Microbiologic profile of the mycosic absess on a reference center in Tunisia.

AIM: Given the increase in cases of fungal keratitis in recent years due to the inadvertent use of large -spectrum antibiotics and corticosteroids on the one hand and the emergence of contactology on the other hand, this study has was carried out in order to better understand the microbiological profile of fungal keratitis, particularly as a function of risk factors in a referral center in Tunisia. METHODS: We report a retrospective study of 43 patients (45eyes) hospitalized for fungal corneal abscess between January 2007 and December 2017. All patients benefited from corneal sampling by scraping the cornea with direct examination and culture. RESULTS: During the study period, 482 patients with corneal abscess were treated at the Ophthalmology Department of the Hédi Raies A Institute in Tunis. 45 eyes of 43 consecutive patients had keratomycosis (9.3%). The direct examination was positive in 71.1% of the cases and the culture in 73.3%. In 78.8% of the cases filaments were isolated: the fusarium being the most found species is in 39.4% of the patients particulary in cases of ocular trauma. Yeast species were more frequently found in surface pathology or local or general deficency. CONCLUSION:   It is important to guide the microbiological diagnosis of mycotic keratitis according to the clinical context, particularly in the case of negativity of the samples in order to establish a suitable treatment to improve the prognosis of this pathology, which represents one of the most difficult forms of infectious  keratitis to manage.

The interest of the OCT spectral Domain for the diagnosis of the acromatopsia.

AIM: the interest of the OCT spectral Domain for the diagnosis of the acromatopsia. CASE REPORT:   It's about 2 brothers consulting for low vision. The big brother, has a vision of 1/ 20 in two eyes. The anterior segment and the fundus examination were normals. The OCT SD shows a disappearance of the ellipsoid line in the macular region with an optic hole. The Global ERG has demonstrated flat plots in photopic component and normal in scotopic component. The ishihara test has showed an absence of the chromatic sense. The acromatopsia was the selected diagnosis.  The exam of the second brother showed a visual acuity limited 1/20 in the right eye and counting finger in the left eye, associated to photophobia and nystagmus. The OCT and global ERG gave the same results. CONCLUSION: The typical clinical picture with the ERG's data gave the diagnosis of the acromatopsia. An early diagnosis is necessary for a suitable life of the patient and genetic consulting. This paper demonstrated the importance of the OCT SD for the diagnosis when it's correclated to the clinic.

Choroidal neovascularization following argon laser photocoagulation for central serous chorioretinopathy.

INTRODUCTION: Choroidal neovascularization (CNV) is a rare complication after laser photocoagulation for central serous chorioretinopathy (CSCR).That's why , little is known about its management. Anti-VEGF therapy has emerged as the treatment of choice in patients with CNV. We report a case of a patient who developed iatrogenic CNV after having argon laser photocoagulation for a CSCR, treated with intravitreal injections of Bevacizumab. AIM: The goal of our paper is to show the efficacy and safety of the intravitreal injections of antiVEGF and discuss the alternative of argon laser photocoagulation to avoid complications. CASE PRESENTATION:   A 35-year-old pregnant woman diagnosed in August 2014 with an acute CSCR in the right eye. The patient was treated by a focal photocoagulation of the leakage point . In December 2015, she was complaining of metamorphopsia in the same eye .The BCVA was 10/10 in the right eye , and the funduscopic examination showed agrayish-white neovascular membrane, which corresponded to the area of the previous photocoagulation.The fluorescein angiography , OCT and the OCT angiography demonstrated the choroidal neovascular membrane .The patient received 3 intravitreal injections of Bevacizumab at monthly intervals in the right eye.The patient was followed-up at regular intervals and she became asymptomatic during three years. CONCLUSION: Choroidal neovascualrization may be an iatrogenic complication after argon photocoagulation in CSCR. Intravitreal injections of anti VEGF appear to be a promising treatment option for iatrogenic CNV due to photocoagulation.

Results of vitrectomy in giant tear retinal detachments.

INTRODUCTION: Giant tear retinal detachments have long been recognized for their management difficulties and poor anatomical surgical prognosis. METHOD: Retrospective, descriptive study of 15 patients collected from IOHRT Department A. These patients were treated for rheumatogenic retinal detachment by giant tear. All patients underwent endocular vitreoretinal surgery. A visual acuity, FO and OCT check was performed at 7 days, 21 days, 45 days and 3 months, 6 months and 1 year postoperatively. RESULTS: Our study included 15 eyes from 15 patients with rheumatogenic giant tear retinal detachments. The average follow-up is 9 months. The average age of the patients was 45 years. Six patients were severely short-sighted; 30% of patients had stage C vitreous proliferations at diagnosis. Immediate postoperative anatomical reapplication was achieved in 85% of patients. After 1 year, anatomical reapplication was achieved in 100% of patients. The average visual acuity was 2/10. CONCLUSION: Surgery for rheumatogenic retinal detachment caused by a giant tear is a procedure that is still considered difficult with uncertain results. The progress of endocular surgery and tamponade methods has made it possible to revolutionize the prognosis of these detachments.