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S Scheer

Publications and source records attributed to S Scheer.

At least 19 recordsLinked to original sources
PubMed2006

Familial central retinal vein occlusion.

AIM: To report four cases of central retinal vein occlusion (CRVO) in a French family. PATIENTS AND METHODS: Ophthalmological examination and medical work-up of seven members of the family. RESULTS: There were four cases of CRVO in two consecutive generations. Three of them had CRVO in both eyes. Arterial hypertension was present in two, associated to glaucoma in one. Medical work-up did not reveal additional risk factors. CONCLUSIONS: We report a case of familial clustering of CRVO. Our cases combined to other cases reported in the literature provide arguments for the existence in some subjects of a genetic predisposition of CRVO. Additional case series are however needed to confirm this hypothesis.

Adult↗
PubMed2006

[Heavy silicone oil as internal tamponade for retinal detachment: efficacy and tolerance].

INTRODUCTION: To evaluate the tolerance and efficacy of heavy silicone oil as internal tamponade for retinal detachment surgery. PATIENTS AND METHODS: Sixty-six eyes requiring heavy silicone oil for retinal detachment, with at least 1 month follow-up, were retrospectively studied. Preoperative status, surgical technique, tolerance, and anatomical and functional results were analyzed from the patient's file. Indications for heavy silicone injection were inferior retinotomy or inferior retraction in 65% of cases. PVR grade C was present in at least 63% of cases. Retinotomy was performed in 45% of cases. An exchange procedure was performed versus DKline in 65% of cases. Mean follow-up was 7 +/- 4 months. RESULTS: At the end of follow-up, 59% of eyes had a completely reattached retina, 32% without internal tamponade. Another surgery was necessary in 54% of cases. During follow-up, mean intraocular pressure was normal, and there was a significant intraocular inflammation in three cases (4.5%). In seven cases of the 44 ablations of heavy silicone oil, an adherence of residual bubbles was present. Redetachment occurred after ablation for anatomical success in 41% of cases. BCVA was better than 0.05 (20/400) in 54% of cases at the end of follow-up. CONCLUSION: Heavy silicone was well tolerated and seems not to be pro-inflammatory in our study. It is a good alternative to standard silicone for inferior retinotomy and inferior breaks without PVR. It is not a treatment of inferior retraction, and is not a long-term internal tamponade. During the ablation of heavy silicone oil, adherence of residual bubbles is possible, in which case a coaxial light or an endoillumination could be needed during ablation.

Adolescent↗
PubMed2005

[Prevention of proliferative vitreoretinopathy using 5-FU heparin: clinical tolerance and efficacy].

PURPOSE: To study the safety and efficacy of adjuvant combination therapy using 5-fluorouracil and heparin for prevention of proliferative vitreoretinopathy (PVR) during vitrectomy for retinal detachment surgery. METHODS: Two consecutive groups of 30 eyes with a rhegmatogenous retinal detachment (grade C1 or more) were prospectively compared. In the study group, 5-FU and heparin were administrated in the intraoperative infusion. Clinical safety and the efficacy were regularly studied over 1 year. RESULTS: In the 5-FU heparin therapy group, keratitis was more frequently observed the 1st day after surgery (p = 0.005), but not after 1 week (p = 0.54). However, conjunctival hyperemia was more severe after 1 and 7 days (p = 0.04). In both groups, no differences were found concerning intraocular pressure, postoperative hemorrhage or inflammatory reaction (flare) of the anterior chamber and the aspect of the eyelids (p > or = 0.14). The number of reoperations resulting from PVR, after 1 month and 1 year, was not significantly different between the two groups (p > or = 0.3). The reattachment rate and visual acuity (BSCVA) were not statistically different after 1 year (p > or = 0.12). CONCLUSION: Adjuvant combination therapy using 5-FU and heparin seems to be safe. However, its efficacy needs to be demonstrated by larger studies including eyes presenting a lower grade of PVR (grade B).

Drug Therapy, Combination↗
PubMed2004

[Acute retinal necrosis: clinical presentation, treatment, and prognosis in a series of 22 patients].

