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O Bernasconi

Publications and source records attributed to O Bernasconi.

11 recordsLinked to original sources
PubMed2000

[Study of panophthalmitis after cataract surgery from 1997 to 1999].

PURPOSE: To define the clinical outcome and microbiological pattern of bacterial endophthalmitis that were referred at the Jules Gonin Eye Hospital from January 1997 to September 1999. METHODS: Patients were recorded in a computerised databank and were managed according to a standard protocol. An anterior chamber tap combined with a vitreous biopsy by the pars plana was performed in all patients. The treatment included an intravitreal injection of 1 mg Vancomycin and 400 micrograms Amikacin diluted in 0.2 ml NaCl 0.9%. Postoperatively hourly therapy Cefazolin 50 mg/ml and Garamycin 9 mg/ml was applied. To determine possible risks factors a standard form was sent to all referring surgeons. The following data were analysed: delay of onset, risk factors, initial and final visual acuity. RESULTS: From January 1997 to September 1999, 31 patients were referred. 18/31 (58%) of the cases were admitted between April and June of each years. The mean age was of 75 +/- 10 years. Initial visual acuity ranged from light perception to 20/40. 17/31 of the patient's cultures were positive. The major pathogen were Staphylococcus epidermidis in 9/31 patients and Staphylococcus aureus in 4/31 patients. No correlation between the endophthalmitis and the surgical technique or perioperative management of the patient, could be determined. Visual outcome was significantly improved in 56.7% of the patients. CONCLUSIONS: The severity of outcome could be correlated to the type of bacteria isolated. The high prevalence of panophthalmitis from March to June suggests that a climatic factors may be involved in its pathogenesis.

Aged↗
PubMed1999

Indocyanine green angiography features in toxoplasmic retinochoroiditis.

BACKGROUND: Indocyanine green (ICG) angiography detects the infrared fluorescence of ICG through the retinal pigment epithelium, providing visualization of the choroidal vascular network. The aim of this study was to analyze ICG angiographic features in toxoplasmic retinochoroiditis. METHODS: Indocyanine green angiography was performed according to a standard uveitis angiographic protocol in 28 consecutive patients diagnosed with acute toxoplasmic retinochoroiditis. Indocyanine green angiographic data were compared with fundus color photographs and fluorescein angiography (FA). Evolution of ICG angiographic signs after therapy (pyrimethamine and sulfadiazine with or without a tapering course of oral corticosteroids) was further analyzed. RESULTS: The main focus of retinochoroiditis was hypofluorescent at all phases of the ICG angiogram in 25/28 cases (89%), but late phase (35-45 minutes) ICG hyperfluorescence was seen in three cases, all of which had very superficial retinal involvement. The most striking features, however, were multiple hypofluorescent satellite dark dots (SDD), present in 21/28 cases (75%). In 17 of these 21 patients, hypofluorescent areas were silent on FA and fundus examination. After therapy, SDD disappeared from most of the cases. Furthermore, the hypofluorescence under the main lesion was markedly reduced or disappeared in some cases. CONCLUSIONS: Indocyanine green angiography showed that toxoplasmic retinochoroiditis is a more widespread process than is clinically suspected because it extends beyond the visible lesions. Indocyanine green angiography appears useful in assessing the extent of choroidal involvement and the evolution of lesions. It might become an important follow-up parameter and also may give new insights into the pathophysiology of this disease. Based on the findings gathered so far, ICG angiography appears indicated in the workup and management of toxoplasmic retinochoroiditis.

Acute Disease↗
PubMed1999

[Non-traumatic orbital diseases in Lausanne from 1965 to 1996].

PURPOSE: Describe our series of patients with non-traumatic orbital diseases. PATIENTS AND METHODS: A series of patients with non-traumatic orbital diseases seen in Lausanne from 1965 to 1996. RESULTS: Inflammatory conditions and infections were the most frequently observed diseases. Pseudotumors were the most representative. Orbital involvement in systemic diseases (for example Graves' disease), vascular tumors and malformations, as well as orbital involvement in rhinological diseases were also often observed. Orbital cysts, particularly dermoid and epidermoid cysts, and orbital diseases of nervous origin were exceptional. Finally, diseases of the lacrimal gland, metastases, secondary tumors from adjacent structures and diseases of mesenchymal origin were more rare. DISCUSSION: This study also reports the proportion of male and female patients and the percentage of proptosis.

