Biomedical subjects

O Berges

Publications and source records attributed to O Berges.

At least 19 recordsLinked to original sources

PubMed2006

[Vascular tumours and malformation of the orbit].

Vascular diseases are an important part of orbital pathology. We describe vascular tumours of the orbit and vascular diseases with repercussion on the orbit, from intra or extra orbital origin. The classification of these abnormalities is difficult and several terms are used to describe the same histological entity. The objective of this work is, using the current classification, to illustrate the different imaging aspects of the most frequent vascular diseases of the orbit.

Aneurysm↗

PubMed2006

[Applications of noninvasive high-resolution ultrasound imaging in ophthalmology].

While ultrasonography has been applied to eye examination since the beginning of medical applications of ultrasound, the use of high frequencies is relatively recent in this context. Recent developments since the 1990s have made devices available that are well suited for examining the anterior segment as well as the posterior pole, providing precise data for corneal lesions, iris, chamber angle, and ciliary body abnormalities, and lesions of the papilla and macula.

Ciliary Body↗

PubMed2005

Sevoflurane effects on retrobulbar arteries blood flow in children.

BACKGROUND: Measure of blood flow velocity in retrobulbar vessels is performed to determine the severity of ophthalmic pathologies as glaucoma. In children, this measure is usually performed under general anaesthesia. Sevoflurane is known to not modify cerebral blow flow velocities. However, its effect on retrobulbar circulation is not known. This study was designed to evaluate the effect of sevoflurane on retrobulbar circulation flow velocity in children undergoing examination for ocular disorders under general anaesthesia. METHODS: Thirteen mechanically ventilated children (Fi(O2))=1) were included. Blood flow velocities of central retinal artery, ophthalmic artery, and middle cerebral artery were measured by Doppler ultrasound during 1 and 2 age-adjusted minimal alveolar concentration (MAC) sevoflurane anaesthesia. Intra-ocular pressure and non-invasive haemodynamic parameters were also measured. End-tidal carbon dioxide tension was controlled during all the study period. RESULTS: Mean arterial pressure decreased from 1 to 2 age-adjusted MAC sevoflurane (58 [12] vs 54 [12] mm Hg, P=0.01). In the ophthalmic artery, end diastolic velocity (EDV) decreased significantly at 2 MAC (1 MAC: 4.4 [4] cm s(-1) vs 2 MAC: 1.4 [2.4] cm s(-1); P=0.04) and resistivity index (RI) increased significantly (1 MAC: 0.83 [0.11] vs 2 MAC: 0.93 [0.09]; P=0.007). Systolic velocity, EDV, and RI remained constant in the central retinal artery and in the middle cerebral artery. CONCLUSION: High alveolar concentration of sevoflurane decreased blood flow velocity in the ophthalmic artery, but not in the central retinal and the middle cerebral arteries in children ventilated in hyperoxic condition. This effect was related to a decrease in mean arterial pressure. This vessel-dependent effect may be explained by the different autoregulatory mechanisms of these arteries. In the present hyperoxic conditions, the vascular effect of sevoflurane may have been limited in the central retinal artery and not in the ophthalmic artery.

Anesthesia, General↗

PubMed2005

[Macular hole evaluation with 10-MHz and 20-MHz ultrasonography and optical coherence tomography].

