed, it is more difficult to perform effective buffering in this type of case. We recommend that retinal detachment be operated internally, to reduce the risk of relapse. CONCLUSION: An inferior location of the retinal wound during retinal detachment appears to be a factor of poor prognosis, but this remains to be ascertained through an ongoing, prospective study.
Female↗
[Temporal arterious obliteration by Candida endophthalmitis].
We report the case of a 50-year-old woman with a branch retinal artery occlusion caused by acute Candida albicans chorioretinitis, diagnosed based on ophthalmoscopic and angiographic examinations. Although vasculitis is frequent during Candida endophthalmitis, branch obstruction is rare. The thrombosis is probably related to perivascular inflammation rather than septic embolus. We propose antiaggregant therapy when the infection is near the retinal vessels.
Candidiasis↗
[Vitrectomy for floaters].
PURPOSE: To clarify vitrectomy indications in the treatment of vitreous floaters. METHODS: This is a retrospective study of four patients, four eyes (age, 42-65 years), who underwent vitrectomy for the treatment of vitreous floaters. Two patients had a total posterior vitreous detachment. All patients were required to think about the intervention for several months before consenting. RESULTS: Preoperative visual acuity ranged from 20/40 to 30/30 and after the operation it ranged from 20/40 to 10/10. Minimum follow-up was 1 year. Visual acuity did not decrease after treatment in any patients. All patients expressed satisfaction with their postoperative visual function. DISCUSSION-CONCLUSION: Visual acuity measures do not always accurately reflect patients' visual discomfort. Vitrectomy has been known for many years. It can be proposed as a last resort after thorough retina examination, after patients have received adequate information and they are psychologically ready for the procedure.
Adult↗
[The importance of flow cytometry and the cell proliferation index in choroidal melanoma].
PURPOSE: To evaluate the prognostic value of DNA ploidy and proliferative activity in metastasis occurrence after enucleation for choroidal melanomas. METHODS: This retrospective study investigated 14 patients (eight males, six females) using flow cytometry and immunohistochemistry with the Ki67 antibody. RESULTS: Two of the tumors were aneuploid, 12 were diploid. The proliferation index was between 0% and 16%. Two tumors progressed to metastatic disease; both were diploid and had a low proliferation index. They were mixed cell type. The median observation period was 3 years and 9 months. CONCLUSION: DNA content and proliferative activity are not correlated with metastasis occurrence. Sclera invasion is the best prognostic factor.
Aged↗
[Intraocular pressure results of contact transscleral cyclophotocoagulation with Neodymium YAG laser for refractory glaucoma].
PURPOSE: To evaluate the effects of contact transscleral cyclophotocoagulation with neodymium YAG laser for refractory glaucoma. METHOD: This was a retrospective study with 36 patients (37 eyes) who were treated at the Rouen Hospital from February 1996 to February 2001. Patients had various types of glaucoma: glaucoma in pseudophakia (12), primary open-angle glaucoma (16), posttraumatic glaucoma (6), glaucoma associated with uveitis (4), neovascular glaucoma (3), and glaucoma after silicone oil (1). The Neodymium YAG laser (Alcon) was used for treatment. Energy was delivered in up 32 applications of 7-9 W for 0.7 seconds each. All patients except one 10-year-old child received retrobulbar anesthesia. Intraocular pressure was measured after 4 hours, 1 month, and 10 years. RESULTS: The mean preoperative intraocular pressure of 30.3 (+/-1.3) mmHg decreased to 19.4 (+/-2) mmHg at 1 month and to 22.2 (+/-2.4) mmHg at 1 year. Seven patients underwent a second treatment during the year, since the first one was insufficient. Treatment lowered the number of medications used to decrease intraocular pressure from a pretherapy mean of 2.7 mmHg to 1.8 mmHg at 1 month and 2.07 mmHg at 1 year. In three patients who were treated for a painful sightless eye, the treatment failed. DISCUSSION: Neodymium YAG laser necroses ciliary bodies. Treatment must be dosed to achieve the greatest efficacy without hypotonia, although hypotonia is rare, as is non-response to treatment. A few patients will be retreated during the year. The subgroup of sightless painful eyes had a high failure rate (75%), with half undergoing evisceration. We found no other differences according to the origins of refractory glaucoma. CONCLUSION: Midterm results of contact transscleral cyclophotocoagulation with Neodymium YAG laser are encouraging in the treatment of refractory glaucoma.
Adolescent↗
Subretinal fluid in primary rhegmatogenous retinal detachment: physiopathology and composition.
During retinal detachment, subretinal fluid is present, whose composition and physiopathology are still little known. Under normal conditions, osmotic and oncotic pressures help keep the retina in place, but the main retinal attachment force is provided by active transport in the pigment epithelium. Subretinal fluid composition varies according to detachment duration; total protein concentration in subretinal fluid increases with time. In addition, all proteins are qualitatively modified. The detached retina loses its oxygen supply, and it then uses the anaerobic pathway to degrade glucose. Thus, long-duration retinal detachments feature increased lactic acid and dextrose concentrations. Phospholipids are also increased in subretinal fluid, reflecting retinal degradation. This review presents data on the physiopathology and composition of the subretinal fluid in retinal detachments.
Adhesiveness↗