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Biomedical subjects

P Massin

Publications and source records attributed to P Massin.

At least 19 recordsLinked to original sources
PubMed2001

Foveal pseudocyst as the first step in macular hole formation: a prospective study by optical coherence tomography.

OBJECTIVE: To establish the natural history of a series of impending macular holes presenting as foveal pseudocysts using optical coherence tomography (OCT). DESIGN: In a prospective observational case series, patients exhibiting a foveal pseudocyst on biomicroscopy were examined with OCT and were followed up for 3 to 26 months (mean, 9.4 months) PARTICIPANTS: Twenty-two eyes of 20 consecutive patients examined for a macular hole in the fellow eye or reporting visual symptoms in only one eye, in whom a foveal pseudocyst was diagnosed on OCT. METHODS: In all cases, fundus biomicroscopy and OCT findings were compared. MAIN OUTCOME MEASURES: Biomicroscopic fundoscopy, OCT scans, and visual acuity. RESULTS: Eight foveal pseudocysts occurred in the fellow eye of an eye with a macular hole, and 14 were diagnosed in patients with unilateral visual symptoms. In four of the 22 eyes, the macula was considered normal on biomicroscopy. In the 18 others, biomicroscopy detected a foveal pseudocyst, radial striae, a yellow spot or ring, or a combination of these findings. No posterior vitreous detachment was seen on biomicroscopy in any of the eyes. On OCT, the cystoid space occupied the inner part of the foveal tissue in the stage 1A impending hole; a stage 1B impending hole corresponded to a cystoid space that extended posteriorly, disrupting the outer retinal layer. During the follow-up period, three pseudocysts evolved into full-thickness macular holes, four turned into lamellar holes, seven resolved completely after detachment of the posterior hyaloid, and eight remained unchanged for a long time. CONCLUSIONS: Foveal pseudocysts are a specific entity occurring either as a primary ocular involvement or in the fellow eye of an eye with a macular hole. Foveal pseudocysts are the first step of full thickness macular hole formation, but they also may evolve into a lamellar hole, may persist unchanged for months, or may resolve completely. Foveal pseudocyst formation may be the result of the incomplete separation of the vitreous cortex at the foveal center and the particular structure of the foveal Müller cells.

Aged↗
PubMed2000

Optical coherence tomography of idiopathic macular epiretinal membranes before and after surgery.

PURPOSE: To examine the preoperative and postoperative anatomical features of the macula using optical coherence tomography in patients who underwent surgery for epiretinal membrane and to correlate these features with functional results. METHODS: In a noncomparative interventional series, 62 eyes of 62 consecutive patients operated on for an idiopathic epiretinal membrane were followed up using a standardized protocol. Preoperative and postoperative examination included best-corrected visual acuity using an Early Treatment Diabetic Retinopathy Study chart, biomicroscopy of the fundus with a contact lens, fundus photography with blue and green filters, fluorescein angiography, and optical coherence tomography. RESULTS: Median preoperative visual acuity was 20/60 (range, 20/32 to 20/320). Median postoperative visual acuity was 20/40 (range, 20/20 to 20/160). Fifty-one eyes (82%) obtained visual acuity of 20/50 or better. Preoperatively, all eyes had increased macular thickness (mean, 419 +/- 105 microm; range, 265.5 to 689 microm), with disappearance of the foveal pit. An epiretinal membrane was visible on optical coherence tomography scans in 26 cases (42%). Intraretinal cystic spaces were present in the thickened macular tissue in 15 cases but corresponded to cystoid macular edema on fluorescein angiography in only three. Postoperatively, mean macular thickness decreased to 300 +/- 65 microm (range, 185 to 511 microm) but returned to normal in only three eyes. The foveal pit reappeared in 20 eyes. Preoperatively, visual acuity correlated with macular thickness (r = 0.56, P <.0001), but not postoperatively (r = 0.12, P =.37). CONCLUSION: Macular thickness decreases after epiretinal membrane surgery, but the macular profile rarely returns to normal. However, this does not preclude satisfactory improvement of visual acuity.

