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1.
J Fr Ophtalmol ; 39(7): 615-21, 2016 Sep.
Article in English | MEDLINE | ID: mdl-27544327

ABSTRACT

PURPOSE: A low concentration of macular carotenoid pigment (lutein and zeaxanthin) is a significant risk factor for macular degeneration. The goal of this paper is to investigate the relationship between macular pigment optical density (MPOD) and lacquer cracks (LC) in high myopia. METHODS: This is a prospective comparative observational study (NCT02205632) including high myopic patients with or without LC. High myopia was defined as a refractive error greater than 6 diopters of myopia or axial length greater than 26mm. All patients underwent best-corrected visual acuity in logMAR, MPOD measurement, multicolor imaging, SD-OCT, autofluorescence and axial length measurement. MPOD was calculated using heterochromatic flicker photometry. Group 1 was defined as eyes without LC and group 2 as eyes with LC. RESULTS: Forty-five eyes of 32 patients with a mean age of 51.3 years were included in group 1, and 15 eyes of 13 patients aged 54.1 in group 2 (P=0.56). Mean spherical equivalent was -10.11 diopters in group 1 and -15.11 in group 2 (P=0.0004). Mean visual acuity was +0.08 logMAR (0.8 in decimal notation) in group 1 and +0.11 logMAR (0.8 in decimal notation) in group 2 (P=0.061). Axial length was 27.8mm in group 1 and 29.2 in group 2 (P=0.0052). Central macular thickness was lower in group 1 (295µm) than in group 2 (305µm) (P<0.0001), and macular choroidal thickness did not differ between the two groups (P=0.094). Mean MPOD in group 2 was 0.52 and 0.63 in group 1 (P=0.042). Differences in axial length were not related to MPOD measurements (P=0.74). CONCLUSION: A lower rate of MPOD was observed in cases of LC in high myopia. Further studies are needed to investigate if dietary carotenoids could have a protective effect in reducing the risk of LC.


Subject(s)
Macula Lutea/pathology , Macular Pigment/analysis , Myopia/pathology , Adult , Aged , Female , Humans , Macula Lutea/diagnostic imaging , Macular Degeneration/diagnosis , Macular Degeneration/etiology , Macular Pigment/metabolism , Male , Middle Aged , Myopia/diagnosis , Myopia/metabolism , Photometry , Risk Factors , Severity of Illness Index , Tomography, Optical Coherence , Visual Acuity
2.
J Fr Ophtalmol ; 39(4): 355-63, 2016 Apr.
Article in English | MEDLINE | ID: mdl-27016335

ABSTRACT

PURPOSE: To describe the prevalence of macular complications in patients with visual acuity decrease related to high myopia (HM). To establish correlations between these complications and demographic or anatomical characteristics. MATERIALS AND METHODS: Cross-sectional observational study including HM patients undergoing best-corrected visual acuity (BCVA), fundus examination, macular SD-OCT, and fluorescein angiography in the case of suspicion of choroidal neovascularization (CNV). The presence of anatomical criteria (staphyloma, subfoveal choroidal thickness [CT]) and macular complications (CNV, lacquer cracks, central chorioretinal atrophy, dome-shaped macula with serous retinal detachment [SRD], retinal foveoschisis, macular hole and epiretinal membrane) was investigated. RESULTS: A total of 87 eyes of 47 patients were included (39 eyes without macular complication and 48 eyes with macular complications). In the case of macular complications, decrease in BCVA was related to CNV in 33%, macular hole in 25%, chorioretinal atrophy in 19%, foveoschisis in 11%, lacquer crack in 6%, to a dome-shape macula with serous retinal detachment in 4% and epiretinal membrane in 2%. After adjusting for interocular correlation and degree of myopia, staphyloma (P=0.0023), choroidal thinning (P=0.0036), and extrafoveal chorioretinal atrophy (P=0.042) were significantly associated with macular complications. CONCLUSIONS: High myopic patients with staphyloma or choroidal thinning should undergo regular comprehensive retinal screening for retinal complications.


