Biomedical subjects

L Missotten

Publications and source records attributed to L Missotten.

At least 55 records · Page 3Linked to original sources

PubMed1997

Eye diseases and the causes of blindness in the southwestern Equator (equatorial forest) in Zaire, data from an eye camp in three rural centers.

OBJECTIVE: To determine frequencies of eye diseases and causes of blindness in this rural area. METHOD: During a one month period (February 1996), a study was carried out in three rural centers (Mbandaka, Iboko, Lukolela) in the South Western Equator, in the tropical equatorial forest area. A total of 700 patients were examined and ophthalmological examination included visual acuity, inspection of adnexa, refraction, slit-lamp examination, direct funduscopy and intraocular pressures. RESULTS: Cataract and glaucoma were the major ocular diseases found. Among the patients 1/5 was legally blind, and common causes of blindness were: cataract (54%), glaucoma (30%), uveitis (6%), corneal disorder (5%), retinitis pigmentosa (3%), atrophy of eye (3%). CONCLUSION: Cataract and glaucoma constituted a public health problem in this rural area of Zaïre.

Adolescent↗

PubMed1997

Glaucoma in Congo.

OBJECTIVE: To determine frequencies of various types of glaucoma in an urban community of Congo. METHODS: The records of 176 patients with the diagnosis of glaucoma examined between 1991 and 1995 at a non-university center were reviewed. A complete ophthalmological examination was performed in each patient including best visual acuity, refraction, slit-lamp examination, ophthalmology and intraocular pressure measurements. Gonioscopy and visual field examination were performed when needed. RESULTS: The frequency distribution of the various subtypes of glaucoma was: open-angle glaucoma (72.2%), aphakic glaucoma (9%), uveitis glaucoma (6%), exfoliative glaucoma (3%), glaucoma secondary to ocular trauma (2.2%), cataract glaucoma (1.7%), normal tension glaucoma (1.7%), congenital glaucoma (1.7%), neovascular glaucoma (1.3%), pigmentary glaucoma (0.6%), corticosteroid-induced glaucoma (0.6%), and glaucoma associated with retinoblastoma (0.6%); CONCLUSION: Despite the limitations inherent of a retrospective review of records, our study provides an indication of the prevalence of various types of glaucoma in a urban community of Congo. This study confirmed also the rarity of primary angle-closure glaucoma in the black.

Adult↗

PubMed1997

Risk factors for open-angle glaucoma in 260 black subjects in Congo.

OBJECTIVE: To identify possible risk factors for open-angle glaucoma (OAG) among 260 black subjects in Kinshasa (Congo). METHODS: Between May 14, 1996 and June 14, 1996, 260 persons, aged 24-60 years old, working at a factory in Kinshasa, have been examined. Twenty-two patients with OAG and 238 controls were identified. Data were obtained through interviews and clinical examinations. OAG was defined by the presence of both optic disc damage and characteristic visual field defects. RESULTS: The frequency of OAG was 8.5%. Associations were found with intraocular pressure greater than 21 mmHg (Odds ratio (OR) = 119.4, 95% confidence interval (CI), 17.62 to 4960.64), current cigarette smoking (OR = 2.77, 95% CI, 1.04 to 7.34) and Mongo ethnic subgroup (OR = 3.195, 95% CI, 0.93 to 9.57). CONCLUSION: Mongo ethnic subgroup seemed to be another risk factor for OAG in Congo.

Adult↗

PubMed1997

Differences in the trabecular meshwork between Belgian and Congolese patients with open-angle glaucoma.

PURPOSE: To study the alterations of the trabecular meshwork of Belgian and Congolese patients with open angle glaucoma (OAG). METHODS: A trabeculectomy was performed in 27 OAG patients from Belgium and 24 from Congo; the trabecular specimens were fixed, embedded, stained, and studied by light microscopy. These specimens were compared with the trabecular meshworks from 5 Belgian non-glaucomatous eyes. RESULTS: The mean number (+/- standard deviation) of trabecular cells per field was 69 (+/- 10) in Belgian normal eyes, 34 (+/- 17) in Belgian OAG patients, and 10 (+/- 6) in Congolese OAG patients. The trabecular meshwork was collapsed and Schlemm's canal was closed in the cases with a diminished number of cells. Pigmentation was present in 79% of the Congolese and in 35% of the Belgian specimens. CONCLUSION: The trabecular meshwork from OAG patients has a lower cellularity than normal, and the effect is much more pronounced in the trabecular meshwork from Congolese patients. This may be a possible explanation for the racial differences in OAG and the more severe forms of glaucoma in black people.