Adolescent↗
PubMed1998

Toxoplasmic retinochoroiditis: resolution without treatment of the perilesional satellite dark dots seen by indocyanine green angiography.

PURPOSE: Satellite dark dots (SDD) seen by indocyanine green angiography (ICGA) around the main retinochoroiditis focus are described in 75% of cases. Whether SDDs represent subclinical infectious foci or just a perilesional inflammatory reaction is not known. The purpose here was to report a case giving additional information on this question. METHODS: We analysed the evolution of ICGA SDDs in a patient with recurrent toxoplasmic retinochoroiditis who received no antitoxoplasmic treatment because the lesion was located outside the areas where treatment is classically recommended. RESULTS: The patient had a recurrence of retinochoroiditis on the nasal aspect of the disc about 2 disc diameters away from the disc. It was decided to observe the recurrence before introducing treatment. Diminution of SDDs occurred by 3 weeks after the initial ICGA, and complete resolution was observed on a follow-up ICG angiogram obtained 8 weeks after the initial visit. CONCLUSION: Resolution of ICGA SDDs in toxoplasmic retinochoroiditis seems to occurring a similar fashion whether or not the retinochoroiditis is treated by anti-toxoplasmic drugs, indicating that SDDs probably represent a non-infectious perilesional inflammatory reaction.

Acute Disease↗
PubMed1998

Indocyanine green angiographic findings in sympathetic ophthalmia.

PURPOSE: To analyze indocyanine green angiography (ICGA) features in two cases of sympathetic ophthalmia using a standard angiography protocol for posterior uveitis. METHODS: Report on two patients who suffered from penetrating ocular injuries 45 and 8 years before sympathetic ophthalmia was diagnosed and confirmed by histopathological examination of the enucleated eye. In addition to routine examination and fluorescein angiography, initial and follow-up ICGAs were performed. RESULTS: The first patient, with a phthisic right eye following s shotgun injury, consulted 6 months after cataract extraction in his good left eye for progressive visual loss due to a neovascular membrane in a moderately inflamed eye. The second patient consulted 8 years after a perforating injury of his right eye by a metallic foreign body because of recent visual loss and inflammation in his good left eye. ICGA of both patients showed numerous hypofluorescent dark dots visible at the intermediate phase, some becoming isofluorescent at the late phase and resolving after long-term corticosteroid therapy, others remaining hypofluorescent until the late phase. CONCLUSION: The two patterns of hypofluorescent areas, either persisting throughout angiography or fading in the late phase, were interpreted respectively as cicatricial and active lesions. ICGA gave determining additional information on choroidal involvement and on subsequent evolution of lesions.

Adult↗
PubMed1998

[Is there a primary and secondary torsion deviation in paralysis of the grand oblique muscle?].

BACKGROUND: An extraocular muscle palsy is conventionally characterized by a deviation of the visual axes, this being greater when measured with the affected eye fixing. By definition and illustrating Hering's law, this secondary angle of deviation is greater than the primary one, measured with the sound eye fixing. We present here a comparative study of the amount of subjective excyclodeviation measured in patients suffering from IVth nerve palsy, with the sound or affected eye fixing. METHODS: Two groups of patients were entered into the study: Group 1 (N = 54) for superior oblique palsies studied retrospectively and Group 2 (N = 14), for a prospective study of those recently acquired (post-traumatic) and followed over 6 months. In both groups, measurements were made at two stages, early (1 to 7 weeks after onset) and late (4 to 6 months later). RESULTS: In both groups, the majority of cases showed a greater secondary torsional deviation, the difference between this and the primary deviation lessening on late stage measurements. CONCLUSION: In both groups, the difference between primary and secondary torsional deviation was not statistically significant.

Exotropia↗
PubMed1998

[Unilateral accommodation spasm: a diagnostic pitfall!].