Subject(s)
Myopia/epidemiology , Retinal Diseases/epidemiology , Adult , Aged , Aged, 80 and over , Choroidal Neovascularization/complications , Choroidal Neovascularization/diagnostic imaging , Choroidal Neovascularization/epidemiology , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , Multimodal Imaging , Myopia/complications , Myopia/diagnostic imaging , Myopia, Degenerative/complications , Myopia, Degenerative/diagnostic imaging , Myopia, Degenerative/epidemiology , Prevalence , Retinal Detachment/complications , Retinal Detachment/diagnostic imaging , Retinal Detachment/epidemiology , Retinal Diseases/complications , Retinal Diseases/diagnostic imaging , Retinal Perforations/complications , Retinal Perforations/diagnostic imaging , Retinal Perforations/epidemiology
3.
J Fr Ophtalmol ; 36(1): 50-4, 2013 Jan.
Article in French | MEDLINE | ID: mdl-23022343

ABSTRACT

INTRODUCTION: The reduced supply of anesthesiologists in the hospital setting calls for a reconsideration of anesthesia management for ophthalmology patients. Therefore, a simplified management protocol has been designed through close collaboration between the involved specialists for cataract surgery under topical anesthesia (anesthetic eye drops or sub-Tenon's injection). MATERIALS AND METHODS: At the conclusion of the visit confirming the need for surgery, the surgeon completes a questionnaire designed to elicit a history of the presence of diabetes mellitus (type I or II), prior organ transplantation, chronic renal insufficiency requiring dialysis, communication difficulties, psychiatric disorders, allergy and/or a complex cataract. If one of the items is positive, the patient is scheduled for a preoperative anesthesia consult. If all the items are negative, this anesthesia evaluation is waived. The surgeon explains the fasting requirement and how to take the patient's usual medications on the morning of surgery. The patient continues his/her medications. No lab tests or chest X-ray are performed. If necessary, the surgeon prescribes preoperative antibiotic prophylaxis and any other preparation. During the surgery, the patient receives IV fluids and is monitored via EKG, non-invasive blood pressure and pulse oxymetry by a certified nurse anesthetist. The anesthesiologist on duty (one per every four rooms) is immediately available for the slightest problem. The surgeon signs the postoperative anesthesia note and discharge order. RESULTS: This procedure was assessed by one surgeon over a one year period, including 145 patients (60% of the patients recruited for this surgery), primarily outpatient (77%) under topical anesthesia (Oxybuprocaine(®)+Visthesia(®), Zeiss) or under sub-Tenon's injection (Xylocaïne(®)). No major complications were observed. Seven cases of arterial hypertension, treated with calcium channel blockers (nicardipine), and three episodes of brief anxiety were observed. CONCLUSION: This simplified anesthesia protocol appears to be safe and effective but requires more demanding involvement of the surgeon, whose scope of competence and responsibility must naturally increase. This is the only way by which cataract surgery can remain competitive.


Subject(s)
Anesthesia, Local/methods , Anesthetics, Local/administration & dosage , Cataract Extraction/methods , Administration, Topical , Aged , Aged, 80 and over , Anesthesia, Local/adverse effects , Cataract Extraction/adverse effects , Cataract Extraction/statistics & numerical data , Female , Follow-Up Studies , Humans , Male , Middle Aged , Monitoring, Intraoperative/methods , Pain, Postoperative/epidemiology , Pain, Postoperative/prevention & control , Postoperative Complications/epidemiology , Retrospective Studies
5.
J Fr Ophtalmol ; 30(3): e8, 2007 Mar.
Article in French | MEDLINE | ID: mdl-17417145

ABSTRACT

Preretinal arterial loops are congenital vascular anomalies that originate from a main branch of the central retinal artery on the optic disc. These arterial loops are usually unilateral and asymptomatic, but they can be associated with retinal artery branch occlusion. We report one case of inferior temporal retinal artery occlusion in a patient with preretinal arterial loops. Two different mechanisms are thought to be the cause of occlusion: twisting of the loop or thrombosis.