Aged↗

PubMed1996

An immunohistochemical study of topical cyclosporine in vernal keratoconjunctivitis.

PURPOSE: To determine the immunomodulating effects of topical cyclosporine on the immune cells in the conjunctival biopsy specimens obtained from patients with active vernal keratoconjunctivitis. METHODS: We studied six patients who had severe active vernal keratoconjunctivitis. Each patient was given topical cyclosporine 2% eyedrops four times daily. A 2 x 2-mm limbal conjunctival biopsy specimen was obtained from each patient before and three weeks after treatment. Using a panel of monoclonal and polyclonal antibodies and immunohistochemical techniques, we analyzed the conjunctival immune cells before and after cyclosporine treatment. RESULTS: Three weeks after topical cyclosporine treatment, there was marked clinical improvement and a statistically significant reduction in the number of epithelial and stromal class II MHC+ cells, UCHL1+ T cells, and stromal IgA+ and IgG+ plasma cells. The mean number of cells before and after therapy, respectively, were: class II MHC+ (epithelium), 31.5 +/- 13.1 and 8.3 +/- 5.6 (P = .031); class II MHC+ (stroma), 77.0 +/- 28.7 and 24.7 +/- 17.5 (P = .031); UCHL1+ T cells (epithelium), 24.5 +/- 14.1 and 4.2 +/- 2.9 (P = .031); UCHL1+ T cells (stroma), 78.7 +/- 31.1 and 44.5 +/- 27.5 (P = .031); IgA+ plasma cells, 66.7 +/- 32.1 and 22.2 +/- 7.8 (P = .031); and IgG+ plasma cells, 37.3 +/- 30.0 and 9.0 +/- 6.4 (P = .031). There was a statistically insignificant decrease in the epithelial class II MHC+ dendritic Langerhans cells, epithelial and stromal KP1+ macrophages, stromal OPD4+ helper/inducer T cells, and stromal L26+ B cells. The numbers of IgE+ plasma cells and mast cells were unaltered. CONCLUSION: The clinical improvement in vernal keratoconjunctivitis after topical cyclosporine therapy may result from its immunomodulating effect on the components of cell-mediated and humoral immune responses. In contrast, the drug has no immunomodulatory effect on mast cells and IgE-mediated allergic response.

Administration, Topical↗

PubMed1996

Leber congenital amaurosis--differential diagnosis, ophthalmological and neuroradiological report of 18 patients.

Between 1985 and 1995 eighteen babies, presenting to our department with absent visual contact and roving eye movements, showed a non-recordable flash electroretinogram (fERG). This was confirmed when repeated after a one-year interval. In four patients with developmental delay an underlying systemic disorder was diagnosed after a thorough pediatric neurological evaluation: Senior Loken syndrome, neuroaxonal dystrophy, ceroid lipofuscinosis and a yet unclear metabolic disorder were the revised diagnoses. The fourteen remaining patients were diagnosed as having primary idiopathic Leber Congenital Amaurosis (LCA). Three of them showed developmental delay. In all three cerebellar abnormalities were visualized on brain computed tomography (CT) and/or magnetic resonance imaging (MRI). Brain CT of the other eleven patients with age appropriate development was normal. We conclude that LCA is a diagnosis of exclusion and a cautious approach with a thorough history and pediatric neurological examination is necessary to exclude a more global pediatric neurological disorder.

Belgium↗

PubMed1996

Fundus changes in patients with the mitochondrial DNA point mutation at position 3243.

The A3243G transition in the mitochondrial DNA is commonly associated with the syndrome of mitochondrial encephalopathy, lactic acidosis and stroke-like episodes (MELAS). Previously, atypical pigmentary retinopathy has been described in patients with this syndrome and in patients with other phenotypes of the same mitochondrial defect. Maternally inherited diabetes mellitus and deafness has been recognized as a distinct clinical presentation of the mitochondrial point mutation at position 3243, and recently a pattern dystrophy has been identified as a characteristic ocular abnormality in these patients. The finding of a macular pattern dystrophy in patients with diabetes should therefore lead to screening for this aberrant mitochondrial genome.

Adult↗

PubMed1996

Immunopathogenesis of vernal keratoconjunctivitis.