Aged↗
PubMed2000

Central retinal artery occlusion associated with head or neck pain revealing spontaneous internal carotid artery dissection.

PURPOSE: To report two cases of head or neck pain and central retinal artery occlusion associated with spontaneous dissection of the ipsilateral internal carotid artery. METHODS: Case reports. RESULTS: We describe two cases of sudden visual loss caused by central retinal artery occlusion. Both cases were preceded by ipsilateral headaches or neck pain and tinnitus. The patient had no other neurological signs or history of trauma. In both cases, cerebral angiography revealed ipsilateral internal carotid artery dissection. CONCLUSION: Ipsilateral headache or neck pain with tinnitus preceding central retinal artery occlusion is highly suggestive of internal carotid artery dissection. Early diagnosis and treatment may reduce the risk of hemispheric stroke.

Adult↗
PubMed2000

Acute transient myopia induced by indapamide.

PURPOSE: To report on a case of acute transient myopia associated with ciliochoroidal detachment induced by indapamide. METHOD: Case report. Clinical examination, ultrasonography, and fluorescein angiography were performed during the acute phase of disease and convalescence. RESULTS: After indapamide was discontinued, acute bilateral myopia, which was associated with anterior chamber shallowing and diffuse choroidal thickening, resolved spontaneously 8 days after onset. The initial angiography showed scattered islands of delayed fluorescein filling that disappeared without any permanent change by day 30. CONCLUSION: Indapamide can induce spontaneously resolving transient myopia associated with diffuse choroidal thickening.

Acute Disease↗
PubMed2000

Long-term incidence of reopening of macular holes.

OBJECTIVE: To report the incidence of macular hole reopening after initial successful surgery. DESIGN: A noncomparative retrospective case series. PARTICIPANTS: From a series of 137 consecutive cases of idiopathic macular holes operated on between August 1993 and May 1996, the authors analyzed the charts of 116 cases of successful surgery. SETTING: A single university-based ophthalmology department. INTERVENTION: Pars plana vitrectomy, posterior hyaloid peeling, fluid-air and air-gas exchange with a nonexpansile 17% C2F6 mixture followed by face-down positioning. Eighty-eight patients (64%) received autologous platelets as a biologic adjuvant. The anatomic success rate at the first postoperative month was 116 of 137 (85%). One hundred and six patients (91%) were followed up for more than 2 years. MAIN OUTCOME MEASURE: Macular anatomic status. RESULTS: Mean follow-up was 27 months. Eleven eyes of 11 patients (9.5%) had reopening of the macular hole. The mean period between hole surgery and reopening was 15.4 months (range, 8-29). In 8 of these 11 cases, reopening occurred after cataract extraction. In two cases, an epiretinal membrane was noted. In another case cystoid macular edema was present. The final anatomic success rate with one surgical procedure was 105 of 137 (77%). Eight reopened holes were reoperated on and all were anatomic successes at 1 month. However, four patients experienced a second reopening. CONCLUSIONS: Macular hole reopening occurred in 9.5% of cases (11 of 116). The cause of reopening might have been any anatomic stress such as epiretinal membrane formation or macular edema. However, in most of our reopened cases, no definite cause was evident. Four patients experienced recurrent reopening.

Aged↗
PubMed2000

The anatomic basis for the concept of lateralized femoral stems: a frontal plane radiographic study of the proximal femur.

We determined the range of sizes for a system of monoblock femoral prostheses that would provide adequate (a term defined in the text) fill in the frontal plane and restore femoral offset and leg length. We performed an anatomic study, based on measurements in 200 anteroposterior pelvic radiographs. If diaphyseal filling implants are to be used, 9 sizes are sufficient to obtain excellent canal filling and restoration of femoral offset in >80% of cases, assuming that the level of neck osteotomy can vary over a 1-cm range. When using metaphyseal filling implants, only a limited adjustment can be obtained from the level of neck osteotomy. A system limited to 8 sizes approximates the anatomy of the femoral canal with satisfactory precision in 73% of cases. If such a system is provided with only a single neck shaft angle for each stem size, it does not allow restoration of the biomechanical center of the hip in >67% of cases. A system of 8 sizes of 1 neck/shaft angle and a 22-mm modular head restores the anatomy in only 49% of cases. Approximating the frontal anatomy of 85% of femora with an implant filling the metaphysis requires at least 15 sizes distributed in 3 metaphyseal configurations, each supplied with 2 different neck shalt angles.