Subject(s)
Optic Disk/blood supply , Retinal Artery Occlusion/etiology , Retinal Artery/abnormalities , Scotoma/etiology , Thrombosis/complications , Adolescent , Fluorescein Angiography , Humans , Male , Radiography , Retinal Artery/embryology , Retinal Artery Occlusion/diagnostic imaging , Retinal Artery Occlusion/physiopathology , Torsion Abnormality , Visual Fields
6.
J Fr Ophtalmol ; 30(1): e2, 2007 Jan.
Article in French | MEDLINE | ID: mdl-17287664

ABSTRACT

INTRODUCTION: Oguchi disease, originally described in Japanese people, is a rare form of stationary night blindness in patients with normal acuity. OBSERVATION: We report the case of an 8-year-old girl who presented with an abnormal terrified behavior in the dark. Thorough questioning revealed hemeralopia. Her clinical examination (visual acuity, Goldmann visual field, and color vision) were normal. The fundus examination showed golden-brown color, grayish, almost greenish yellow discoloration in the peripheral area with no osteoclast. This abnormality disappeared after prolonged dark adaptation. The electroretinogram showed a reduced b wave amplitude under scotopic conditions. Her parents were cousins. CONCLUSION: This diagnosis should be suggested when hemeralopia is associated with typical fundus aspect resolving after dark adaptation (so called Mizuo-Nakamura phenomenon). The long-term prognosis in these patients is good in the absence of clinical progression. This is a genetic autosomal recessive disease caused by mutations in the gene coding for arrestin located in 2q37.1.


Subject(s)
Arrestin/deficiency , Night Blindness/congenital , Vision Disorders/congenital , Arrestin/genetics , Child , Chromosomes, Human, Pair 2/genetics , Color , Consanguinity , Dark Adaptation/physiology , Dreams , Electroretinography , Fear , Female , Fundus Oculi , G-Protein-Coupled Receptor Kinase 1/metabolism , Genes, Recessive , Humans , Night Blindness/diagnosis , Night Blindness/genetics , Night Blindness/pathology
7.
Diabetes Metab ; 33(1): 37-43, 2007 Feb.
Article in English | MEDLINE | ID: mdl-17258929

ABSTRACT

AIMS: Insulin resistance is a key feature of type 2 diabetes. It is also involved in the development and progression of microvascular complications. We analysed the relationship between parental history of diabetes, insulin resistance and diabetic nephropathy (DN) and assessed the specific maternal and paternal influences of history of type 2 diabetes on DN in type 1 diabetic offspring. METHODS: We recorded information regarding family history of type 2 diabetes and of cardiovascular disease in 160 consecutive, unrelated type 1 diabetic patients. Insulin resistance was assessed using a validated estimation of the glucose disposal rate (eGDR). RESULTS: Type 1 diabetic patients with a maternal history of type 2 diabetes were more likely to be insulin-resistant (P=0.043) and to have renal complications (P=0.0041) than those from the reference group (without parental history of diabetes), while patients with a paternal history were not different from those from the reference group, regarding eGDR and DN. Time to development of abnormal albuminuria was significantly affected by maternal history of type 2 diabetes (log-rank=12.66; P=0.0004) and by familial history of premature cardiovascular disease (log-rank=5.48; P=0.0234). In multivariate analysis, a maternal history of type 2 diabetes was independently associated with nephropathy after adjustment for sex, diabetes duration and familial history of premature cardiovascular disease. CONCLUSION: Maternal history of type 2 diabetes is independently associated with DN in type 1 diabetic patients. This might suggest the transmission of a maternal trait related to microvascular complications, raising the hypothesis of imprinted genes predisposing to diabetic renal disease.


Subject(s)
Diabetes Mellitus, Type 1/epidemiology , Diabetes Mellitus, Type 1/genetics , Diabetes Mellitus, Type 2/genetics , Diabetic Nephropathies/epidemiology , Diabetic Nephropathies/genetics , Mothers , Blood Pressure , Body Mass Index , Body Size , Cholesterol/blood , Female , France , Glycated Hemoglobin/analysis , Humans , Insulin Resistance/genetics , Lipids/blood , Male , Medical History Taking
8.
J Fr Ophtalmol ; 28(3): 290-7, 2005 Mar.
Article in French | MEDLINE | ID: mdl-15883494