PURPOSE: To evaluate and compare the data provided by 10-MHz and 20-MHz ultrasonography and optical coherence tomography (OCT) in macular hole exploration. MATERIAL AND METHODS: Sixty patients with macular hole at different stages were included in the study from January 2002 to April 2003. All patients received three successive examinations: an echographic examination with a 10- and 20-MHz probe (Quantel Medical Cinescan) and an examination with optical coherence tomography (OCT) (Humphrey Zeiss). RESULTS: In stages I and II, the 10-MHz examination was not a useful tool; in certain cases the 20-MHz examination highlighted stage II macular holes. OCT was better than ultrasonography in all these cases: it clearly defined the outline of the hole and perifovea posterior vitreous detachment (PVD). In stage III, the 10-MHz examination only allowed the visualization of the high reflectivity of the prefoveal operculum; the 20-MHz examination could also measure the thickness of the macular neuroepithelium. OCT very precisely visualized the hole as well as the opercula and the detachment of the posterior hyaloid located in the macular area but still attached to the papilla. In stage IV, the 10-MHz examination confirmed total PVD. High-frequency ultrasound examination and OCT provided somewhat similar information. OCT provided the advantage of measuring the hole. DISCUSSION: It is possible now to use probes of frequencies higher than 10 MHz for the study of the posterior pole and the vitreomacular junction at the cost of a more reduced exploration area than that usually obtained with a 10-MHz probe and a lower reflectivity of the interfaces encountered. One is indeed very quickly limited by noise if the gain is increased. Usually, the standard gain with 20 MHz is close to 90 dB and beyond 100 dB, the images are uninterpretable because of noise. CONCLUSION: The 10-MHz ultrasonography is very useful for an overall assessment of the vitreous body, its mobility, and in searching for PVD. The 20-MHz examination gives very valuable information on the analysis of the vitreomacular junction, approaching the precision level provided by OCT. It demands a very rigorous examination protocol. OCT, however, remains better for the fine morphological study of this zone, unless opaque media studies are necessary to determine the maximum frequency usable to increase the space resolution of the lesions of the posterior pole. In this case, the combined ultrasonographic study using 10 and 20 MHz provides a valid diagnosis and a therapeutic approach to the posterior pole.

Humans↗

PubMed2005

[Adenocarcinoma in a pleomorphic adenoma of the lacrimal gland: a case study].

PURPOSE: To report a patient with an adenocarcinoma in a pleomorphic adenoma of the lacrimal gland. Adenocarcinoma constitutes a distinct group of epithelial malignancies of the lacrimal gland. METHODS: The clinical presentation, workup, surgical approach, and pathological findings were reviewed. RESULTS: A 56-year-old man presented with a 3-month history of a lacrimal fossa mass. This patient presented a painless mass in the upper outer eyelid with significant displacement of the globe. The tumor was localized to the lacrimal gland. Radiological investigations showed a round, well-defined lesion in the fossa of the lacrimal gland. We performed a lateral orbitotomy; en bloc resection was accomplished. The final specimen showed an adenocarcinoma in a pleomorphic adenoma. No recurrences were detected during follow-up. CONCLUSION: Although adenocarcinoma has rarely been reported in association with a pleomorphic adenoma of the lacrimal gland, this combination can exist. If the malignant tumor is limited in the pleomorphic adenoma, the prognosis appears to be better than in cases of local extension. Adjuvant therapy, radiation or others, are not useful.

Adenocarcinoma↗

PubMed2004

[Anterior segment tumor imaging: advantages of ultrasound (10, 20 and 50 MHz) and optical coherence tomography].

PURPOSE: Detail the role of different imaging techniques for diagnosis of tumors of the iris. MATERIAL AND METHODS: Sixty-one tumors of the iris were explored using ultrasound at 10 and 20MHz (Cinescan, BVI Quantel Medical) and 50MHz (UBM, Paradigm) and optical coherence tomography (OCT) (Humphrey Zeiss). RESULTS: Ultrasound should be used at frequencies of 20MHz or greater to precisely characterize, localize and measure a lesion. Ultrasound biomicroscopy (UBM) is inadequate to measure large tumors (extending toward the back of the ciliary body), because of the transducer and the considerably lower image quality caused by the lesion. Ultrasound alone cannot characterize a solid lesion, and moreover cannot differentiate benign and malignant lesions. Clinical notions are also important in diagnosis and patient management. OCT recognizes whether a lesion is liquid or solid in certain cases. CONCLUSIONS: With a tumor that seems solid, a 50MHz examination must be done rapidly, and if the entire lesion is difficult to see, a 20MHz ultrasound should be used. With a protruding iris, high-frequency ultrasound and OCT differentiate a cystic lesion from a solid mass, but only BMU provides a precise measurement and regular surveillance capabilities.

Anterior Eye Segment↗

PubMed2001

Sonographic, CT, and MR imaging findings in diffuse infiltrative retinoblastoma: report of two cases with histologic comparison.

SUMMARY: Diffuse infiltrating retinoblastoma is a rare form of retinoblastoma. We report two cases of this disease in which sonographic, CT, and MR imaging findings were compared with histologic studies obtained after enucleation. Although nonspecific, MR imaging provides valuable morphologic data for the diagnosis of diffuse infiltrating retinoblastoma and may help in decisions regarding enucleation.