Aged↗
PubMed2000

Genetic analysis of the compatibility between polymerase proteins from human and avian strains of influenza A viruses.

In order to determine how efficiently the polymerase proteins derived from human and avian influenza A viruses can interact with each other in the context of a mammalian cell, a genetic system that allows the in vivo reconstitution of active ribonucleoproteins was used. The ability to achieve replication of a viral-like reporter RNA in COS-1 cells was examined with heterospecific mixtures of the core proteins (PB1, PB2, PA and NP) from two strains of human viruses (A/Puerto Rico/8/34 and A/Victoria/3/75), two strains of avian viruses (A/Mallard/NY/6750/78 and A/FPV/-Rostock/34), and a strain of avian origin (A/Hong Kong/156/97) that was isolated from the first human case of H5N1 influenza in Hong Kong in 1997. In accordance with published observations on reassortant viruses, PB2 amino acid 627 was identified as a major determinant of the replication efficiency of heterospecific complexes in COS-1 cells. Moreover, the results showed that replication of the viral-like reporter RNA was more efficient when PB2 and NP were both derived from the same avian or human virus or when PB1 was derived from an avian virus, whatever the origin of the other proteins. Furthermore, the PB1 and PB2 proteins from the A/Hong- Kong/156/97 virus exhibited intermediate properties with respect to the corresponding proteins from avian or human influenza viruses, suggesting that some molecular characteristics of PB1 and PB2 proteins might at least partially account for the ability of the A/Hong Kong/156/97 virus to replicate in humans.

Animals↗
PubMed2000

Superselective ophthalmic artery fibrinolytic therapy for the treatment of central retinal vein occlusion.

AIM: To study the effect of superselective ophthalmic artery fibrinolysis as a treatment for central retinal vein occlusion (CRVO). METHODS: Retrospective, university based single centre study. The charts of 26 eyes of 26 patients treated were reviewed. Among the 26 patients, there were nine cases of combined artery and vein occlusion, three cases of combined cilioretinal artery and CRVO, and 14 cases of classic CRVO. Complete preoperative and postoperative ophthalmological examination and fluorescein angiography were performed in all cases. The therapeutic procedure comprised the infusion of urokinase through a microcatheter into the ostium of the ophthalmic artery, via a femoral artery approach. The main outcome measure was the improvement in visual acuity 48 hours after the procedure. RESULTS: Six eyes of six patients exhibited significant improvement in visual acuity immediately after the fibrinolysis procedure. Among them, four had a initial funduscopic appearance suggestive of combined occlusion of the central retinal artery (CRAO) and vein. For these patients, the visual benefit was maintained in the long term. Intravitreal haemorrhage occurred in two patients. There were no extraocular complications linked to the procedure. CONCLUSIONS: Selective ophthalmic artery infusion of urokinase was followed by improvement in VA in six out of 26 cases of CRVO. Eyes with combined CRAO and CRVO with recent visual loss appeared to be the most responsive. This treatment did not prevent the occurrence of ischaemia in the failure cases. The efficacy of in situ fibrinolysis for treatment of CRVO needs to be further evaluated in a controlled study.

Adult↗
PubMed2000

Superselective ophthalmic arterial fibrinolysis with urokinase for recent severe central retinal venous occlusion: initial experience.

