Biomedical subjects

M-L Le Lez

Publications and source records attributed to M-L Le Lez.

3 recordsLinked to original sources

PubMed2004

[Post operative Enterococcus faecalis endophthalmitis: three case report].

We report three cases of endophthalmitis following cataract extraction. Enterococcus faecalis was the causative organism in all of them. Initial visual acuity was only light perception in all cases, final visual acuity was negative light perception in two cases, and light perception in one case. After initial improvement, inflammation was exacerbated in one patient and evisceration realized. The capsular bag was examined using scanning electron microscopy and it was shown that enterococci were adherent to the capsular bag, four months after the onset of the infection. Enterococcus faecalis can be the causative agent both of an acute and a chronic form of post operative endophthalmitis. Experimental studies on rabbit eyes could explain the poor prognosis of these endophtalmitis and focused on bacterial toxins. The contamination appears to be post operative, because Enterococcus faecalis is not a commensal agent of the conjunctiva. So we have to inform our patients about some hygienic habits, to prevent from this devastating complication of cataract surgery.

Aged↗

PubMed2004

[Repeated pulse corticosteroid therapy in Vogt-Koyanagi-Harada disease. A case report].

Vogt-Koyanagi-Harada disease is an autoimmune bilateral uveitis that occurs in people with genetic sensitivity. Diagnosis was based on the association of ocular inflammatory manifestations such as diffuse choroiditis, with or without anterior uveitis, and extraocular manifestations such as meningismus, tegumentary or auditory findings. Intravenous pulses of corticosteroid followed by oral corticosteroid is the mainstay therapy. We present the case of a woman who showed a first improvement of symptoms with three consecutive daily pulses of corticosteroid, but none during the following oral therapy. A second phase of intravenous pulses of corticosteroid, a Month after the first one, induced great improvement in symptoms and retinal findings, whereas oral therapy seemed not to be effective. This case provides the opportunity for a discussion on the advantages of multiple pulses of corticosteroid at the acute phase of this disease, because of its vascular effects associated with anti-inflammatory effects.

Administration, Oral↗

PubMed2002

Follow up by colour Doppler imaging of 102 patients with retinal vein occlusion over 1 year.

BACKGROUND/AIM: Retinal vein occlusion (RVO) is one of the most frequent ocular vascular diseases and leads to severe vision impairment. Colour Doppler imaging (CDI) is the first method which allows distinct evaluation of arterial and venous velocities in RVO. CDI is valuable for diagnosis of RVO and shows the effects of isovolaemic haemodilution. Patients with RVO were monitored by CDI for 1 year in order to clarify venous and arterial involvement in the pathogenesis of this disease. METHODS: Patients with RVO were monitored prospectively for 1 year with clinical examinations, fluorescein angiography, and CDI every 3 months. 102 adults referred for RVO for less than 2 months were enrolled. Unaffected eyes were used as control. The maximum systolic and diastolic flow velocities and the resistance index (RI) were measured in the central retinal artery (CRA) and the maximum and minimum blood flow velocities in the central retinal vein (CRV). RESULTS: During the year of observation, branch retinal vein occlusion (BRVO), ischaemic central retinal vein occlusion (CRVO), and non-ischaemic CRVO had a distinct pattern of venous velocity changes. BRVO had a similar profile to that observed in controls. Venous velocities were continuously lower in central forms, with the lowest values in ischaemic occlusion. In contrast, a brief decrease in arterial diastolic velocity was observed in ischaemic CRVO at presentation, correlated with arteriovenous passage time on fluorescein angiography, but with rapid normalisation. CONCLUSIONS: CDI findings were correlated with the type of RVO at all times during follow up. CDI showed persistent impairment of central venous velocity in CRVO whereas there was a fast initial values recovery of the arterial velocity. These results using CDI show strong evidence of a primary venous mechanism in RVO.

Adult↗