Child, Preschool↗

PubMed2001

[Neovascular glaucoma following proton-beam therapy. Case report].

A 52-year-old-male patient was treated for a posterior choroid melanoma of the right eye. When it was diagnosed, it measured 6mm in thickness and 11.9mm for the largest diameter and had a typical mushroom shape. General investigations found no metastatic disease. It was treated with proton-beam irradiation. Seven years later, the patient experienced increased intraocular pressure associated with cataract and pain. The patient finally accepted enucleation, as the vision of this eye was completely lost and the eye had become painful. Histologic analysis of the eye showed changes affecting both the anterior and the posterior segments of the eye, mostly related to the tumor and the consequences of treatment. Neovascular glaucoma is a major complication that very often leads to enucleation.

Cataract↗

PubMed2001

[Uveal effusion in its pseudotumoral form. A case report].

Uveal effusion exhibits various clinical presentations, some of which may lead to erroneous diagnosis and mimic a choroidal tumor. A 73-year-old female patient displayed a choroidal lesion with a tumoral appearance spontaneously affecting her right eye. Ultrasonography did not establish the diagnosis, leaving doubt for a tumor. In addition to the tumor - like lesion, a moderate inflammation was found in her right eye. The clinical course was favorable and one month after the initial examination, no fundus abnormalities were observed. The delay imposed by the MRI examination contributed to the lack of any active treatment. Apart from cases occurring postoperatively, the diagnosis of uveal effusion may sometimes be difficult to establish. In order to avoid enucleation and even if ultrasonography is helpful in reaching the correct diagnosis, it seems appropriate to wait and regularly follow up the patients when the diagnosis is not certain. The clinical course might be helpful to establish the diagnosis. Our case suggests that in pseudotumoral forms of uveal effusion, we should repeat clinical examination and ultrasonography in order to manage these patients appropriately.

Aged↗

PubMed2000

[Choroidal melanoma. An anatomic-clinical case report].

A 78-year-old-male-patient had his left eye affected by a 10 mm thick choroidal malignant melanoma. The size of the tumor did not allowed to keep the eye, and no conservative treatment was used for therapy. Enucleation was performed and histopathological study of the eye showed a mushroom-shaped and mixed-cell choroidal melanoma, devoid of transcleral extension, but harboring intrascleral infiltration. A period of 2 year-follow-up without metastasis was observed since the removal of the tumoral eye.

Aged↗

PubMed2000

[Residual left orbital phlebolith. An anatomic-clinical observation].

A 29-year-old female patient displayed a dense and hard left orbital mass, inferiorly, 3 years after she was treated through a neurosurgical approach for a left orbital varix. The lesion was hyperdense on CT-scan and was removed through a trans-conjunctival approach, with an excellent result. The histological diagnosis was a phlebolith.

Adult↗

PubMed2000

[Unusual preseptal location of an orbital cavernous hemangioma in African patient].

Cavernous hemangioma is the most common primary vascular orbital tumor in adults. Generally the benign tumor arises within the muscle cone, revealed by proptosis with choroidal folds, and more rarely develops in other orbital localizations. We report the case of a 42-year-old female African patient who had a cavernous hemangioma in an unusual anterior localization. Clinically, a small superficial tumor was palpated in the right superior nasal orbital angle. After complete surgical excision, the histopathological study established the diagnosis of cavernous hemangioma

Adult↗

PubMed1994

[Collar-button choroidal melanoma. Anatomo-radiologic correlations].

Malignant melanomas of the choroid are the most frequent symptomatic eye tumours in adults. They often have a pathognomonic appearance, being collar-button or mushroom shaped due to rupture of Bruch's membrane by the tumoral mass. The ultrasonographic image of collar-button melanoma is well known: the head of the tumour is hyperechogenic and its base hypoechogenic. According to some authors, this is caused by difference in blood supply between the two parts. At MRI strongly pigmented melanomas emit a high-intensity signal on T1-weighted sequences and a low-intensity signal on T2-weighted sequences, but these characteristic features are inconstant. We present a case of collar-button melanoma explored by ultrasonography, colour Doppler Flow Imaging (CDFI) ultrasound and MRI, then enucleated. Flows and signals were different in front of, or behind the rupture of Bruch's membrane: ultrasounds showed a hyperechogenic image at the head and a hypoechogenic image at the base; on T2-weighted MRI sections intensity was greater in the head than in the base (head: 69 ms, base 180 ms) on CDFI, no flow was detectable in the head and very high flows were seen in the base of the tumour. Comparisons of these images with pathological findings, where there was no difference between head and base in melanin concentration and in cellular type (mixed or mainly epithelioid), led us to believe that the differences observed in images were essentially due to differences in blood supply between the two parts of the tumour constricted by the sides of the ruptured Bruch's membrane.