We have analyzed the in situ distribution of immune cells in the conjunctival biopsy specimens obtained from patients with active vernal keratoconjunctivitis (VKC). We used immunohistochemical techniques and a panel of monoclonal and polyclonal antibodies. Our data point to a complex immunopathogenesis of the disease. Distinct components involved in IgE-mediated immune mechanisms, as well as humoral and cell mediated immune mechanisms were detected in the conjunctival tissues. In addition, we investigated the presence and distribution of adhesion molecules. In the normal conjunctiva, intercellular adhesion molecule-1 (ICAM-1) was expressed only on the vascular endothelium, lymphocyte function associated antigen-1 (LFA-1) and intercellular adhesion molecule-3 (ICAM-3) on epithelial and stromal mononuclear cells, and very late activation antigen-4 (VLA-4) on a few stromal mononuclear cells. Endothelial leukocyte adhesion molecule-1 (ELAM-1) and vascular cell adhesion molecule-1 (VCAM-1) expression was not detected. In VKC a marked increase of all these antigens was observed. Strong ICAM-1 expression was induced on the basal epithelial cells, and vascular endothelium. Furthermore, about 30% of the stromal mononuclear cells expressed ICAM-1. LFA-1 and ICAM-3 were expressed on the majority of infiltrating mononuclear cells. VLA-4 expression was noted on about 25% of the stromal mononuclear cells. ELAM-1 and VCAM-1 were induced on the vascular endothelial cells. Our results suggests that increased expression of adhesion molecules in VKC promotes the recruitment of inflammatory cells through blood vessels and the cell interaction between lymphocytes and antigen presenting cells, among lymphocytes, as well as between lymphocytes and epithelial cells.

Antigens, CD↗

PubMed1996

A modified Jones tube.

A modified Jones tube was designed and this new model was implanted in 33 cases with severe canalicular or common canalicular obstruction. The tube, with a length of 24 mm, has a 130 degree angulation in the middle. The insertion of this Jones tube can be performed with or without dacryocystorhinostomy. Despite some problems in the beginning, the results seem to be very promising, with a 80% success rate.

Adult↗

PubMed1996

Evaluation of echography in orbital disease.

A report is given on a series of 34 patients with suspicion of orbital disease, who were examined by standardized echography. We compared the efficacy of standardized echography in orbital disease with CT and NMR and concluded that SE has not become less important since the introduction of CT and NMR. It can supplement CT and NMR and remains a valuable and indispensible guide for the management of orbital disease.

Adult↗

PubMed1996

[Ocular refraction in Zaire].

PURPOSE: to determine frequencies of refractive errors in Zairian blacks and to investigate the influence of race upon refraction. METHODS: we examined the records of all patients seen at the department of Ophthalmology from 1963 to 1972. Refraction was measured by objective (skiascopy) or subjective methods. RESULTS: we found 4326 patients with ametropia, about 16% of the total. The records of 2594 Zairian patients with refractive errors were compared to those of 1417 non Zairian black patients and 315 Caucasian patients. The frequency of spherical refractive errors in Zairian black patients was 56%: (simple myopia: 33% myopia over 5 D: 1%, hypermetropia: 22%), astigmatism was seen in 44% (myopic astigmatism: 31% and hypermetropic astigmatism: 11%). The data of Zairian were similar to those of non-Zairian black patients. Spherical refractive errors in Caucasian patients were found in 46% of the patients (simple myopia: 19%, myopia over 5 D: 2%, hypermetropia: 25%). Astigmatismatic errors were seen in 54% (myopic astigmatism: 27%, hypermetropic astigmatism: 24%, mixed astigmatism: 3%). Hypermetropia increased with age in all groups, but slightly earlier in Zairian patients. CONCLUSION: Although the data of refractive errors did not show significant differences between Zairian and Caucasian patients, hypermetropic astigmatism seems to be less frequent and myopia more frequent among Zairian patients.

Adolescent↗

PubMed1996

Pelli-Robson contrast sensitivity test in Zaire.

The purpose of this study was to establish in this first report the age standards of the Pelli-Robson contrast sensitivity in Zaïre. Contrast sensitivity using the Pelli-Robson chart was performed in 100 normal Zairian black subjects aged from 10 to 59 years and 36 patients (22 patients with open-angle glaucoma and 14 with optic nerve disease). Scores of normal subjects were age related (p < 0.05). The results of Zairian young subjects were similar to those found previously in young white subjects; scores for older subjects were lower when compared to those of whites. Scores of patients were lower than those of normals (p < 0.001). Contrast sensitivity using the Pelli-Robson chart can be useful in developing countries.

Adolescent↗

PubMed1995

[Ocular complications in diabetes mellitus in Zaire].