ABSTRACT

INTRODUCTION: Idiopathic epiretinal membrane (ERM) results from detachment of the posterior hyaloid. Vitrectomy and peeling are the treatment of choice. Trypan blue 0.15% (TB) stains the epiretinal membrane and the internal limiting membrane (ILM), facilitating surgery and thus allowing selective and complete removal with less retinal damage. We conducted a study evaluating the advantages of selective staining associated with surgery, the incidence of postoperative damage, and the influence on final visual acuity. MATERIAL AND METHODS: Fourteen patients were operated on by the same surgeon, who carried out a complete vitrectomy, then fluid-air exchange for dye injection of undiluted 0.2 ml of Trypan blue 0.15% in front of the membrane, which was then easily distinguished from the area under the retina. Preoperative visual acuity, postoperative damage, as well as eye status at the end of follow-up are discussed. Transmission electron microscopy was used to determine if epiretinal membrane removal was complete and selective. Angiography was systematically used to study the state of retina before and after surgery. RESULTS: Preliminary results show that trypan blue is useful and facilitates complete removal of ERM and ILM. It may reduce long-term complications and recurrent membrane formation. Trypan blue is a staining agent that is quick and easy to use. It presents no short-term toxic effects. Functional results in 6 months show improvement of visual acuity and disappearance of metamorphopsia. CONCLUSION: Idiopathic epiretinal membrane surgery with tryptan blue staining is a better alternative than indocyanine green staining.


Subject(s)
Coloring Agents , Epiretinal Membrane/surgery , Trypan Blue , Vision Disorders , Vitrectomy , Aged , Aged, 80 and over , Female , Follow-Up Studies , Humans , Male , Microscopy, Electron, Transmission , Middle Aged , Postoperative Complications , Recurrence , Time Factors , Visual Acuity
9.
J Fr Ophtalmol ; 28(2): 169-76, 2005 Feb.
Article in French | MEDLINE | ID: mdl-15851950

ABSTRACT

INTRODUCTION: Idiopathic epiretinal membranes are considered the consequence of glial proliferation through a defect of the internal limiting membrane and can induce a functional macular syndrome associating mainly metamorphopsia and visual acuteness. Visual disturbance is not bound to the area and the degree of transparency of the membrane, but to distortion of external layers of the retina. Multifocal electroretinography (ERGm) can assess the macular area and retina extending 20 degrees. We used this tool to study macular function pre- and post-operatively with seven patients presenting idiopathic epiretinal membrane. PATIENT AND METHOD: All patients had successful vitrectomy, with 0.2 ml of 0.15% trypan blue (TB) staining to facilitate peeling. This stain is not toxic for the pigment epithelium but it becomes so for photoreceptors at doses exceeding 0.2%. We tried to estimate the echo of TB 0.15% on photoreceptors through this exam. An ERGm was done 1 week before the operation as well as 1 month and 4 months after on 14 eyes of seven patients with ERMs. RESULTS: Results show a pre-operative decrease in the electrical retinal response densities in the foveal, perifoveal and parafoveal areas. One month after operation, no significant difference was found compared to pre-operative results. However, at 4 months, an improvement of the retinal response density was observed. Retinal response densities in the macular area increased progressively after ERM surgery. CONCLUSION: The 0.15% TB facilitated ERM peeling and does not seem to present any retinal toxicity.


Subject(s)
Epiretinal Membrane/pathology , Epiretinal Membrane/surgery , Trypan Blue/adverse effects , Electroretinography , Epiretinal Membrane/physiopathology , Female , Humans , Male , Prospective Studies , Retina/drug effects , Retina/physiopathology , Retina/ultrastructure
10.
J Fr Ophtalmol ; 28(2): 159-67, 2005 Feb.
Article in French | MEDLINE | ID: mdl-15851949

