[Corneal manifestations of measles in the unvaccinated adult: two typical cases during an epidemic]. / Manifestations cornéennes de la rougeole chez l'adulte non vacciné : deux cas typiques en période d'épidémie.

Measles is a disease due to morbillivirus, which belongs to the paramyxoviridae subfamily. It affects mostly young patients, and evolves through four phases: incubation, invasion, eruption and desquamation. Ophthalmic manifestations may occur during the invasive and eruptive phases. Conjunctivitis is the most common ophthalmologic manifestation and is often asymptomatic. Measles keratitis is the most concerning manifestation, with possible corneal ulcer, bacterial superinfection and corneal perforation. We report two cases of acute keratitis occurring during the eruptive phase of measles in two unvaccinated young adults. The involvement was central and strictly epithelial in both patients. The outcome was favorable with symptomatic treatment.

[Management of herpes zoster neurotrophic ulcer using a new matrix therapy agent (RGTA): A case report]. / Utilisation d'un agent biodégradable de la régénération tissulaire (RGTA) dans le traitement d'un ulcère trophique résistant d'origine zostérienne : à propos d'un cas.

Neurotrophic keratopathy is a potential consequence of herpes simplex virus (HSV) or varicella zoster virus (VZV) infection. The treatment is based on artificial tears and the withdrawal of preserved eye drops or other types of epitheliotoxic topical medicines. Autologous serum or amniotic membrane transplantation may also be used in severe cases, but their cost and safety are still under debate. We report a case of a patient with a history of herpes zoster ophthalmicus, who developed a persistent epithelial ulcer after cataract surgery, with no improvement despite 3 weeks of artificial tears (eight drops per day). A new ophthalmologic solution based on a regenerating agent (RGTA, Cacicol20(®)) was then used, with a dosage of two eye drops per week for 6 weeks. Improvement was observed 1 week later, and complete healing was obtained in less than 3 weeks, with no side effects. This heparin mimetic, which may stimulate extracellular matrix healing, may be a possible alternative therapy to autologous serum or amniotic membrane transplantation in severe neurotrophic ulcer. However, randomized studies are necessary to validate this observation.

Spontaneous thrombosis of an orbital arteriovenous malformation revealing hereditary haemorrhagic telangiectasia (Rendu-Osler-Weber disease). A case report.

Hereditary Haemorrhagic Telangiectasia (HHT) is a genetic disorder responsible for cutaneous or mucosal telangiectasia and arteriovenous malformations (AVMs). The most frequent locations are lung and brain. In contrast, orbital AVMs are very rare. We describe a case of symptomatic orbital arteriovenous malformation due to spontaneous thrombosis. A 65-year-old woman was referred for chronic right eye proptosis associated with dilation of conjunctival vessels with a jellyfish pattern. Right visual acuity was 20/40 and intraocular pressure was 40 mmHg. Personal and familial history of recurrent epistaxis, associated with multiple telangiectasia within lips and palate, led to the diagnosis of HHT. Magnetic resonance imaging (MRI) completed with cerebral angiography found a giant and occluded AVM within the right orbit. Other AVMs were also found in brain and chest, confirming the diagnosis. Antiglaucomatous eyedrops were added to reduce intraocular pressure and a steroid therapy was begun. Two months later, visual acuity decreased in the right eye, due to a central retinal vein thrombosis. In conclusion, Most brain or pulmonary AVM can be treated by embolization. By contrast, this treatment in case of orbital location can lead to central retinal artery and/or central retinal vein occlusion, which may also appear as a spontaneous complication of the orbital AVM. Therapeutic management of orbital AVM is thus not standardized, and the balance between spontaneous and iatrogenic risk of visual loss has to be taken into account.

[Hypertony and uveitis: 103 cases of uveitis]. / Uvéite et hypertonie : à propos de 103 patients.

PURPOSE: To determine the prevalence of high intraocular pressure (HIOP) in 103 patients. METHODS: One hundred and three consecutive patients referred to our department for uveitis were included. Files were retrospectively analyzed for age at time of presentation, gender, type of uveitis (as defined by International Uveitis Study Group) and etiology, time of HIOP (primary or secondary to treatment), and associated filtering surgical procedure. Intraocular pressure (IOP) was measured using Goldmann applanation tonometry and HIOP was defined as intraocular pressure 21 mm Hg or higher. RESULTS: Among these patients, 36% of uveitis cases were related to a concomitant infectious disease (herpetic disease in 20% of cases and herpes zoster in 4%). No significant difference in age or gender was found between groups. At least one episode of HIOP was found during the acute phase of the disease in 27 patients (26.2%): anterior uveitis accounted for 74% of patients. Most hypertensive cases were associated with herpetic disease (37%), whereas steroid-induced HIOP was suspected in only two patients (7.4%). HIOP was controlled by topical hypotensive treatment in 74.1% of patients, and a filtering surgical procedure was found necessary in seven patients (25.9%). CONCLUSION: This retrospective study confirms that HIOP is a major complication of uveitis, especially in those involving the anterior chamber of the eye and/or related to viruses. Most cases responded rapidly to combined topical steroids/antiglaucomatous therapy.

[Optical coherence tomography: a reliable tool for localisation of macular hemorrhage. Two case reports]. / Intérêt de la tomographie par cohérence optique pour localiser une hémorragie maculaire. A propos de deux cas.

Recent observations have found that premacular hemorrhage in Valsalva retinopathy is located under the internal limiting membrane. We confirm these findings in two case reports of Valsalva retinopathy. Visual acuity rehabilitation was obtained in the first case by conservative treatment and by draining the hemorrhage into the vitreous with Neodymium (Nd):Yag laser in the second case. We report the current therapeutic guidelines for Valsalva retinopathy, including the systematic search of autosomal dominant syndrome of retinal arterial tortuosity, a rare condition, often discovered after this type of benign macular hemorrhage.

[Purtscher-like retinopathy: case report and review of the literature]. / Pseudo-rétinopathie de Purtscher: à propos d'un cas et revue de la littérature.

Purtscher's retinopathy is a rare condition, seen in patients with a history of trauma. Purtscher-like retinopathy includes the nontraumatic causes of this retinal disease, which is often misdiagnosed. The diagnosis is based on clinical settings and is supported by intravenous fluorescein angiography. We describe a case of acute, severe retinopathy in a patient experiencing a scleroderma renal crisis. We discuss the pathogeny, prognosis and treatment, which is still widely controversial.