BACKGROUND: Accommodation-convergence spasm (spasm of the near reflex) is usually bilateral, resulting in increased myopia, convergence, and miosis. Unilateral spasm of accommodation has rarely been reported. PATIENTS: We investigated three females (age range 10-19 years) referred for investigations of retrobulbar optic neuritis (2 cases) and decompensated esophoria (1 case). RESULTS: They all presented unilateral spasm of accommodation with visual loss due to increased myopia (-3.5 to -11.75 diopters). Apart from that, results of neuro-ophthalmological examination were normal. CONCLUSIONS: Unilateral accommodation spasm is rare and can mimic retrobulbar optic neuritis and convergent strabismus. The three components of the accommodation-convergence spasm may not always be present simultaneously. Recognizing such an entity is important to prevent the patient from useless, costful and potentially harmful investigations.

Accommodation, Ocular↗
PubMed1997

Toxoplasmic retinochoroiditis: new insights provided by indocyanine green angiography.

PURPOSE: To analyze features of indocyanine green angiography associated with recurrent toxoplasmic retinochoroiditis. METHODS: Indocyanine green angiography was performed according to a standard protocol and correlated with clinical signs and fluorescein angiography in 12 eyes of 12 consecutive patients with recurrent toxoplasmic retinochoroiditis. RESULTS: In 10 of 12 eyes with recurrent toxoplasmic retinochoroiditis, indocyanine green angiography showed multiple satellite dark dots not seen on fluorescein angiography or clinical examination of the fundus. CONCLUSION: Indocyanine green angiography shows that recurrent toxoplasmic retinochoroiditis is more widespread than clinically visible lesions indicate. Indocyanine green angiography is useful in assessing the extent of involvement of recurrent toxoplasmic retinochoroiditis and the evolution of lesions and might also provide insights into the pathophysiology of the disease.

Angiography↗
PubMed1997

Recurrent toxoplasmic retinochoroiditis. Significance of perilesional satellite dark dots seen by indocyanine green angiography.

PURPOSE: To suggest an explanation for the satellite dark dots seen by indocyanine green angiography (ICGA) around the main focus of a toxoplasmic retinochoroiditis. METHODS: The authors analysed the evolution of ICG satellite dark dots in two cases of recurrent toxoplasmic retinochoroiditis receiving anti-toxoplasmic treatment not including corticosteroids. RESULTS: Both patients had a recurrence on the peripheral aspect of scars from previous retinochoroiditis and were treated with pyrimethamine (50 mg/day) and sulfadiazine (4 g/day) for seven weeks. Resolution of satellite ICG dark dots was observed in both cases on the follow-up ICG angiogram performed at the end of treatment. CONCLUSION: Resolution of ICG satellite dark dots after anti-toxoplasmic treatment not including corticosteroids tends to indicate that there is probably an infectious component in these hypofluorescent dots and that they probably do not represent a purely inflammatory perilesional reaction.

Adult↗
PubMed1995

[Comparative study of administration time of mitomycin C in trabeculectomy: 2.5 or 5 minutes?].

BACKGROUND: To analyse the inocuity and the incidence of complications of a 0.2 mg/ml solution of Mitomycin C (M.M.C.), for two application time, 2.5 or 5 minutes. METHODS: 110 trabeculectomies were realised in 99 patients; they were high-risk (HR) patients in 66 cases, and low-risk (LR) patients in 44 cases. M.M.C. was used for 2.5 minutes in 44 cases (20 HR patients, 24 LR patients), and for 5 minutes in 66 cases (46 HR patients, 20 LR patients). RESULTS: In both groups HR and LR, there is no significant difference on the pressure lowering whether the 0.2 mg/ml solution of M.M.C. is used during 2.5 minutes or 5 minutes (Student t-test at 6 months: HR: p = 0.224; FR: p = 0.542). For the early and late complication in the HR group, there is no significant difference whether M.M.C. is used 2.5 or 5 minutes. In the LR group, there is a significant difference for hypothalamy (p = 0.035) and choroidal detachment (p = 0.027). In this LR group, there is no significant difference in the late complications. CONCLUSIONS: A 0.2 mg/ml solution of M.M.C., when indicated, may be used as well in the HR and LR group during 2'30". In the HR group, if there are several risk factors, we propose to adapt the application time between 2.5 and 5 minutes, and increase it by 1/2 or 1 minute for each risk factor.

Adult↗