ABSTRACT

INTRODUCTION: Idiopathic epiretinal membrane results from detachment of the posterior hyaloid and is believed to be related to naturally occurring defects in the internal limiting membrane (ILM) of the retina. Vitrectomy and peeling are the treatment of choice. Trypan blue 0.15% (TB) stains epiretinal membrane and internal limiting membrane. It allows selective and complete removal, facilitating surgery, with less retinal damage. An ultrastructural study was conducted showing ultrastructural features of idiopathic epiretinal membranes (ERM) and those of the internal limiting membrane and its connections with the retinal side. MATERIAL AND METHODS: After pars plana vitrectomy and induction of posterior vitreous detachment, 0.2 ml TB 0.15% was injected over the ERM in an air-filled eye. The stained tissue was peeled with intraocular forceps. Specimens were at once collected in 4% glutaraldehyde for a transmission electron microscopy study. RESULTS: TB may allow complete and easier ERM and ILM peeling. The staining does not present toxic effects. The major cellular contingent is represented by glial cells, participating actively in neocollagen synthesis. Their presence supports the hypothesis of a migratory movement of retinal cells toward the vitreoretinal side. CONCLUSION: The presence of an intact internal limiting membrane, the absence of optical fibers belonging to the under retina, and the absence of any sign of apoptosis make TB a useful staining agent for ERM and ILM peeling.


Subject(s)
Retina/ultrastructure , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Prospective Studies , Trypan Blue
11.
J Fr Ophtalmol ; 27(7): 791-4, 2004 Sep.
Article in French | MEDLINE | ID: mdl-15499277

ABSTRACT

PURPOSE: Asteroid hyalosis is a vitreous degeneration with calcium and phosphorus--lipid complexes in elderly patients with vascular risk factors or general disease such as diabetes mellitus. Synchysis scintillans is a complication of pathological eyes. Generally there are no symptoms. This study aims to evaluate the role of vitrectomy in patients with a decrease in visual acuity. CASE REPORTS: Pars plana vitrectomy was performed in three patients with visual acuity less than 1/10. The biomicroscope examination showed white and bright particles with rounded and variable shapes localized in the anterior vitreous, moving with the eye. The visualization of the fundus was difficult or impossible. On echography B, the vitreous was very dense with a complete posterior vitreous detachment. The vitrectomy was completed in one case by peeling an epiretinal membrane. Visual acuity was improved for two patients (6/10 or more) and stable for one patient with an atrophic DMLA. DISCUSSION AND CONCLUSION: These results were compared with studies in the literature: in spite of complications, vitrectomy can be indicated in patients with a substantial decrease in visual acuity. However, the result is conditioned by the macular status. Fluorescein angiography can, when it is possible, evaluate the fundus before surgery.


Subject(s)
Eye Diseases/surgery , Vitrectomy , Vitreous Body/pathology , Aged , Aged, 80 and over , Eye Diseases/diagnosis , Fluorescein Angiography , Humans , Male , Treatment Outcome , Visual Acuity , Vitreous Body/surgery
12.
J Fr Ophtalmol ; 26(1): 59-63, 2003 Jan.
Article in French | MEDLINE | ID: mdl-12610411

ABSTRACT

BACKGROUND: Described by Theodore Leber in 1916, this syndrome is characterized by unilateral visual loss, optic disc swelling and a stellate pattern of exudative deposits in the macula. MATERIAL AND METHODS: Two young adults were examined for sudden unilateral visual loss preceded by a flu-like syndrome. Fundus examination revealed a swollen optic disc and a macular star, visualized on fluorescein angiography. Visual field, laboratory tests and cranial and orbital tomodensitometry were performed. RESULTS: Visual field examination showed a centrocecal scotoma. Laboratory tests showed inflammatory syndrome in one case. Serology testing (leptospirosis, cat scratch disease, toxoplasmosis and syphilis, etc.) were negative. Tomodensitometry of the brain and orbits gave normal results. One of the patients was treated with intravenous steroid boluses; the other received no treatment. A few weeks after the beginning of symptoms, the swelling of the optic disc seemed to have declined, leaving the macular star unchanged. CONCLUSION: These two cases typically describe Leber's idiopathic stellate neuroretinitis. The prognosis for visual recovery is usually reported to be excellent, but visual sequelae have been described.


