[Advantages of acetazolamide associated with anti-inflammatory medications in postoperative treatment of macular edema]. / Intérêt de l'acétazolamide associé aux anti-inflammatoires dans le traitement de l'oedème maculaire postopératoire.

PURPOSE: To analyze the effectiveness of acetazolamide associated with topical nonsteroidal anti-inflammatory drugs (NSAIDs) and/or steroids in the treatment of postsurgical macular edema (ME). PATIENTS AND METHODS: Sixteen eyes of 15 consecutive patients presenting with clinical ME 1-120 months after ophthalmologic surgery were studied retrospectively. The mean duration of ME before treatment was 5 months. All patients were treated with 250-500 mg of acetazolamide per day, associated with topical NSAIDs and/or steroids for an average of 6.9 months. The main outcome measures were the best-corrected visual acuity expressed in Log MAR, and the retinal thickness evaluated with OCT. RESULTS: The mean initial visual acuity was 20/100 (0.7 +/- 0.28 Log MAR), with a macular thickness of 599.67 +/-174.17 microm (average +/- standard deviation). The mean final visual acuity was 20/40 (+0.3 +/- 0.2 Log MAR) with a macular thickness of 264.69 +/- 106.59 microm. Treatment was effective in 87.5% of overall cases. The effectiveness was 100% in the subgroup treated with acetazolamide, NSAIDs, and steroids. CONCLUSION: This study suggests that medical treatment with a combination of acetazolamide, topical NSAIDs and/or steroids may be beneficial for reducing retinal thickness and improving vision in postsurgical ME.

[Fibrinolysis in the treatment of the amaurosis fugax: a case report]. / Fibrinolyse dans le traitement de l'amaurosis fugax. A propos d'un cas.

The authors report a case of amaurosis fugax treated first by systemic fibrinolysis and then by antiplatelet treatment. A 47-year-old suffering from transient amaurosis due to recurrent occlusion of retinal arterial branches improved after treatment and showed no recurrence. This protocol appears effective in cases of probable embolus in a young patient with no contraindications and when flow is not reestablished (amaurosis fugax), or when the required 6-hour time delay is respected.

[Limbal stem cell deficiency associated with KID syndrome, about a case]. / Insuffisance limbique bilatérale associée à un syndrome KID. A propos d'un cas.

We report the case of a 30-year-old woman with KID (keratitis ichthyosis deafness) syndrome consulting for massive corneal neovascularization. She had already undergone two unsuccessful penetrating keratoplasties in her left eye. Visual acuity was limited to no more than light perception because of the opacity and neovascularization of the graft. In the light of this case of limbal cell deficiency, we discuss the ophthalmologic manifestations of KID syndrome as well as its clinical characteristics, physiopathology, and mode of transmission.

Analysis of retinal and choroidal circulation during central retinal vein occlusion using indocyanine green videoangiography.

OBJECTIVE: To explore the hemodynamic changes and their correlation with clinical presentation during central retinal vein occlusion. MATERIALS AND METHODS: Retrospective, 2-center study. The medical records of 27 patients with central retinal vein occlusion were reviewed. For each patient, the plasma transit in central retinal vessels and in peripapillary choroidal vessels was analyzed using indocyanine green videoangiography. RESULTS: The incidence of alteration in retinal plasma transit, ie, pulsatile filling of arteries and/or veins and increased arteriovenous filling time, was inversely correlated to duration from the onset but not to funduscopic features. Among the 14 patients with less than 1 month's duration of symptoms, 3 developed chronic macular edema, and impairment of arterial flow preceded its onset. Among the 10 patients with opticociliary circulation, choroidal drainage routes were identified in 5 cases, with pulsatile filling in 3. CONCLUSIONS: Early in the course of central retinal vein occlusion, arterial and/or venous flow alterations are present, irrespective of visual acuity, vein dilation, or fundus hemorrhages. These alterations are less frequent in chronic than in recent-onset central retinal vein occlusion. The mechanisms of these alterations remain uncertain but may involve arterial constriction and/or intermittent venous compression. The relationship between these alterations in retinal flow and the secondary onset of macular edema or capillary nonperfusion deserves further investigation.