PURPOSE: To investigate the effects of local ophthalmic arterial fibrinolysis on central retinal venous occlusion (CRVO). MATERIALS AND METHODS: Thirteen patients had recent severe nonischemic CRVO for which no alternative therapy was available. A flow-guide microcatheter was introduced coaxially via the femoral artery into the ophthalmic arterial ostium, and urokinase was perfused for 40 minutes. Vision, funduscopic findings, and retinal perfusion were assessed during 1 year of follow-up. RESULTS: Five of the 13 patients treated experienced visual improvement (P =.05) and retinal perfusion within 24-48 hours. Vision returned to normal within 24-48 hours in three patients, within 1 week in one patient, and within 1 month in one patient. These five patients exhibited progressive lesion regression within 2-4 weeks at funduscopy. Their clinical course prior to treatment resembled that of combined central retinal arterial occlusion (CRAO) and CRVO, which typically has a poor visual outcome. One patient relapsed 1 month after fibrinolysis. Of the remaining eight patients, one had normal vision at 12 months, and seven had no improvement. No technical complications were observed. CONCLUSION: Although there was no control group, the short period between fibrinolysis and substantial visual improvement, combined with marked retinal perfusion improvement, suggests that fibrinolysis is beneficial for CRVO, especially for recent CRAO and CRVO.

Adult↗
PubMed2000

Evaluation of fluorescein-labeled autologous leukocytes for examination of retinal circulation in humans.

PURPOSE: Increased leukocyte-endothelium interaction have been suggested as a phenomenon contributing to capillary occlusion and/or rupture of the blood-retina barrier during human retinal vascular diseases. This study was performed to evaluate if fluorescein-labeled autologous leukocytes (FLALs) can be used for examination of leukocyte transit in the human retina. METHODS: The preparation consisted of human dextran-separated leukocytes mixed with fluorescein. After reinjection in normal subjects and in one diabetic patient, a confocal scanning laser ophthalmoscope was used to visualize them in the retinal circulation. The changes between FLALs and control leukocytes in the expression of leukocytes adhesion molecules CD11b and CD62L were evaluated by flow cytometry. RESULTS: The circulating FLALs were clearly visible in retinal vessels. The mean (+/- SD) capillaries velocity was 1.43 (+/- 1.3) mm/s in the macula and 1.82 (+/- 1.4) mm/s in the peripapillary area. No leukostasis was detected in the normal subjects, while it was detected in te diabetic patient. Flow cytometry revealed an increase in CD11b and a decrease in CD62L expression of leukocytes after labeling, suggesting that compared to normal leukocytes FLALs are more susceptible to interact with vascular endothelium. CONCLUSIONS: The use of FLAL is presently the only technique applicable in humans for study of leukocyte transit in the retina. Their preparation is technically simple and unexpensive. Precise measurement of the velocity of leukocytes in small vessels can be obtained. Despite evidence of a certain degree of leukocyte activation after the labeling procedure, no leukostasis was detected in vivo in normal subjects. Potential applications for this technique may include the detection of leukostasis in the human retina during severe forms of diabetes and retinal phlebitis.

Adult↗
PubMed1999

Macular hole formation: new data provided by optical coherence tomography.

OBJECTIVE: To establish the sequence of events leading from vitreofoveal traction to full-thickness macular hole formation. METHODS: Both eyes of 76 patients with a full-thickness macular hole in at least 1 eye were examined by biomicroscopy and optical coherence tomography. RESULTS: Sixty-one fellow eyes had a normal macula. Optical coherence tomograms showed central detachment of the posterior hyaloid over the posterior pole in 19 cases (31%) and a perifoveal hyaloid detachment not detected on biomicroscopy in 26 cases (42%). In the 4 impending macular holes, optical coherence tomography disclosed various degrees of intrafoveal split or cyst, with adherence of the posterior hyaloid to the foveal center and convex perifoveal detachment. In the 14 stage 2 holes, eccentric opening of the roof of the hole was observed, and in the 24 stage 3 holes, the posterior hyaloid was detached from the entire posterior pole. CONCLUSIONS: In fellow eyes of eyes with macular holes posterior hyaloid detachment begins around the macula, but the hyaloid remains adherent to the foveolar center, indicating the action of anteroposterior forces. This results in an intraretinal split evolving into a cystic space, and then to the disruption of the outer retinal layer and the opening of the foveal floor, thus constituting a full-thickness macular hole.

