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Biomedical subjects

M A Quere

Publications and source records attributed to M A Quere.

At least 19 recordsLinked to original sources
PubMed1994

[Medial rectus stretching test in recurrent esotropia].

In oculomotor surgery, evaluation of muscle elongation is necessary before deciding on the operative plan. This is particularly important in recurrent esotropia where the motor problem is highly complex because of visco-elastic alterations caused by previous surgery. The study of a series of 132 cases of recurrent esotropia shows that weakening of the medial rectus almost always causes reduced muscle elongation, the extent of which is directly proportional to the amount of recession.

Esotropia↗
PubMed1993

[A case of Tolosa Hunt syndrome].

The authors review the clinical signs, results of investigations and clinical course under treatment of the Tolosa-Hunt syndrome; they illustrate their case presentation with a complete sequence of the imaging and the clinical and radiological findings of a case which fits the classical description found in the literature. They insist on the term of syndrome rather than disease because of the obvious diversity of anomalies encountered in this condition.

Adult↗
PubMed1990

[A new technic for recording eye movements by image processing. Principle and method].

Nowadays, electro-oculography remains the only clinical method for ocular movement recording which is largely used in daily practise, but it has many drawbacks and limits. Till now the photo-oculographic technics have been only applied in laboratory conditions. A new differential photo-oculographic procedure is presented. This optical method is based upon the measurement of gaze direction and ocular movement amplitude from the relative pattern of five reflected corneal dots and pupil image which are located in two different optical plans. The authors relate in detail the recording devices and processing materials for the computerized analysis of video signals. The preliminary results confirm the real advantages of the method which allows to record all sorts of ocular movements in clinical conditions.

Eye Movements↗
PubMed1990

[Comparative study of electrooculographic and photooculographic recordings].

The authors present the results of clinical application of a new invasive real time method for ocular movement recording. There is an optical system which measures the gaze direction from the video signals of five reflected corneal dots and pupil image. Their study is based upon 110 simultaneous P.O.G. - E.O.G. recordings of normal beings or patients having various oculomotor troubles. It appears that the heavy odds of such a new method is obvious. It allows to obtain an absolute measurement of eye positions in relation to the basic line whatever the pattern and axis of the moving may be. A quantitative evaluation of all movement parameters is in progress. It still remains to solve the problem of large deviations and the wearing of optical correction during the examination.

Electrooculography↗
PubMed1989

[Diffuse infiltrating retinoblastoma].

We report 3 new cases of diffuse infiltrating retinoblastoma, and we review the 21 cases of the literature. Clinical features are typical but must not be confused with uveitis. The average age of onset is about 7 years, later than the usual retinoblastoma. Clinical features associate ocular redness, pseudo hypopion, iris nodules, clusters on the pupil and in the anterior chamber, opacities on the posterior face of the cornea. Hypertension appears resistant to medical treatment. The vitreous is hazy but the retina is still visible. The ophthalmoscopic examination reveals exudates covering the peripheric retina, and gray infiltrated retina. Usually there is no focal tumour mass, but totally diffuse tumoral infiltration. Echographic examination does not reveal calcification as in typical retinoblastoma. Neoplastic cells are demonstrated in anterior chamber paracentesis. Cytologic examination of aqueous humor aspirates may be misinterpreted and should be evaluated carefully. Because of tumor cells seeding, lactate dehydrogenase assay is of diagnostic value, prior to considering definitive therapy. None of the tumors were bilateral. The prognosis after enucleation appears good.

Child↗
PubMed1989

[Postoperative secondary divergent strabismus. Statistical analysis of 160 consecutive exotropias].

Exotropias secondary to convergent squint surgery are fully different from primary exotropias. Their frequency appears to be largely variable according to the operative procedures. The computerized analysis of 160 consecutive exotropias reveals the compound nature of their motor impairments. In each case it is necessary to carry out a careful check up of various causal parameters, but the authors find they are not bound by simple correlations. In all cases an elongation reducing one or several muscles is noticed. Such anomalies are much more frequent and heavy than those observed in primary esotropias. Their iatrogenic origin is unquestionable. In 37% of the cases heavy capsular scars have been observed; their consequences on passive forces are obvious, but it is difficult to carry out their exact evaluation by the usual clinical tests. In that series the resulting surgical planning was made according to the various abnormal parameters had allowed the achievement of a good motor result in 89% of the cases. In 86% of the cases, only one additional operative procedure was necessary.

Esotropia↗
PubMed1986

[Spatial binocular adaptation in microtropia and orthotropia. Definition and method of measurement].

For a long time the problem of the functional recovery in convergent strabismus has been a hardly debated topic. For some authors, it is very rare; for others, on the other hand, the result is frequently achieved. Such disparities seem to be chiefly related to the tests used. The authors have selected 10 binocular tests and they carried out this scale in a prospective study in 100 cases of esotropias having normal moving performances following a medico-surgical management and in 20 normal cases. statistical correlations reveal that there is a very large disparity of "good answers" according to the tests; but there is no redundancy at all between them. Consequently for a relevant check up every single one is necessary. The total of "good scores" and differential values of ten tests allow to know the true state of binocular spatial adaptation. The statistical analysis shows that in secondary microtropias and orthotropias there is almost always an actual binocular spatial adaptation. Its level may be high, medium or low. The high margin is clearly different from the binocular scores in normal cases. Two events are very uncommon: a full recovery of binocular vision and the opposite condition of its complete suppression. The results of such a method give a clear explanation of conflicting opinions about the binocular evolution of convergent squints following medical and surgical management.