PURPOSE: To evaluate the clinical outcome and medical management in a series of patients diagnosed with acute retinal necrosis. MATERIAL AND METHODS: Between 1993 and 2000, 22 patients suffering from acute retinal necrosis were referred to our department. We retrospectively reviewed the clinical course, delay between diagnosis and first clinical manifestation, biological profiles, treatment and complications. RESULTS: All patients had vitreous inflammation; retinitis was seen upon examination in 82% of the cases. Nevertheless, for six patients (27% of the cases), failure to recognize the diagnosis led to delay (mean, 5.5 days) between the first ophthalmological examination and antiviral therapy. Nineteen patients underwent laboratory evaluation, and virological diagnosis was made in 16 of them: varicella zoster virus was found in 11 cases, herpes simplex type 1 in three cases, and herpes simplex type 2 and cytomegalovirus in one case each. Nine patients were treated with a combination of aciclovir and foscarnet and 13 with aciclovir alone. Among the 16 patients who received aciclovir, one did not respond to therapy after 2 days and was cured only after foscarnet was added. Recurrence occurred at the end of treatment in only one patient. Retinal detachment complicated the course for 11 patients and was always associated with proliferative vitreoretinopathy. Among those, seven of the ten patients who accepted surgery were successfully treated. Eleven out of 22 patients had a final visual acuity up to 20/200 and two up to 20/40. CONCLUSION: In our series, acyclovir alone was sufficient to cure the majority of cases. Even with antiviral therapy, the prognosis of acute retinal necrosis remains poor. Retinal detachment is the main complication.

Acyclovir↗
PubMed2004

[The relationship between keratoconus and axial myopia].

PURPOSE: To study the relationship between keratoconus and axial myopia. METHODS: We prospectively studied refraction and ocular biometry in 100 consecutive keratoconus eyes, and 100 emmetropic eyes. Biometric data (including posterior segment length) were obtained by A-scan ultrasound, Orbscan, and ultrasonic pachymetry. Biometric measurements were compared in both groups. RESULTS: Anterior chamber depth, posterior segment length and axial length were significantly different between the two groups (p<0.001). Axial length was significantly greater in the keratoconus group than in the emmetropic group (23.97 mm versus 23.21 mm, p<0.001). Posterior segment length was significantly greater in the keratoconus group than in the emmetropic group (16.54 mm versus 15.99 mm, p<0.001). In the keratoconus group, the posterior segment length and the subjective spherical equivalent were significantly correlated (rs=-0.45, p<0.001). CONCLUSION: The increase in posterior segment length in the keratoconus group and the correlation between posterior segment length and spherical equivalent in the keratoconus group suggest a statistical relationship between keratoconus and axial myopia.

Adolescent↗
PubMed2004

[Pharmacological adjuvants for surgical treatment of proliferative vitreoretinopathy].

Proliferative vitreoretinopathy (PVR) is the major cause of retinal detachment surgery failure. Many adjuvants were studied in vitro and on animals, some were studied on humans. Daunomycin seems to reduce PVR recidivism. 5-FU and steroids are nontoxic but their efficacy is not clear. Heparin reduced postoperative inflammation and seems to reduce PVR recidivism when associated with 5-FU. Associating heparin and steroids seems to reduce PVR in some groups of patients (aphakic, anterior PVR). Colchicine and retinoic acid per os are ineffective, silicone oil is effective as an internal tamponade but not as an adjuvant of PVR. Currently, no molecule has proven efficacy as an adjunctive treatment of PVR.

Chemotherapy, Adjuvant↗
PubMed2004

[A study of pupil dilation using the Mydriasert ophthalmic insert].