Aged↗
PubMed1999

Sclerochoroidal calcification associated with Gitelman syndrome.

PURPOSE: To investigate sclerochoroidal calcification in a patient with Gitelman syndrome. METHOD: Case report. Bilateral fundus abnormalities observed in a 58-year-old woman were documented with fluorescein angiography and tomodensitometry. RESULTS: Symmetric yellow-white subretinal lesions were observed in the superotemporal midperiphery of the fundus of each eye. Tomodensitometry examination was consistent with calcium deposition. The medical history included Gitelman syndrome. Sclerochoroidal calcification probably resulted from the severe hypomagnesemia. CONCLUSION: Gitelman syndrome may be a cause of sclerochoroidal calcification.

Calcinosis↗
PubMed1999

Effect of autologous platelet concentrate in surgery for idiopathic macular hole: results of a multicenter, double-masked, randomized trial. Platelets in Macular Hole Surgery Group.

OBJECTIVE: To evaluate prospectively the efficacy and safety of autologous platelet concentrate (APC) as an adjuvant in surgery for idiopathic macular hole. DESIGN: Multicenter, double-masked, randomized clinical trial. SETTING: Four university-based ophthalmology clinics. PARTICIPANTS: One hundred ten patients with stage 3 or 4 idiopathic full-thickness macular holes of less than 3 years' duration were randomized (53 eyes to the platelet group and 57 eyes to the control group). INTERVENTIONS: Standardized macular hole surgery versus surgery combined with injection of an APC. In all cases, the procedure consisted of three-port pars plana vitrectomy, posterior hyaloid separation, and nonexpansile fluid-gas exchange. After the fluid-gas exchange, patients were randomized to receive either injection of an APC or no adjunctive treatment. After surgery, patients were positioned face down for 12 days. Platelet counts showed that the concentrates contained a mean of 96.106 platelets (range, 82-102). MAIN OUTCOME MEASURES: Anatomic and functional evaluations were performed at 1, 3, and 6 months after surgery in a double-masked fashion by an independent observer. The main outcome was reapposition of the edge of the macular hole 1 month after surgery. Secondary outcomes were anatomic status at 3 and 6 months, changes in Early Treatment Diabetic Retinopathy Study score, and complications. RESULTS: One month after surgery, the anatomic success rate in the platelet group was 52 of 53 (98%; 95% confidence interval, 0.90-1.00) versus 47 of 57 (82%; 95% confidence interval, 0.70-0.91) in the control group (P = 0.009, Fisher's exact test; relative risk, 0.11; 95% confidence interval, 0.01-0.81). Visual acuity was not significantly different between the two groups at any timepoint. There were no complications specifically attributable to the platelet injection. CONCLUSION: Injection of APC improved significantly the anatomic success rate of surgery for idiopathic macular holes of less than 3 years' duration, but postoperative visual acuity of the platelet group was not statistically different from the control group.

Aged↗
PubMed1999

Visual outcome of surgery for epiretinal membranes with macular pseudoholes.

OBJECTIVE: To evaluate the effect of macular pseudohole on visual results after epiretinal membrane (ERM) surgery. DESIGN: Retrospective case-control study. PARTICIPANTS: The postoperative results for 50 eyes with ERMs combined with pseudohole were compared with the results for a paired series of idiopathic ERMs without pseudohole operated on during the same period. INTERVENTION: All patients underwent standard three-port pars plana vitrectomy, including core vitrectomy, and removal of the membrane. MAIN OUTCOME MEASURES: Anatomic and functional evaluations were performed before and after surgery. Main outcome measures were postoperative visual acuity and the persistence or disappearance of the pseudohole. RESULTS: For the patients with pseudohole, median preoperative visual acuity was 20/63 (range, 20/32-20/860) and median postoperative visual acuity was 20/40 (range, 20/20-20/860). Vision improved by 2 or more lines in 31 (62%) of 50 eyes. Forty eyes (80%) reached visual acuity of 20/50 or more. Pseudohole persisted in 22 eyes (44%) 3 months after surgery and in 15 eyes (30%) at 6 months. There was no difference in visual acuity, whether or not the pseudohole persisted. For the patients without pseudohole, median preoperative visual acuity was 20/63 (range, 20/32-20/860). Median postoperative visual acuity was 20/40 (range, 20/20-20/860). Vision improved by 2 or more lines in 37 eyes (74%). In 36 eyes (72%), it was 20/50 or more. Neither preoperative nor postoperative visual acuity differed significantly in the groups with and without pseudohole. CONCLUSION: After surgery for idiopathic ERMs combined with pseudohole, visual outcome is good, and pseudohole has no adverse prognostic value. Pseudohole disappears inconstantly after surgery, but its persistence does not preclude good postoperative visual recovery.

