[Value of clindamycin in the treatment of ocular toxoplasmosis]. / Intérêt de la clindamycine dans le traitement de la toxoplasmose oculaire.

PURPOSE: Chorioretinal toxoplasmosis can threaten visual function when located in the posterior pole. The aim of this study was to compare the advantages and disadvantage of combination of malocid-sulfadiazine and clindamycin subconjunctivally. METHODS: Two groups of patients affected by unilateral chorioretinal toxoplasmosis were studied. The diagnosis was performed in 77% of cases on acqueous humor analysis. The first group of twenty-six patients was treated with a combination of malocid-sulfadiazine while the second group (seventeen patients) was treated with clindamycin subconjunctivally. Local and general corticosteroids were associated in all cases. Mean follow-up was 19 months in the first group and 16.5 months in the second. RESULTS: Visual acuity was increased in 88.5% of cases in the first group and in 94% of cases in the second group. Cicatrization obtained in both groups was comparably delayed 1.68 months for the first and 1.26 months for the second. Recurrences were rarely observed in the two groups: respectively 8% and 6% of cases. No local and general complication was noted. CONCLUSION: These findings suggest the advantages of subconjunctival clindamycin treatment due to the absence of general hematological toxicity.

[The cornea of diabetics]. / La cornée du diabétique.

PURPOSE: The aim of the study is to investigate corneal sensitivity and the risk factors of corneal hypoesthaesia in diabetics. METHODS: General examination and full ophthalmologic examination completed by exploration of corneal sensitivity were performed in one hundred thirty diabetic patients. RESULTS: Eleven per cent of patients showed microkystic oedema, whereas corneal hypoesthaesia was found in 45% of cases. Corneal hypoesthaesia was correlated with the duration and balance of diabetic mellitus, the age of patients and the presence of diabetic retinopathy. On the other hand, peripheral neuropathy was found in 88% of cases. CONCLUSION: Ophthalmologic examination of diabetics should not be limited to retina only but should also include the entire eye ball and especially the cornea in patients with high risk.

[Choroid metastases]. / Les métastases choroïdiennes.

PURPOSE: The aim of the present study is to investigate the clinical features and the risk factors characteristic of choroidal metastasis, which is known as the most common malignant neoplasm of the adult eye. METHODS: A systematic ophthalmologic examination together with angiography and echography were performed in 106 patients with carcinoma. RESULTS: 10% of patients showed choroïdal metastasis. Breast and bronchogenic carcinoma were the most common primary tumor. 82% of cases died within a mean 6.5 months. Clinical, angiographic, echographic and histopathologic features of such metastasis were described. CONCLUSIONS: The importance of an early diagnosis of such metastasis are raised.

[Methods for screening and surveillance of diabetic retinopathy]. / Moyens de dépistage et de surveillance de la rétinopathie diabétique.

PURPOSE: The aim of this study is to investigate the various tests which allow to detect and follow-up diabetic retinopathy (DR). METHODS: Sixteen patients without DR or with background retinopathy underwent, once every six months: a full ophthalmologic investigation; a fluorescein angiography; a color vision test; a central visual field investigation. RESULTS: The impairment of angiography preceeded damage of eye fundus in 27% of cases. Deficiency of color vision and visual field were found in 57% of cases and in 35% respectively. These preceeded the appearance of angiographic DR in 50% of cases and 32% of cases respectively. CONCLUSION: The importance of such tools in the evolution of DR especially in young diabetics is discussed.

[Etiologies and risk factors of endophthalmitis]. / Etiologies et facteurs de risque des endophtalmies.

Endophthalmitis is a serious disease with multiple aetiologies. Its development seems to be dependent upon various risk factors. Among 99 cases of endophthalmitis, 79% were secondary to intraocular surgery especially cataract surgery and perforating ocular trauma. To identify risk factors of post-cataract surgery endophthalmitis, we performed a case-control study: 55 cases and 269 controls were used. Five risk factors were identified: duration of the operative procedure longer than 60 min, suture dehiscence, persistence of lens mass, traumatic cataract and left eye operated. The importance of prevention of endophthalmitis by avoiding such risk factors is raised.