PURPOSE: To evaluate the tolerance and efficiency of the Mydriasert(R) ophthalmic insert on pupil dilation. METHOD: Two pharmaceutical forms of a combination of tropicamide and phenylephrine (HCl) were compared on both eyes of 80 patients. For each patient, one Mydriasert insert (Ioltech) was placed in the lower conjunctival sac of the eye. Dilation of the control eye was obtained using 0.5% tropicamide eye drops and 10% phenylephrine eye drops (Novartis Ophthalmics), which were instilled with three frequency regimens (5, 10 or 15 min). The pupil diameter was regularly measured until the maximal mydriasis had occurred. RESULTS: Both subjective and objective tolerance of the insert was excellent. The size of the maximal mydriasis obtained when using the insert was significantly greater than that obtained when using the eye drops, regardless of the frequency of the instillation (p < 0.04). The difference in maximal pupil diameter ranged from +0.16 mm to +0.38 mm. Mydriasis kinetics was slower with the insert. The time necessary to obtain a maximal mydriasis was 47.3 min when the insert was used, whereas it was in the range of 31.4 to 38.5 minutes with the eye drops (p < 0.001). As far as pupil diameter is concerned, the superiority of the insert compared to the eye drops became observable only about 45 min after the insert had been placed in the eye. The relative efficacy of the insert compared to the eye drops did not correlate with patient features (p > or = 0.06). CONCLUSION: Despite the small quantity of drug delivered by the insert, Mydriasert allows a much greater mydriasis compared to that usually obtained when the eye drops were used. However, a longer time lapse is necessary for this to occur.

Adolescent↗
PubMed2004

Tissue crossmatch before corneal transplantation.

AIM: To investigate the influence of anticorneal antibodies on the outcome of transplantation in recipients before penetrating keratoplasty. METHODS: 100 consecutive penetrating keratoplasties performed between July 1995 and June 1996 were included in this study. Donor corneoscleral rim cryosections were incubated with recipient serum. Fixation of recipient IgM on donor corneas was revealed with a polyclonal anti-human mu-chain antibody. The mean follow up time was 61 months. Five years after transplantation, 63% of patients were available for follow up. During the follow up period, 15% of keratoplasties failed because of irreversible rejection. RESULTS: Anti-donor stromal lamellae IgM were found in 14 recipients. Anti-donor keratocyte IgM were present in 28 recipients. Dilution of recipient serum (up to 1/800) did not modify the results of positive crossmatch assays. Crossmatch assays performed with positive recipient sera and negative donor corneoscleral rims were negative. No significant influence of IgM crossmatch results on graft survival and rejection-free graft survival was found. CONCLUSION: Donor specific anticorneal stroma IgM were found in 28% of recipients before transplantation. This pre-immunisation was not associated with a higher risk of transplantation rejection.

Adult↗
PubMed2003

[Long-term refractive and topographic changes after penetrating keratoplasty].

PURPOSE: To analyze long-term refractive and videokeratoscopic changes after penetrating keratoplasty. PATIENTS AND METHODS: Forty eyes of 40 patients (26 keratoconus) with a clear corneal graft and no other ocular disease were examined after all sutures were removed, respectively at 22.0+/-7.3 months and 50.5+/-13.6 months after keratoplasty. All of the eyes were examined using videokeratography (EyeSys 2000) and ultrasonic pachymetry. Changes in subjective refraction, best spectacle-corrected visual acuity (LogMAR units), topography, and central corneal thickness between both exams were recorded. RESULTS: Visual acuity increased by an average of 0.41 lines +/-0.24 (p<0.001) between both exams, whereas no significant change in refractive astigmatism and videokeratoscopy (i.e., power, pattern, and indices) was observed. Central corneal thickness significantly increased from 545+/-36 micro m to 574+/-40 micro m (p<0.001). Change in best spectacle-corrected visual acuity significantly correlated with delay between the exams (r(s)=+0.34, p=0.03), whereas change in refractive astigmatism, topographic indices, and topographic patterns did not significantly correlate with delay. CONCLUSION: After penetrating keratoplasty, visual acuity improves long after surgery, whereas refraction and corneal surface regularity show no significant modification. This improvement in visual acuity, not explained by current techniques, may be due to an increase in graft transparency.

Adolescent↗
PubMed2003

[Incidence and factors influencing glaucoma after penetrating keratoplasty].