Adult↗
PubMed1999

Prevalence of macular pattern dystrophy in maternally inherited diabetes and deafness. GEDIAM Group.

OBJECTIVE: To evaluate the prevalence of macular pattern dystrophy (MPD) in maternally inherited diabetes and deafness (MIDD), a new subtype of diabetes mellitus that cosegregates with a mutation of mitochondrial DNA (i.e., the substitution of guanine for adenine at position 3243 of leucine transfer RNA) and to report the clinical characteristics of MPD. DESIGN: Prospective cohort study. PARTICIPANTS: Forty-six patients from 29 families with an adenine-to-guanine mutation of mitochondrial DNA were recruited from a French collaborative multicenter study. Thirty-five patients had MIDD, 8 were asymptomatic children of MIDD patients, and 3 had MELAS syndrome (mitochondrial myopathy, encephalopathy, lactic acidosis, and strokelike episodes). The 33 MIDD patients with diabetes were matched for diabetes duration and gender with 33 patients with "common" type-2 diabetes to compare the prevalence of diabetic retinopathy (DR) in both series. METHODS: All patients had a full ophthalmologic examination and fundus photographs. MAIN OUTCOME MEASURES: The presence and severity of MPD and DR were assessed in each patient. RESULTS: Thirty MIDD patients (85.7%) of 35 exhibited bilateral MPD characterized by linear pigmentation surrounding the macula and optic disc. In 24 of these 30 patients, visual acuity was 20/25 or more in both eyes. The prevalence of DR was 6% in MIDD patients with diabetes versus 15% for patients with common type-2 diabetes (a difference that was not significant, P = 0.23). The fundus of each of the eight asymptomatic children was normal. MPD was present in one of the three cases of MELAS. CONCLUSION: The prevalence of MPD in MIDD is high. Its detection may be helpful for the diagnosis of this new subtype of diabetes, for which specific treatments may be proposed.

Adult↗
PubMed1999

vig-1, a new fish gene induced by the rhabdovirus glycoprotein, has a virus-induced homologue in humans and shares conserved motifs with the MoaA family.

We used mRNA differential display methodology to analyze the shift of transcription profile induced by the fish rhabdovirus, viral hemorrhagic septicemia virus (VHSV), in rainbow trout leukocytes. We identified and characterized a new gene which is directly induced by VHSV. This VHSV-induced gene (vig-1) encodes a 348-amino-acid protein. vig-1 is highly expressed during the experimental disease in lymphoid organs of the infected fish. Intramuscular injection of a plasmid vector expressing the viral glycoprotein results in vig-1 expression, showing that the external virus protein is sufficient for the induction. vig-1 expression is also obtained by a rainbow trout interferon-like factor, indicating that vig-1 can be induced through different pathways. Moreover, vig-1 is homologous to a recently described human cytomegalovirus-induced gene. Accordingly, vig-1 activation may represent a new virus-induced activation pathway highly conserved in vertebrates. The deduced amino acid sequence of vig-1 is significantly related to sequences required for the biosynthesis of metal cofactors. This suggests that the function of vig-1 may be involved in the nonspecific virus-induced synthesis of enzymatic cofactors of the nitric oxide pathway.

Amino Acid Sequence↗