Subject(s)
Optic Atrophy, Hereditary, Leber/diagnosis , Optic Nerve Diseases/diagnosis , Retinitis/diagnosis , Adolescent , Female , Fluorescein Angiography , Fundus Oculi , Humans , Macula Lutea , Male , Optic Disk , Prognosis , Visual Fields
13.
J Fr Ophtalmol ; 25(6): 621-6, 2002 Jun.
Article in French | MEDLINE | ID: mdl-12223951

ABSTRACT

PURPOSE: We report two techniques for treatment of dural arteriovenous fistulas using femoral vein catheterism and direct surgery via the superior ophthalmic vein. We will attempt to show the advantages of these new techniques instead of using the arterial pathway, which is currently the reference procedure. SUBJECTS AND METHOD: Mrs G, 75 years old was sent by her ophthalmologist because of a suspected orbital tumor. Visual acuity: right eye: 3/10, exophthalmia, chemosis, with no thrill or murmur. The fundus examination was normal. The ultrasound exam with color Doppler imaging showed an arterialization of the superior ophthalmic vein compatible with an arteriovenous sinus dural fistula. Angio-MRI revealed a large left cavernous sinus, confirming the diagnosis. Considering the type of the fistula and the weak physical condition of the patient, we decided to attempt an endovascular embolization with coil placement, using femoral vein catheterism. Exophthalmia regressed within days. The fistula remains sealed 1 year after the procedure. Mr D, 40 years old, showed a similar clinical aspect of sinus dural fistula. We attempted an embolization with the femoral vein, which failed. We decided to embolize the cavernous sinus via the direct surgical pathway of the superior ophthalmic vein. Coils were placed and the fistula was sealed. CONCLUSION: These clinical cases show two less invasive alternatives giving better results than arterial embolization, the reference method (Brooks 1930; Spearmann 1964; Parkinson 1965), endovascular trapping, or surgery.


Subject(s)
Arteriovenous Fistula/therapy , Cavernous Sinus/abnormalities , Cerebral Veins/pathology , Adult , Cavernous Sinus/diagnostic imaging , Cavernous Sinus/surgery , Embolization, Therapeutic , Exophthalmos/diagnosis , Female , Humans , Ultrasonography, Doppler, Color , Visual Acuity
14.
J Fr Ophtalmol ; 20(4): 252-7, 1997.
Article in French | MEDLINE | ID: mdl-9181135

ABSTRACT

PURPOSE: We report two cases of toxocariasis peripheral granuloma in adults. METHODS: Diagnostic difficulties linked to parasite serologies, particular to these two cases, are presented. Serology is often poorly contributive, but PCA and/or vitreous study with the ELISA reaction to Toxocara canis homologous antigens in the endocular fluids are the most reliable means of reaching a diagnosis, as evidence in our two observations. In the same way, the presence of eosinophils and of IgE in the aqueous humor and or vitreous is of great importance for orienting the diagnosis. RESULTS: The treatment consisted in systemic steroids and granuloma cryotherapy associated with vitrectomy and for one case indentation due to a traction. Later, retinal membrane peel was performed for the same patient. No treatment with antihelminthic drugs was proposed. The functional and anatomic results were good in both cases (8/10-P2 and 6/10-P2). CONCLUSION: Toxocara canis infection is based on clinical aspects. The ELISA technique is useful for biological diagnosis.


Subject(s)
Granuloma/parasitology , Retinal Diseases/parasitology , Toxocara canis , Toxocariasis/diagnosis , Adult , Animals , Female , Granuloma/therapy , Humans , Middle Aged , Retinal Diseases/therapy , Toxocariasis/therapy
15.
J Fr Ophtalmol ; 19(10): 597-602, 1996.
Article in French | MEDLINE | ID: mdl-8959100

ABSTRACT

PURPOSE: Vision prognostic study depending on the germs and the therapic performed in bacterial endophthalmitis. METHODS: In a retrospective study over a period of 3 years (1991-1993), 32 cases of post surgery bacterian endophthalmitis were detected: 30 cases after cataract surgery (29 cases after extra capsular surgery and one case after intra capsular), one case after trabeculectomy and one case after keratoplasty. RESULTS: A risk factor was evidenced in 15.6% of the cases. Endocular samples were done in 68.75% of the cases. The positive rate was 36.4% showing a Staphylococcus in 5 cases out of 8 (62,5%). In 37.5% of the cases an intraocular antibiotic injection was associated to the anterior chamber punction. 40% of the cases contaminated with Staphylococcus regained a visual acuity of more than 3/10. For the two cases where a Streptococcus was isolated an evisceration was necessary. Our results show that a higher visual acuity was obtained when a posterior vitrectomy was performed. When the posterior vitrectomy was associated with a corticoid therapy, the visual prognostic was better. Thus, 71% of these cases regained a visual acuity of more than 3/10. CONCLUSION: Our results show that performing a posterior vitrectomy associated to a general corticotherapy within 48 hours from the bacterian endophthalmitis diagnosis would allow best vision improvement.


