[Wolfram syndrome about 2 family cases]

Wolfram syndrome or DIDMOAD syndrome is an hereditary optic atrophy occurring in insulin-dependent diabetics. It can be associated with other endocrinal, ORL, neurologic or urologic disorders, We report 2 cases: brother and sister presenting 2 principal signs of this syndrome: optic atrophy and insulin-dependent diabetes. The ophthalmologic exam shows a visual acuity at stade of blindness. The genetic inquiry shows a parental consanguinity and 2 other supposed dead cases affected in the family

[Treatment of Xanthelesma palpebrarum with monochromatic green laser - about 20 patients]

To report the therapy of xanthelesma with a green laser as an alternative to surgery. A prospective study including 20 patients with xanthelasma of the eyelid were included in this study. The mean follow-up period was 5.8 months [range, 3 to 24 months]. All patients were satisfied regarding the laser therapy and the cosmetic result. Remarkably, the wounds were dry after laser therapy. No infections of the wounds occurred; wounds were epithelialized after 2 to 3 weeks by a normal-appearing epithelium. The area of argon laser treatment was less pigmented than the surrounding skin in one case. One case of relapse occurred in a patient with dyslipemia. Green laser therapy of xanthelasma seems to be a useful alternative to traditional surgery. It is easy to perform, well tolerated by the patients and shows excellent cosmetic results

Bilateral optic disc swelling and mycoplasma pneumoniae

Mycoplasma pneumoniae is an atypical bacterium that can cause a great variety of respiratory infections. Ocular involvement other than conjunctivitis are uncommon, and papillitis have infrequently been reported. We report an additional case of bilateral optic disc swelling following mycoplasma pneumoniae and review the litterature on the ocular manifestations associated with this pathogen

[Cone-rod dystrophy: a case report]

Cone-rod dystrophy [CRD] is an inherited retinal dystrophy with initial loss of cone mediated functions followed by rod dystrophy. We report the case a young male affected by CRD. Case report: The case of a 27-year-old male patient is presented. He was hospitalized for decreased vision of both eyes and hemeralopia. The eye fundus examination showed bilateral lesions of retinitis pigmentosa in the supero temporal sector and macular cystoid oedema. Both photopic and scotopic full field ERG amplitudes were reduced, showing involvement of both photoreceptor systems. However, cone response was reduced more than that of rod response suggesting CRD diagnosis. His mother was diagnosed with age-related macular degeneration and his brother with CRD. The patient refused genetic analysis. Based on family history and clinical diagnosis, the disease was classified as cone-rod dystrophy. Discussion and Cone-rod dystrophy [CRD] is a particular form of retinitis pigmentosa [RP] which characteristically lead to early impairment of vision, usually from the first or second decade of life. CRD patients suffer from hemeralopia, loss of visual acuity and peripheral visual fields and show reduced ERG responses. In later life, vision may be reduced to a bare perception of light. Ophthalmoscopic abnormalities in CRD patients ranged from minor granular pigmentary changes in the posterior pole to widespread atrophy. Genetic analysis revealed various mutations in many genes may lead to CRD. There's no treatment available for this condition. Genetic advice is the most effective mean for preventing this inherited disease

[Vitrectomy results in retinal vein occasion]

Retinal vein occlusion results in decrease of visual acuity secondary to complications such as intravitreal hemorrhage due to retinal neovascularisation, neovascular glaucoma and retinal detachment. The purpose of our study is to discuss the surgical indications, the results and the post operative complications after vitrectomy for intravitreal hemorrhage or retinal detachment due to retinal vein occlusion. 75% of our patients underwent vitrectomy for retinal vein occlusion with retinal neovascularisation and intravitreal hemorrhage. A three port pars plana vitrectomy was performed, and if needed peeling of fibrovascular membrane, endophotocoagulation, scleral buckling and internal tamponnement. Improvement in visual acuity was noted in 80% of the patients. Cataract was the main postoperative complication : in 80% of cases. Final prognosis was determined by the macula state

Les troubles de la refraction chez le diabetique

Refractive disorders in unbalanced diabetics are frequent. Results of ophthalmologic investigations in 36 cases with bad balanced diabetes mellitus but without cataract or diabetic retinopathy were reported. Refractive changes were found in 78% of patients. These changes were towards hypermetropia in 67% of cases and myopia in 11% of cases. Return to the previous refractive state was observed in all cases within 4 weeks [average: 2 - 7 weeks]. Physiopathological mechanisms of such disorders are discussed. The importance of well balanced diabetes for treatment and prevention of such disorders are raised

retina after 20 years of diabetes

Diabetes durations is one of major risk factors of diabetic retinopathy [D.R].D.R. remained almost constant during 20 years following diabetes appearance. However the prevalence of D.R. was only 74.5% in 110 diabetic patients in which the duration of diabetes exceeded 20 years. The absence of D.R. in the remaining 25.5% of patients seems to be due to one or more controlled factors such as: - a good glycemic control - old -aged discovery of diabetes - the infrequency of systemic hypertension - myopia The role of a good control of both glycemia and blood pressure in DR is discussed