Biomedical subjects
Publications and source records attributed to P Bec.
An immunological study of aqueous humour and serum was carried out in experimental ocular candidosis in rabbits. Anti-candida antibody titres, immunoglobulin G, and albumin levels were evaluated in the aqueous humour and in the serum. A local synthesis of anti-candida antibodies was detected in numerous rabbits at the height of clinical activity of the lesions.
An anterior chamber paracentesis was carried out on six patients with candida endophthalmitis and on control subjects. We endeavoured to find out if there was local production of antibodies by evaluating the anti-candida antibody titres, the immunoglobulin G, and the albumin levels in the aqueous humour and in the serum. A significant difference in the level of specific antibodies between patients and controls was found. Local synthesis of anti-candida antibodies was discovered in five out of six patients with candida endophthalmitis. There would seem to be a correlation between the severity of uveitis and antibody titres.
We studied 11 healthy rabbits and 15 rabbits with experimentally induced Candida endophthalmitis. Using a microbiological procedure, ketoconazole levels were determined 1, 2, 4, 8 and 24 h after its oral administration. Ketoconazole penetration was average in the aqueous humour, significant in tears and poor in the vitreous. Vitreous penetration was not detectable in healthy rabbits or in rabbits with chorioretinits exhibiting little or no vitreous reaction. Such penetration was only significant in rabbits exhibiting massive vitreous exudation; however, in such rabbits, penetration was not always observed (only in 2 out of 6 animals). Given these results, the treatment of Candida endophthalmitis in humans using ketoconazole would appear to be of questionable value.
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Adjustable sutures have been used as a curative procedure in 31 cases of diplopia, 16 cases of plegic causes, 4 cases of acute concomitant squint and 11 cases of mechanical strabismus: thyroid myopathy, orbital fracture, oculomotor imbalance after scleral indentation. In oculomotor paralysis if a few functional motor units remained at plegic muscle level, we were able to obtain new rotational balance by combining, with adjustable sutures, recession and resection of the couple agonist-antagonist. On the other hand, if no functional motor unit remained, it was then necessary to turn to the muscular translocation process modulated by adjustable surgery. In acute concomitant strabismus, adjustable retroposition of the medial rectus enabled us to fall back into an area controlled by fusional vergencies. Lastly, in mechanical strabismus by passive limitation, adjustable sutures usually enabled hyperaction of the contralateral synergists to be controlled and to bind a new rotational balance, compatible with a simple binocular field of vision. The advantage of this technique was to adapt, on adjustment, the motor response to the new innervational background which had disappeared under anaesthesia.
The authors studied 33 maculopathies in 54 patients affected by typic retinitis pigmentosa: atrophic macular degeneration 31 cases (49%); cystoïd macular oedema: 1 case (3%) and macular retraction syndrome: 1 case (3%). These results are confronted with those of the literature. Two therapeutical trials based on pathogenical hypothesis were conducted. The patient with cystoïd macular oedema was treated by Hyperbar oxygenotherapy, basing one of selves on the theory ischemia. Six other patients with atrophic foveolopathies were treated by the cyclophosphamide, according to the autoimmune theory. In the first trial, the result was positive. In the second one, the results did not permit any available conclusion.
An increasing frequency of ocular lesions due to Candida albicans has been reported, but clinical detection of lesions, which may cause permanent blindness, remains difficult. Hematogenous endophthalmitis caused by Candida albicans in the rabbit is a useful model to study the pathogenesis of the disease, and perhaps to find new methods of biological diagnosis. A suspension of Candida albicans was injected in 15 rabbits, according to the method described by Edwards et al. In 1975, causing uni or bilateral chorioretinitis in 12 of them. Unaffected eyes were chosen as controls. After aspiration of the anterior chamber fluid, serum and aqueous humour titres of specific antibodies were determined. A local synthesis of IgG antibodies was detected, after comparison of the titres of specific antibodies in the aqueous humour and in the serum, related to the serum and aqueous humour concentrations of IgG antibodies. According to a formula proposed by Witmer and Desmonts in ocular lesions due to different pathological agents, we calculated the "C" coefficient: C = antibody titres aqueous humor/serum x IgG serum/aqueous humor. A local synthesis of specific antibodies in cases of experimental endophthalmitis leads us to believe that aqueous humour aspiration could be used in the diagnosis of endophthalmitis in humans.
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Two patients presenting ocular complications of hyperviscosity syndrome in Waldenström's macroglobulinemia have been treated by plasmapheresis after inefficiency of immunosuppressive therapy. Plasma exchange seems an useful treatment as shown by clinic and angiographic improvement. In each case improvement of retinopathy was correlated with decrease of serum IgM level and blood viscosity measured by isotopic method. Fluorescein angiography, easily repeated, seems a very good method for following hyperviscosity syndrome in Waldenström's macroglobulinemia.
The efficiency of a light amplifier system for the improvement of night vision has been tested on 30 normal subjects and on subjects suffering from night blindness including 36 patients with pigmentary retinopathy, 18 myopic patients with night blindness and 12 patients with senile cataracts. In all cases, the scotopic vision presented a great improvement and it reached up to half of photopic vision. The use of the light amplifier would certainly provide a considerable improvement for subjects suffering from night blindness and mostly for those suffering from pigmentary retinopathy. But two conditions are necessary for this: miniaturization of the device and absence of major macular lesions in the patient.
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