Subject(s)
Bacterial Infections , Endophthalmitis/microbiology , Adrenal Cortex Hormones/therapeutic use , Aged , Anti-Bacterial Agents , Bacterial Infections/microbiology , Bacterial Infections/physiopathology , Bacterial Infections/therapy , Combined Modality Therapy , Drug Therapy, Combination/therapeutic use , Endophthalmitis/physiopathology , Endophthalmitis/therapy , Female , Humans , Male , Prognosis , Treatment Outcome , Vitrectomy
16.
J Fr Ophtalmol ; 19(4): 271-7, 1996.
Article in French | MEDLINE | ID: mdl-8734220

ABSTRACT

PURPOSE: The purpose of this study was to assess the effects of amount of myopia, axial elongation staphyloma and type of optical correction on contrast sensitivity of high myopic subjects. METHODS: Fifty-one patients (91 eyes) were selected on the following qualifications: myopia > or = 8 dpt and/or axial length > or = 26 mm, and visual acuity > or = 0.1 recorded through spectacle lenses. Contrast sensitivity was measured using a "Moniteur Ophtalmologique" for all subjects when corrected with spectacle lenses, and thereafter on a lot of patients (50 eyes) wearing a contact lens. RESULTS: Contrast sensitivity obtained with spectacle lenses was significantly decreased over the whole spatial frequency range. The higher the spatial frequency was, the lower contrast sensitivity was. The impairment increased with the amount of myopia and axial length, but without positive correlation. Contrast sensitivity was significantly lower for only the three highest spatial frequencies measured (6.4; 12.8 and 25.6 c/deg), when a staphyloma (n = 52) was present by comparison with results obtained for eyes without staphyloma (n = 39). Differences between the two situations (spectacle lens vs. contact lens) were not significant for eyes wearing daily spectacle lenses; conversely, for myopic subjects generally fitted with contact lenses, contrast sensitivity with contact lenses was significantly better than that measured with spectacles for the three highest spatial frequencies tested. CONCLUSION: This suggests that the decrease in contrast sensitivity measured in high myopia is related to defects in the optical and neuro-retinal systems.


Subject(s)
Contrast Sensitivity , Myopia/physiopathology , Space Perception , Adult , Aged , Contact Lenses , Eyeglasses , Humans , Middle Aged , Perceptual Disorders/etiology , Visual Acuity
17.
J Fr Ophtalmol ; 18(11): 650-5, 1995.
Article in French | MEDLINE | ID: mdl-8745762

ABSTRACT

PURPOSE: Bacterial contamination of anterior chamber at the end of cataract surgery, was compared between two techniques: extracapsular extraction and phacoemulsification. The effectiveness of preoperative antibiotic eyedrops using Norfloxacine 0.3% (Chibroxine) was also evaluated. METHOD: The study focused on 101 patients grouped according to surgical technique and presence of preoperative antibiotic eyedrops. Conjunctival sampling was made the day prior the surgery, as well as in the operating room, after skin and conjunctival desinfection with povidone iodine in all the patients included in the study. Aqueous humour was collected at the end of surgery. RESULTS: Eight samples out of 101 were positive which represents 7.9% of the cases. In 75% of the cases, the anterior chamber aspirate showed a different germ or non-recurrent germ in the second conjunctival sample. None of the included patients developed endophthalmitis. The two most frequent pathogens were Propionibacterium acnes in 62.5% of the cases, and Staphylococcus epidermidis in 50%. Another pathogen was found in a culture environment: Micrococcus roseus. In two samples, two different bacteria grew: Propionibacterium acnes and Staphylococcus epidermidis. Whatever the surgical technique, no statistically significant bacterial contamination was found. There was no significant statistical difference between patients who had local antibiotic eyedrops and those who did not. CONCLUSION: This study confirms the poor reliability of local antibiotic eyedrops to prevent surgical contamination. Furthermore performing an anterior chamber aspirate at the end of the surgery for risk patients would help the physician identify the pathogens involved in endophthalmitis in order to begin antibiotic treatment as soon as possible.


