[Intravitreous cysticercosis. Spontaneous course. Apropos of a case]. / La cysticercose intravitréenne. Evolution spontanée. A propos d'un cas.

We report a case of intravitreous cysticercosis in a 54-year-old woman from Madagascar. Since the patient refused surgical treatment, the lesion evolved toward blindness. The authors highlight the interest of surgical treatment and discuss the role of praziquantel which might increase local inflammatory reactions with subsequent severe damage.

[Mass treatment of onchocerciasis in 1996]. / Le traitement de masse de l'onchocercose en 1996.

Mass treatment of onchocerciasis has changed radically in the last 20 years. With implementation of the Onchocerciasis Control Programme (OCP), use of insecticides to control vector larvae has been effective but has not been extended to all infected areas due to the cost. The consequences of this problem have been lessened thanks to ivermectin, an effective drug that can be administered in a single yearly dose. Although ivermectin does not appear to induce major side-effects, surveillance is necessary after administration in polyparasitized subjects living in zones where loaiasis is present and in hypermicrofilaremic subjects. To assist in the fight against onchocerciasis, ivermectin is distributed free of charge through the Mectizan Foundation by Merck Laboratories. Inexpensive community distribution programs with active participation of the populations at risk have demonstrated their usefulness. The results of mass treatment through the Mectizan Foundation have been excellent. Non-governmental organizations and in particular the Organization for the Prevention of Blindness (OPB) have become increasingly involved in the fight against onchocerciasis. The campaign conducted by the OPB in Mali, Senegal and Guinea illustrate this involvement. The role of non-governmental organizations expanded greatly with the implementation of the APOC programme supported by the World Bank.

[Xerophthalmia: current data]. / La xérophtalmie: données actuelles.

Xerophthalmia is a term covering a range of ophthalmologic manifestations due to vitamin A deficiency. This condition occurs in preschool children in tropical regions affected by protein-caloric malnutrition. Clinical manifestations of the disease have been summarized in the 1974 five-grade WHO classification. Clinical diagnosis was traditionally made using a slit lamp to detect the pathognomonic manifestations and consequences of corneal and conjunctival xerosis. Currently diagnosis is greatly facilitated by determination of plasma levels using a micromethod, especially the relative dose response (RDR) test, and by conjunctival impression cytology (CIC). CIC is a simple and reliable method which allows mass screening and thus more effective evaluation of the impact of xerophthalmia on public health in Africa. The relationship between xerophthalmia and measles is complex. Vitamin A deficiency promotes measles which can in turn hasten perforation of keratomalacia especially in undernourished children. Vitamin A has a beneficial effect on both xerophthamia and measles. Curative and prophylactic administration of vitamin A at doses recommended by the W.H.O. considerably reduces not only xerophthalmia-related morbidity but also child mortality in tropical areas.

[Cysticercosis: a frequent and redoubtable parasitic disease]. / La cysticercose: une maladie parasitaire fréquente et redoutable.

Cysticercosis is due to development of the larval form of Taenia solium, Cysticercus cellulosae in human tissue. It is widespread in developing countries especially in rural areas where it is endemic. Larval invasion of the central nervous system constitutes a dreadful complication. The incidence of this worldwide disease is underestimated in French-speaking Black Africa; the Indian ocean region has one of the highest incidences with Madagascar reporting a seroprevalence of 18% in 1994. It is estimated that 50 million people are infected in the world with 50,000 deaths a year. "Taenia solium carriers" play a major role in transmitting the disease to their immediate entourage even if the initial contamination of the carrier was due to infestation of pork. A wide range of epileptic manifestations can and often do constitute the first signs of neurocysticercosis which has been estimated to be the cause of epilepsy in two thirds of cases. This fact explains the numerous neuro-epidemiologic studies have been undertaken. In industrialized countries computeur tomodensitometry and magnetic resonance imaging are widely used for diagnosis and follow-up but immunologic diagnosis is most common in developing countries since medical imaging techniques are generally unavailable. The immuno-enzymatic method provides a basis for suspicion of infection and immuno-electrotranfer-blot allows diagnosis of progression of the disease to a stage at which cestocide treatment is active. New agents against cysticercoids that can circulate in the central nervous system (praziquantel, albendazole) have greatly improved the prognosis of neurocysticercosis. Massive single-dose treatment with praziquantel is especially useful in developing countries since taeniasis is rarely diagnosed in Taenia solium carriers. Persistent efforts to prevent contamination of pork have eradicated the infection in industrialized countries and diminished seroprevalence in others (Reunion Island). Cysticercosis is a major public health problem in developing countries. Systematic detection of the hotbeds and application of adequate control measures are needed.

