Chronic uveitis in Kinshasa (D R Congo).

PURPOSE: To determine frequencies of different types of chronic uveitis and the possible associated conditions. METHODS: In the retrospective study a review is made of all 336 consecutive patients with chronic uveitis seen during 1983 through 1993. All patients were evaluated ophthalmologically and most of them medically. Traumatic uveitis was excluded from this study. RESULTS: There were 171 (51%) males and 165 (49%) females. Of 336 patients with chronic uveitis, 194 (58%) had anterior uveitis, 76 (23%) had isolated posterior uveitis, 38 (11%) had panuveitis and 28 (8%) intermediate uveitis. Associated conditions were found in 151 (46%) of 336 patients. AIDS, Herpes Zoster Ophthalmicus, toxoplasmosis, tuberculosis, rheumatoid arthritis and onchocerciasis were the most common associated disease respectively in 12.5%, 6.4%, 6%, 6%, 6% and 4% of cases. CONCLUSION: The findings of this study were different from those of other studies published in Europe and the United States.

[How to establish an etiological assessment of uveitis in 1994--personal results in 110 cases]. / Cømment établir un bilan étiologique d'uvéite en 1994--résultats personnels sur 110 cas.

From the present state of our knowledge, an etiological research in uveitis must concern causal agents, mechanisms, systemic diseases associated to uveitis and clinical entities. In our experience, etiological factors can be detected in 80% of the cases with anterior uveitis (n = 59), in 90% of the cases with posterior uveitis (n = 21) and in the three cases with total uveitis, but in no more than 15% of the cases with intermediate uveitis (n = 27).

Ocular toxocariasis: a presumed case of peripheral granuloma.

We report a case of peripheral Toxocara granuloma in a young boy of 17. Of the 3 forms of ocular toxocariasis, macular granuloma, endophthalmitis and peripheral granuloma, the latter is the least common and is characterized by the retention of relatively good vision. A differential diagnosis was performed between an intraocular foreign body encapsulated in fibroglial tissue, toxoplasmic retinochoroiditis, retinoblastoma, intermediate uveitis and toxocariasis. Fluorescein angiography showed not only some neovascularizations at the level of the peripheral granuloma but also manifestations of inflammatory reactions at the level of the posterior pole, i.e. diffuse leakages from retinal capillaries and parietal staining of some venous segments. Among the various laboratory tests, the most significant are eosinophilia, IgE concentration and detection of specific antibodies in serum as well as in aqueous humour.

[Etiological studies in cases of uveitis--the value of diagnostic tests]. / Recherches étiologiques en cas d'uvéite--valeur des tests diagnostiques.

In clinical practice it may be difficult to determine the cause of uveitides because the etiopathogenic mechanisms are not yet well known. From the present state of our knowledges, it appears that an etiological research must concern 1) the causal agents (bacterial, viral, parasitic or fungal), 2) the mechanisms (allergy, association to HLA antigens...), 3) systemic diseases associated to uveitis (for example sarcoidosis) and 4) clinical entities (such as sympathetic ophthalmia, Fuchs' cyclitis...). Concerning methodology, an etiological research in uveitis patients must begin with a careful clinical examination and an elaborate anamnesis which will give information about a possible etiology to be confirmed by appropriate laboratory tests.

[The Posner-Schlossman syndrome]. / Le syndrome de Posner-Schlossman.

The Posner-Schlossman syndrome, also called glaucomato-cyclitic crisis, is an ocular disease characterized by monocular rises in intraocular pressure and cyclitis. The cause of the disease remains unknown. However it could be asked whether this syndrome is not the clinical expression of immunologic reactions of the anaphylactoid type, in connection with a viral infection, in genetically predisposed patients. The treatment of the crisis consists of the administration of inhibitors of carbonic anhydrase as well as local application of betablockers and corticosteroids drops. There is actually no treatment preventing recurrences.

Immunoglobulin E in aqueous humour.

The level of immunoglobulin E (IgE) was determined in the aqueous humour (AH) and serum by particle counting immunoassay (limit of sensitivity: 0.2 IU ml-1). This level in the AH was below 0.75 IU ml-1 in case of senile cataract (n = 22) and ranged from this assumed normal value to 550 IU ml-1 in case of uveitis (n = 37), Fuchs' cyclitis (n = 11), intraocular tumour (n = 7) and perforating ocular injury (n = 6). To know whether the IgE increase was related to a possible local production the AH/serum concentration ratio for IgE was calculated and divided by that for albumin. Values higher than 0.60 were considered as suggestive of a local synthesis and were observed in 31 of the 37 samples examined.