Adolescent↗
PubMed1985

[Statistical study of the basic angle and intensity of spasm in functional esotropia (surgical consequences)].

In esotropia surgery all statistical results give the correlation between the amount of the operative correction and the angle of deviation; but this last entity is without value, because a consistent deviation nearly ever exists in spite of protracted medical management; indeed it is usual to notice large spatial variations. In a prospective series of 122 cases the authors have carefully studied the basic angle, the amount of angular variations which give evidence of the strength of spasm, the deep narcosis angle and the muscle elongation test. The various statistical correlations are analyzed. It appears that the basic angle and the strength of spasm are two essential connected but distinct characteristics of innervational imbalance, and it is necessary to carefully evaluate each one. There exists a highly significant correlation between the degree of innervational troubles and the frequency of visco-elastic impairments. The authors make several statements about medical management, early surgery and one-step surgery. They give new guidelines for their operative plan with the Faden operation.

Anesthesia, General↗
PubMed1985

[Current epidemiology of strabismic amblyopia in France].

It is well known that good early management of squint prevents the appearance of functional amblyopia and, when it exists, allows a cure in more than 90% of cases. The authors report a series of 1 552 esotropias. Statistical analysis reveals that the present epidemiologic state of functional amblyopia is dismal. 47% of cases have an amblyopia in spite of 64.6% of children being previously treated. The mean age is 7 years 6 months. The therapeutic results after a 6 months range still shows 38% of poorly applied treatment, but 57% of well-managed patients recover normal visual acuity. The long range results (average 33 months) show that in 47% of cases the treatment was badly applied. On the contrary, 70% of patients having good management were successful. Two main reasons explain such a situation : firstly the lack of information and casualness of parents; and on the other hand faltering and unsuitable medical technics. The only real answer to such a problem is early medical management of every squint. According to the author's experience it seems that such a state is not a special feature of amblyopia epidemiology in the western part of France, but it is observed in the same way in many countries having high level medical care.

Age Factors↗
PubMed1982

[Surgical treatment of optical nystagmus (author's transl)].

Effective management improves the sensory-motor state of most optical nystagmus cases. Treatment is always medical and sometimes surgical. Previous complete sensory and motor examinations are necessary. A surgical cure is warranted by the extent of nystagmus, a torticollis, or when a squint is associated. The authors review the various clinical aspects, and their operative plan, which is simple in Kestenbaum's, more delicate in dissociated forms, convergence blockages and nystagmic squints. It is often very difficult in complex nystagmic impairments.

Diagnosis, Differential↗
PubMed1981

[Electro-oculographic study of vergence movements (author's transl)].

The study of vergence movements imperatively needs a recording method. Nowadays, in spite of its various drawbacks, electro-oculography is the most accurate method for clinical wants. The authors have studied the refixation vergence along a symmetrical inducing axis. With regard to both eyes in binocular and monocular fixations the analysis of a great lot of recordings in normal patients allows to reveal some phenomena unknown till now. In binocular fixation it is usual to notice a physiologic dyssynergy of vergence movements. The monocular fixations bear out evidence that Hering's Law doesn't apply to vergence movements. On the contrary they are submitted to a complete opto-motor dissociation, because the motor responses fully change according to the modalities of inducing visual inputs. In others respects, the analysis of all recordings proves that a vergence movement is made up with two synkinetic phases: a slow phase which was known for a long time thanks to physiological laboratory works; but also a fast phase having a saccadic feature. The fast vergence is related with a monocular visual attraction reflex and it is not bound only to the macular function.

Accommodation, Ocular↗
PubMed1981

[Electro-oculographie study of vergence movements. II. Asymmetric vergence (author's transl)].

In relation to symmetrical vergence, a study of asymmetrical vergence reveals, in normal cases, particular kinetic phenomena of the most marked degree. In binocular fixation, Johannes Müller's phenomenon is noticed on the axial eye. It exhibits reflex competition between fast and slow vergence, and is always impaired in amblyopias. Monocular fixation with the centered open eye induces a pure and slow consensual vergence on the excentric occluded eye. The movement is mainly be accommodative in nature, and anomalies are shown to very frequent. Monocular fixation with the excentric open eye induces a relative vergence characterized by a fast version phase, limited and corrected by a slow vergence phase. Relative vergence is largely impaired in amblyopias, convergence deficiencies, functional squints and oculo-motor palsies. Generally, the different methods for investigating kinetic vergence patterns reveal a more or less physiological asymmetry in sensori motor potentialities of each eye. This asymmetry strongly increases in nearly all oculo-motor disorders.

Electrooculography↗