PURPOSE: To determine the incidence and factors influencing glaucoma following penetrating keratoplasty. MATERIAL AND METHOD: We prospectively studied 440 consecutive patients undergoing penetrating keratoplasty over a period of 5 years, with an average follow-up of 2 years. High intraocular pressure was defined as IOP over 20 mmHg measured by Goldmann applanation for at least 1 week or if a patient required topical treatment for at least 1 week. Before surgery, 18.7% of the patients presented with glaucoma or high intraocular pressure; 44.9% received a graft for a bullous keratopathy condition, 25.6% had keratoconus, 31.5% received an anterior chamber lens, and 48.5% were phakic. RESULTS: After surgery, 42.2% of the patients had ocular pressure at 20 mmHg or more and required treatment for high ocular pressure. The increase in intraocular pressure appeared after an average delay of 3.3 +/- 4.7 months. The frequency of the increase in intraocular pressure was 54.3% for the bullous keratopathy patients, 26.6% for the keratoconus patients (p<0.001). At the end of the second year, the graft survival was 82.1% in absence of glaucoma, whereas it was 71.5% in cases of glaucoma after keratoplasty. Between all parameters that we studied, high intraocular pressure before surgery, etiology, the status, and receiver age over 60 years were the main factors influencing high intraocular pressure after keratoplasty. Intraocular pressure was correlated with the decrease in endothelial cell density and was at the origin of graft failure. Intraocular pressure correlated with the Best Spectacle Corrected Visual Acuity (BSCVA) by its effect on endothelial cell density and optic nerve destruction. CONCLUSION: The increase in intraocular pressure is a real and serious complication of keratoplasty. Its physiopathology is very complex. Better knowledge of risk factors can be useful in controlling it.

Adolescent↗
PubMed2003

[Immunosuppression in corneal transplantation].

Rejection is the leading cause of corneal graft failure, induced by loss of the so-called eye immune privilege. Prevention of graft rejection with immunosuppressive therapy is then necessary. Topical corticosteroids are currently the gold standard, and steroids are the only treatment for acute rejection episodes. Steroids are nonspecific immunosuppressive agents, and they can induce glaucoma, cataract, infections, and epithelial defects. Cyclosporin has a specific effect, because it inhibits interleukin-2 transcription and, consequently, the specific activation of T lymphocytes. When cyclosporin is given orally, it effectively prevents graft rejection in high-risk recipients, but it may induce severe side effects (i.e., systemic hypertension, kidney deficiency, and malignant tumor induction). When cyclosporin is given topically, it can effectively replace steroids in case of dexamethasone-induced glaucoma and graft infection, but it can also induce serious corneal epithelial defects. Cyclosporin is not a treatment for acute rejection episodes. Mycophenolate mofetil and FK 506 are promising drugs, but currently they cannot be used routinely to prevent corneal graft rejection.

Adrenal Cortex Hormones↗
PubMed2003

[Treatment of the sequelae of ocular burns using limbal transplantation].

PURPOSE: To report the results of limbal transplantation in patients with severe ocular burns and limbal stem cell deficiency. PATIENTS AND METHODS: This series includes six autografts (unilateral ocular burns) and five allografts (bilateral ocular burns) performed in ten eyes of ten males with an average age of 43 years. The origin of the ocular burn was chemical in eight cases and thermal in the remaining two cases. The average time between the initial trauma and limbal transplantation was 79 months. The average size of limbal grafts was 190 degrees (range: 80-20 degrees for autografts and 120-360 degrees for allografts). Patients with allografts received oral cyclosporine in three cases, topical cyclosporine in one case, and intravenous methylprednisolone in one case. Eight patients underwent penetrating keratoplasty an average of 11 months after limbal transplantation (range: 5-24 months). RESULTS: The average follow-up time was 36 months (range: 7-77 months). The overall success rate of limbal transplantation (ocular surface improvement) was 73% (8/11). The success rate of penetrating keratoplasty was 63% (5/8). The average initial visual acuity was 0.4/10 and the average final visual acuity was 1.6/10. Visual acuity improved by two lines or more in seven cases. DISCUSSION: Limbal transplantation is a useful surgical technique in patients with severe ocular burns. However, results remain insufficient and new techniques such as limbal stem cell culture and transplantation are needed to improve the visual prognosis of these patients.

Adult↗
PubMed2002

[Orbscan: a new device for iridocorneal angle measurement].