Bruch Membrane↗

PubMed1994

[Value of immersion B-scan ultrasonography in vitreo-retinal pathology].

Diagnosis immersion B Scan ultrasonography is very useful to study anterior segment lesions of the eye (angle of iris, anterior synechiae, iris and ciliary body tumors). We studied forty patients with posterior segment lesions of the eye with this technique. We think that it is useful to study anterior vitreous (cyclitic membranes, vitreoretinal relationships in front of ora serrata). It is useful to study the posterior segment of the eye with this immersion technique, in case of high hyperopia, microphthalmos, phtysis bulbi with retinal detachment and to evaluate acute vitreous hemorrhages, vitreous membranes in case of proliferation diabetic retinopathy, tractional retinal detachment and vitreoretinal adhesions. All the structures were better defined with the immersion technique than with the contact technique: with the immersion technique, these anterior structures are located close to the focus point of the probe (which is the case with the contact technique).

Eye Diseases↗

PubMed1993

[Cavernous hemangioma of the orbit].

Cavernous hemangioma is one of the commonest primary orbital tumors. Painless and progressive reducible unilateral proptosis causing a variable degree of hyperopia is the usual clinical presentation. The case of a 39-year-old-female patient is reported. The clinical presentation was unilateral left axial proptosis with acquired hyperopia. Imaging studies showed a well circumscribed mass in the orbit, a superior neuro-surgical approach allowed complete resection of the tumor, and histopathology revealed the diagnosis of cavernous hemangioma.

Adult↗

PubMed1992

Colour Doppler flow imaging of the orbital veins.

Experience is given from 79 orbital lesions examined by Colour Doppler Flow Imaging (CDFI) Dec. 1990 to Febr. 1992. We further examined 167 ocular tumours, or tumour-like lesions, and 32 ophthalmic cases groups as 'various'. Here, our experience is summarized concerning the flow patterns demonstrated in orbital veins, pathologic and normal. Adding dynamic and quantitative information to the clinical evaluation CDFI proved superior to conventional B- and A-mode echography. The method is essential in assessing and establishing the diagnosis of low flow dural malformations of the cavernous sinus. Pulsed Doppler appears helpful for the decision of therapy (embolization) and its optimum timing.

Arteriovenous Fistula↗

PubMed1992

High resolution B mode echography and colour Doppler (CDFI) of the macula.

Based on experience from 30 patients the usefulness of high resolution B-scan echography and colour Doppler flow imaging for evaluating lesions of the macula is discussed. With B-scan there is a high detectability of even very flat lesions (less than 1 mm) but fluorescein angiography still gives more detail regarding specific diagnosis. In lesions thicker than 2 mm the Doppler imaging technique adds valuable information about vascularity, to make the assessment of differential diagnosis more exact. The results are considered preliminary; obviously focused ultrasound transducers of high frequency (20 mHz and above) will increase the possibilities of the method.

False Negative Reactions↗

PubMed1992

[Pilomatrixoma of the eyelid. Apropos of a case].

Primary adnexal tumors of the eyelids are quite uncommon. This diagnosis should be considered in the case of a sub-epidermal tumor. We report the case of a 25-year-old female patient presenting with a left eyelid nodular tumor, which appeared clinically as a whitish swelling of the lateral part of the eyelid, covered by normal epidermis. Ultrasonography showed a heterogeneous structure probably containing calcified areas. Complete surgical removal was performed under local anesthesia. Macroscopically, the tumor was encapsulated, with an irregular surface, and it appeared stony under section. Microscopically, it was characteristic of a pilomatrixoma, with sheets of mummified cells devoid of nuclei, either clear or basophilic, and partially calcified. Neither granulomatous reaction nor ossification were observed. This clinicopathological report recalls that pilomatrixoma may appear as a single nodular tumor of the eyelid.

Adult↗