Subject(s)
Anti-Infective Agents/therapeutic use , Antibiotic Prophylaxis , Aqueous Humor/microbiology , Bacterial Infections/prevention & control , Cataract Extraction , Norfloxacin/therapeutic use , Administration, Topical , Anti-Infective Agents/administration & dosage , Bacterial Infections/microbiology , Cataract Extraction/methods , Conjunctiva/microbiology , Humans , Norfloxacin/administration & dosage
18.
J Fr Ophtalmol ; 15(12): 645-50, 1992.
Article in French | MEDLINE | ID: mdl-1299676

ABSTRACT

The progression of field loss was determined by Humphrey Automated threshold perimetry in the short and intermediate term after surgical trabeculectomy for chronic glaucoma: mean indices (MD, PSD et FOV) were studied before and after normalisation of the intraocular pressure. Risk factors such as secondary glaucoma, previous visual field defects and cardiovascular risk factors were significantly correlated to poor or bad progression of field loss: the mean variation of MD = +1.23 dB +/- 2.84 (p < 1.5%), the mean variation of PSD = 0.50 dB +/- 1.37 (p < 6%), but the mean variation of FOV was not significant; so 36% of field defects were improved, 42% were stabilized and 22% were aggravated. When the risk factors were absent, 86% of field losses were stabilised but when cardiovascular factors were present, only 64% were stabilised. These risk factors can also be used to ascertain the prognosis of post-surgical progression of visual field, as already shown in previous reports. Automated threshold perimetry was useful to study the visual field progression with standardized and reliable numerical parameters, allowing statistical computerised management of the patients with glaucoma.


Subject(s)
Glaucoma/surgery , Visual Field Tests , Visual Fields , Adolescent , Adult , Aged , Aged, 80 and over , Chronic Disease , Female , Glaucoma/physiopathology , Humans , Male , Middle Aged , Postoperative Period , Prognosis , Risk Factors , Time Factors , Trabeculectomy
19.
Ophtalmologie ; 4(2): 213-4, 1990.
Article in French | MEDLINE | ID: mdl-2235018

ABSTRACT

The subjective aniseiconia was measured with spatial eiconometer on 51 isometropic and unilateral pseudophakic patients in relation with the post-operative anisometropia. The median value of subjective aniseiconia is 2-3% for anisometropia minus or equal to 5 diopters, without statistic correlation, related to a probably "sensorial brain adaptation". So error of intra-ocular lens power calculation less than 7.5 diopters may be accepted.


Subject(s)
Aniseikonia/diagnosis , Cataract Extraction , Lenses, Intraocular , Aged , Aniseikonia/etiology , Cataract Extraction/adverse effects , Female , Humans , Lenses, Intraocular/adverse effects , Male , Vision, Binocular
20.
Bull Soc Ophtalmol Fr ; 89(8-9): 1039-44, 1989.
Article in French | MEDLINE | ID: mdl-2620421

ABSTRACT

We measured apparent accommodation in 51 pseudophakic eyes (44 patients, after implantation of anterior (15 eyes) or posterior (36 eyes) intraocular lens. Glasses for distant vision were born during the test. The mean apparent accommodation was 1.89 +/- 0.91 dpt. 25 among these 51 pseudophakic eyes who were tested without their glasses showed a mean apparent accommodation that was not different in statistical and clinical terms. The mean accommodative power of 25 phakic and presbyopic eyes used as controls was 1.31 +/- 1.01 dpt. For these 51 pseudophakic eyes the correlation between apparent accommodation and the reciprocal of the pupillary diameter is the most significant (r = 0.79): the smaller the pupil, the greater the apparent accommodation. There was a negative correlation between apparent accommodation and anterior chamber depth (r = -0.64). No correlation was found between pseudo-accommodation and corrected visual acuity, corneal astigmatism and refractive error.


Subject(s)
Accommodation, Ocular , Lenses, Intraocular , Accommodation, Ocular/physiology , Humans , Postoperative Period
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