ABSTRACT
12 patients suffering from Behçet's disease have received immunosuppressive therapy. All patients have been given chlorambucil. In addition 5 patients who were threatened by an acute and permanent blindness from severe retinal vein involvement received antilymphocyte globulins. The follow-up ranges from 1 year up to 71/2 years with an average of 31/2 years. Complete recovery from ocular inflammation has been achieved in all patients. Visual acuity remained unchanged or improved in all patients but 1. Ocular recurrences occurred in 2 patients after decreasing the daily dose of chlorambucil and in 1 patient 2 years after the end of a 1-year treatment. The action of chlorambucil was not so constant upon systemic involvement of the disease than upon ocular inflammation. Nevertheless, 1 patient recovered from severe central nervous system involvement with hemiplegia. The review of the literature and comparison with our own experience leads to suggest that the discrepancy of the published results should be related to the variety of the immunosuppressive drugs which have been tried in Behçet's disease. Chlorambucil seems to be the most effective and the less toxic drug. But its action upon eye inflammation requires 2-3 months to take place. Therefore, in the most severe cases threatened by an acute and permanent blindness, the treatment should be started with antilymphocyte globulins.
Subject(s)
Antilymphocyte Serum/therapeutic use , Behcet Syndrome/drug therapy , Chlorambucil/therapeutic use , Chlorambucil/administration & dosage , Drug Administration Schedule , Follow-Up Studies , Humans , Visual AcuityABSTRACT
The 595 angiographic lesions observed in 233 eyes of 169 patients affected with central serous retinopathy have been classified upon their localization. 498 angiographic lesions (83.7 percent) are located within a three optic disc diameter area centered by the foveola. Among them 20 are located right behind the foveola, 113 are located in the upper temporal quadrant, 166 in the upper nasal quadrant and 85 in the lower temporal quadrant. The relative density of the angiographic lesions decreases from the center of the macula to the periphery. 97 angiographic lesions (16.3 percent) are located beyond the three optic disc diameter central area. 41.1 percent of the lesions are situated behind the macula or/and behind the papillo-macular bundle. Therefore only 58.9 percent of the angiographic lesions observed in central serous retinopathy can be treated without any risk by means of photocoagulation.
Subject(s)
Arachnoiditis/diagnosis , Cranial Fossa, Posterior , Diagnosis, Differential , Humans , Macula Lutea , Radiography , Retinal Detachment/diagnostic imaging , Retinitis/diagnostic imagingABSTRACT
The precision of adjustment, of control of indentation, and above all of cryocoagulation made under microscopic control with Goldman's glass, allows us to improve our anatomical and functional results in the surgical treatment of retinal detachment.