PURPOSE: To evaluate the accuracy and reproducibility of iridocorneal angle measurement obtained with a slit-lamp method (Orbscan). METHODS: The iridocorneal angle was measured in 100 normal eyes of 50 patients using the Orbscan II device. Angles were measured in eight meridians using both the "plane" and "polynomial" modes. For each eye, two exams were taken successively and the reproducibility was calculated by analyzing the difference between both measurements. Angle value was correlated with subjective spherical equivalent and other biometric measurements obtained by Orbscan (i.e., anterior chamber depth, axial length, corneal diameter). RESULTS: Reproducibility of the angle measurement was significantly better with the plane mode than with the polynomial mode (5.4%+/-4.7 versus 7.2%+/-6.2; p<0.001). Reproducibility significantly varied with localization (p<0.001). Significant differences were found between reconstruction modes (49.3 degrees +/-4.6 degrees for plane mode versus 42.8 degrees +/-6.7 degrees for the polynomial mode; p<0.001) and according to localization (p=0.02). Correlation with the other biometric measurements was higher for the plane mode than for the polynomial mode. Angle measurement with the plane mode showed significant correlation with subjective spherical equivalent (r(s)=-0.59; p<0.001), the anterior chamber depth measurement (r(s)=-0.74; p<0.001), the axial length measurement (r(s)=-0.34; p<0.002), and the corneal diameter measurement (r(s)=-0.34; p<0.002). CONCLUSION: The iridocorneal angle measure obtained with the plane mode showed high reproducibility and it significantly correlated with clinical parameters. It appears to be useful for clinical application.

Adolescent↗
PubMed2001

Undiagnosed and unreported AIDS deaths: results from the San Francisco Medical Examiner.

To determine whether AIDS surveillance misses a substantial number of persons who die with unreported AIDS, we conducted a cross-sectional survey of decedents examined by the San Francisco (SF) Medical Examiner. Decedents who received toxicology screening were tested for HIV antibody and examined for evidence of AIDS. Names of decedents with positive or indeterminate HIV antibody test results were cross-referenced against the SF AIDS registry to identify previously reported AIDS cases. Medical records of unreported cases were reviewed to determine whether AIDS had been diagnosed prior to death. Of 1959 decedents tested, 176 (9%) were HIV positive; 105 (60%) were identified as having AIDS by the Medical Examiner. Of the 105 AIDS cases, 101 (96%) had been previously diagnosed; 98 (97%) had been previously reported. Overall, diagnosis and reporting were 93% complete. HIV-infected decedents were more likely than those uninfected to be men and <45 years old, and less likely to be Asian/Pacific Islander or Native American (p <.001). They were more likely to have died of suicide (p <.05) or drug abuse/overdose (p <.001). In SF, AIDS case reporting is highly complete. Current surveillance activities, which identify cases from health care settings, are appropriate. To decrease deaths among HIV-infected persons, suicide prevention and substance abuse treatment programs are needed.

Acquired Immunodeficiency Syndrome↗
PubMed2001

Effect of highly active antiretroviral therapy on diagnoses of sexually transmitted diseases in people with AIDS.

BACKGROUND: There has been an increase in high-risk sexual behaviour and sexually transmitted diseases (STD) during the time period when highly active antiretroviral therapy (HAART) became widely available. We examined whether taking HAART increased the risk of acquiring an STD--an epidemiological marker of unsafe sex--in people with AIDS. METHODS: We did a computerised match of people in the San Francisco STD and AIDS registries. People with AIDS who were diagnosed before 1999 and alive in November, 1995, or later, were classified as having had an STD after AIDS diagnosis or not having had an STD after AIDS diagnosis. We used a Cox proportional hazards model to see whether use of antiretroviral therapy was associated with acquiring an STD after AIDS, after adjustment for sex, age, race, HIV-1 risk category, and CD4 count at AIDS diagnosis. FINDINGS: People with AIDS who had had HAART showed an independent increase in the risk of developing an STD (hazard ratio 4.10; 95% CI 2.84-5.94). Americans of African origin, younger age, and higher CD4 count at AIDS diagnosis were also associated with acquiring an STD after AIDS. The number of people living with AIDS who acquired an STD increased over time from 60 (0.66%) in 1995 to 113 (1.32%) in 1998 (p<0.001). INTERPRETATION: We have shown that people on HAART are more likely to develop an STD, an epidemiological marker of unsafe sex. More intensive risk-reduction counselling and STD screening for people with AIDS is needed.