OBJECTIVE: to determine the incidence of ocular complications of diabetes in Zaïre. METHODS: the study was based on an analysis of data from 382 diabetic patients seen from 1978 through 1989, and from Jan. 1990 through April 1990. Ocular complications were determined by routine ophthalmic examination including an inspection of adnexa, biomicroscopy, ophthalmoscopy. RESULTS: the average age of patients was 46 years the male to female ratio being 2:1. Ocular complications were found in 200 (52%) of 382 patients and included diabetic retinopathy (32%), cataract (18%) and other manifestations (vitreous hemorrhage, diabetic papillopathy, neovascular glaucoma, rubeosis iridis, keratitis, hordeolum) were rare (2%). Blindness caused by diabetes mellitus was found in 4% of patients and was due to diabetic retinopathy and cataract. CONCLUSION: Ocular complications seen in this study were comparable to those reported in Africa and the World.

Adolescent↗

PubMed1995

Prospective HLA-DR matching in penetrating keratoplasty.

This prospective study examines whether HLA-DR matching has a beneficial effect on corneal graft survival of high risk patients. Until now, 196 donors have been typed in order to provide 20 patients with a matching graft. The results, though preliminary, are very encouraging.

Adult↗

PubMed1995

Light-induced maculopathy.

In this retrospective study of fluorescein angiograms performed between 1991 and 1995, we retrieved 17 eyes (15 patients) with light-induced maculopathy after a cataract extraction and lens implantation. Sixteen eyes underwent non-complicated procedures; 12 extracapsular cataract extractions and 4 phaco-emulsifications. One phaco-emulsification was complicated by a posterior capsular rupture and required an anterior vitrectomy. In 11 eyes the maculopathy was an incidential finding and the lesions were paracentral. In 6 eyes the phototoxic scar was central and the cause of a central scotoma with metamorphopsia.

Aged↗

PubMed1995

Non-arteritic anterior ischemic optic neuropathy and refraction.

A small cup-disk ratio has been reported as a risk factor in non-arteritic anterior ischemic optic neuropathy. Hyperopia is possibly related with a small cup-disk ratio. The purpose of the present study is to compare the refraction of 37 eyes with non-arteritic anterior ischemic optic neuropathy with a sex and age matched control group of 74 eyes. In our study, mild hyperopia was more frequently observed in the anterior ischemic optic neuropathy group than in the control group.

Adult↗

PubMed1995

[Myelin fibers in Zairian patients].

PURPOSE: to determinate the characteristics of myelinated nerve fibres in Zairian blacks patients. METHODS: a review of records of patients with myelinated nerve fibers seen from 1962 to 1994. RESULTS: the relative incidence of myelinated nerve fibers was 0.02%. There were 13 (76%) male patients and 4 (24%) female patients. The average age at the moment of diagnosis was 32 years (range, 7 to 61 years). Myelinated nerve fibers were bilateral in 8 (47%) patients (16 of 25 eyes, 64%) and unilateral nerve fibers, 21 (84%) eyes contained a single lesion and 4 (16%) eyes contained multiple separate and distinct patches of myelinated fibers. Continuous lesions were present in 21 (84%) eyes and discontinuous lesions in 4 (16%) eyes. The 25 affected eyes varied in refractive error from a spherical equivalent of + 1.5 to - 16.00. The distribution of refraction was: emmetropia in 2 (12%) patients (2 eyes, 8%), simple myopia in 4 (24%) patients (5 eyes, 20%), myopia over 6 D with amblyopia in 6 (35%) patients (10 eyes, 40%), hypermetropia in 5 (29%) patients (8 eyes, 32%). CONCLUSION: this study showed a low relative incidence of myelinated nerve fibers and the bilaterality of lesions was frequent.

Adolescent↗

PubMed1995

[Exophthalmias in Zaire].

PURPOSE: To determinate the frequencies of causes of exophthalmos in Zaïre. METHODS: In a retrospective study, the records of 129 patients with exophthalmos seen from 1986 to 1994 were reviewed. All patients were examined ophthalmologically and most of them medically. X-Rays, orbital CT Scan, were performed most frequently. RESULTS: The sex distribution was: 79 (61%) male patients and 50 (39%) female patients. The sex ratio being 1.50/1. The ages of patients ranged from one to 68 years. Unilateral exophthalmos was frequent (76% of cases). Tumors were present in 42% patients, followed by inflammatory diseases in 26% of patients, thyroid eye disease in 9% and traumatic aetiology in 1.6%; the etiology was not determined in 14%. Retinoblastoma (8%), lymphoma (7%) and rhabdomyosarcoma (5%) were the most frequent tumors seen. Orbital cellulitis (26%) was frequently associated with adjacent sinus infection. CONCLUSION: The etiologic factors found in this study could be compared to those published in the World with the exception of orbital cellulitis and retinoblastoma that showed a high incidence in this study.

Adolescent↗