Trachoma and cataract in developing countries.

Cataract and trachoma, the principal causes of blindness in the world, are two ubiquitous diseases with different origins and distributions. They may coexist in the same patient due to their high frequency. They have complex interrelations which raise epidemiological, diagnostic and particularly therapeutic problems which are sometimes difficult to resolve, especially in the case of the commonest combination of senile cataract and presumably cicatricial trachoma. The public health problem raised by these two diseases in developing countries must be resolved. Two easily curable or preventable diseases should no longer be the principal causes of blindness in the world.

[Ophthalmologic manifestations of acquired immunodeficiency syndrome (AIDS) in central Africa]. / Manifestations ophtalmologiques du syndrome d'immunodépression acquise (SIDA) en Afrique centrale.

In central Africa, the authors have performed an ophthalmological examination of 77 adult patients (18-55 years) with AIDS: 33.7% had ocular abnormalities. Frequent manifestations included cotton-wool patches and retinal hemorrhages, while lacrymal hyposecretion, palpebral and conjunctival kaposi sarcoma, ocular palsy, ptosis, herpes zoster, papillar oedema, cytomegalovirus retinitis and periphlebitis were less frequent. The authors underline the necessity to perform an ocular examination for each patient with AIDS.

[The perimetric score in Bjerrum's area]. / Le score périmétrique dans l'aire de Bjerrum.

The authors have examined a protocole in automatic perimetry. On glaucoma they have measured, with different instruments, deficits in visual fields in Bjerrum's area. The perimetric score gives them a numeric data which determines rapidly the patient's state. This data may be used on graphics.

[The cataract in Bangladesh. Epidemiology--treatment]. / La cataracte au Bangladesh. Epidémiologie--traitement.

The Bangladesh, earth of mud and water, is one of the most poor countries in the world. And it is a fact that the very special geographical, climatical and vital statistics are the victims of certain endemic diseases. For the most part, the diarrheoïcal diseases are prevailing. From the ophthalmologic point of view, avitaminosis A is the major risk factor during the childhood. However, as in many other countries, the prime cause of blindness is the cataract. This disease is surgically curable. The treatment is affected by the lack of surgeons and the big number of cases. An example of therapeutic strategy is presented by B.N.S.B.: Bangladesh National Society for the Blind.

[Orbital and ocular tumors in the Republic of Mali]. / Les tumeurs orbito-oculaires en République du Mali.

Analysing 82 cases of oculo-orbital tumours in Malian patients, the authors find the classical features characterizing ocular carcinoma in Africa, i.e. early arising, development, late request for treatment. They stress on the age of the patients at the occasion of the first request for treatment in case of retinoblastoma, and notice the special frequency of squamous cell carcinoma with conjunctival or limbic localization.

[Role of eye manifestations in chlamydioses]. / Place des manifestations oculaires dans les chlamydioses.

Following an up-to-date bacteriological resume, are recalled the most important clinical manifestations presently attributed to C. trachomatis: general manifestations (pulmonary, articular, venereal, congenital, viscereal and others still under discussion); ocular manifestations (trachoma, inclusion conjunctivitis of newborn infants or adults, other ocular affections still under discussion). The main theories are exposed, which try to explain some epidemiological links between all these manifestations.