AIDS-Related Opportunistic Infections↗
PubMed2001

Screening human donor corneas during organ culture for the presence of guttae.

AIMS: To detect the presence of guttae by means of light microscopy during organ culture and to evaluate the influence of the presence of guttae in the donor tissue on transplantation outcome. METHODS: Donor corneas were investigated for the presence of guttae by means of light microscopy at the end of organ culture. Recipient corneal buttons from patients with severe Fuchs' dystrophy and donor corneas with advanced guttae were first studied by light microscopy and subsequently by transmission electron microscopy. Lastly, 168 consecutive donor corneas were evaluated for the presence of guttae and issued for transplantation. RESULTS: Corneal specimens with Fuchs' dystrophy displayed numerous round highly reflecting guttae at the level of the corneal endothelium. Donor corneas with advanced guttae showed less numerous guttae. Among 168 organ cultured donor corneas issued for transplantation, low density guttae were found in 43 (25.6%) corneas. The endothelial cell density and figure coefficient were significantly lower and organ culture time was significantly higher in the cornea guttata group than in the control group. The presence of grouped guttae significantly decreased the adjusted graft survival. The incidence of postoperative stage 3 cornea guttata was significantly higher when grouped guttae were found (5/6) than when no guttae or scattered guttae were found (8/101). CONCLUSION: Cornea guttata can be detected during organ culture by means of light microscopy. It is associated with a decrease in endothelial cell figure coefficient and cell density. The presence of grouped guttae is associated with poorer graft survival and more frequent stage 3 cornea guttata in the graft after transplantation.

Adolescent↗
PubMed2001

[Correlation between corneal topography and subjective refraction in idiopathic and surgery-induced astigmatism].

PURPOSE: To study the correlation between subjective refraction and corneal topography. To compare the topographic analysis of surgically induced astigmatism (cataract and penetrating keratoplasty) with that of idiopathic astigmatism. METHODS: Subjective astigmatism, subjective spherical equivalent, best spectacle-corrected visual acuity (LogMAR units), and videokeratoscopy using the EyeSys 2000((R)) device (axial, tangential, and refractive power) were recorded in 100 eyes with idiopathic astigmatism, 100 eyes after cataract surgery, and 100 eyes after penetrating keratoplasty. Topographies were classified according to pattern (Bogan classification) and asphericity (shape factor: prolate or oblate). RESULTS: The asphericity shape distribution was significantly different between the 3 groups (p<0.001). The shape of idiopathic astigmatism was almost always prolate (90%) whereas the oblate shape was more frequent in the penetrating keratoplasty group (75%). There was no significant difference in topographic pattern distribution between the 3 groups (p=0.11). The asymmetric bow tie pattern was the most common topographic pattern. Topography pattern classification was significantly correlated with the subjective astigmatic cylinder. (r(s)=0.60, p<0.001). Unlike the round and oval patterns, the bow tie pattern was associated with the high subjective cylinder. Correlation between the subjective cylinder, the refractive power cylinder, and the axial power cylinder was strong (r(s)=0.92 p<0.001), but it was weak for the tangential power cylinder (r(s)=0.72 p<0.001). The correlation between the subjective spherical equivalent and central cornea power was poor (r(s)<0.37, p<0.001). Subjective astigmatic cylinder showed the strongest correlation with best spectacle-corrected visual acuity (r(s)=0.70, p<0.001), whereas the predicted corneal acuity, corneal uniformity index, asphericity, and refractive power symmetry index were poorly correlated with it (r(s)<0.54, p<0.001). CONCLUSION: Despite the difference in the asphericity shape, the topographic pattern was similar in the 3 groups. The pattern type was significantly correlated with the subjective astigmatic cylinder. Topographic indices failed to predict visual acuity, while the subjective cylinder showed a strong correlation with visual acuity.

Astigmatism↗