Mapping of a congenital microcoria locus to 13q31-q32.

Congenital microcoria is an autosomal dominant disorder characterized by a pupil with a diameter <2 mm. It is thought to be due to a maldevelopment of the dilator pupillae muscle of the iris, and it is associated with juvenile-onset glaucoma. A total genome search for the location of the congenital microcoria gene was launched in a single large family. We found linkage between the disease and markers located on 13q31-q32 (Zmax = 9.79; theta = 0). Haplotype analysis narrowed the linked region to an interval <8 cM between markers D13S1239 proximally and D13S1280 distally.

Multivariate analysis versus vector analysis to assess surgically induced astigmatism.

PURPOSE: To present a multivariate probability computation method for assessing surgically induced astigmatism. SETTING: Department of Ophthalmology, Rennes University Hospital, Rennes School of Medicine, France. METHODS: The multivariate method was used to evaluate 100 patients who had cataract surgery by phacoemulsification. Keratometry was recorded on the day before and 12 days after surgery. Surgically induced astigmatism was assessed by the multivariate method as well as by most of the published vector analysis methods. RESULTS: The mean surgical induced astigmatism (+/- SD) with the multivariate analysis was 1.18 +/- 0.36 diopters (D) for the cylinder power and 25.00 +/- 5.50 degrees for the cylinder axis. With the vector analysis, the mean surgically induced astigmatism was 1.67 +/- 0.54 D with the Naylor, Jaffe, and Holladay methods; 0.45 +/- 0.30 D with the latest Naeser method; 1.34 +/- 0.38 D with the Cravy method (Cravy's vector); and -0.05 +/- 0.42 D for Cravy's delta K. CONCLUSION: Although vector methods constitute interesting geometrical models, their number and their lack of linearity and explicit expression of results make them unsuitable for statistical analysis. Instead, a reliable, easily programmable method that uses existing software is recommended.

Excimer laser photorefractive keratectomy to correct astigmatism.

PURPOSE: To evaluate the efficacy of excimer laser photorefractive keratectomy (PRK) to correct astigmatism. SETTING: Hôpital Morvan, Brest, France. METHODS: A 193 nm excimer laser was used to perform toric ablation with an expanding slit to flatten the cornea in the steeper meridian and/or to correct myopia with an iris diaphragm in 72 eyes (55 patients): 68 eyes for compound myopic astigmatism and 4 for astigmatism only. RESULTS: Preoperative cylinder was -2.14 diopters (D) +/- 1.99 (SD) (range -0.50 to -5.50 D); 6 months postoperatively, it was -1.75 +/- 1.34 D (range -0.25 to -5.25 D). Preoperative spherical equivalent was -5.33 +/- 3.22 D (range -0.25 to -14.50 D); 6 months postoperatively, it was -0.86 +/- 2.32 D (range 2.50 to -9.75 D). The axial error was within 30 degrees. Uncorrected visual acuity was 0.50 or better in 64.5% of patients. CONCLUSIONS: Overall patient satisfaction seemed the result of the myopic correction; cylindrical correction was incomplete. Future software refinements should improve the results. In particular, single elliptical ablation seems to offer theoretical advantages.

[Multiple pilomatricoma. Apropos of a case]. / Pilomatricomes multiples. A propos d'un cas.

Pilomatricoma is a benign, solitary tumor. The histopathologic findings of viable basaloid cells in the periphery, shadow cells in the central part and foci of calcification are characteristic of pilomatricoma. The microscopic aspect of multiple pilomatricomas was not different from solitary pilomatricomas. Though, some consider them as a pathognomonic sign of myotonic dystrophy. Complete surgical excision is the best management.

Association of congenital microcoria with myopia and glaucoma. A study of 23 patients with congenital microcoria.

BACKGROUND: Congenital microcoria, a bilateral condition of the iris dilatator, is defined as a pupil with a diameter of less than 2 mm when looking at a distant object. Although it is usually a hereditary condition resulting from autosomal dominant transmission with no marked difference between the sexes, it is sometimes sporadic. The ocular abnormalities associated with this condition (myopia, astigmatism, and glaucoma) have never been linked to the malformation. METHOD: Forty-two members of a family were examined: 23 had microcoria and 19 did not. The two groups were studied to identify symptoms of the condition and its associated abnormalities. RESULTS: There was a very strong correlation between microcoria and myopia (Fisher's exact test, P < 0.00001), between microcoria and astigmatism (Fisher's exact test, P < 0.0001), and between microcoria and glaucoma (Fisher's exact test, P = 0.011). CONCLUSIONS: There is a statistical correlation among myopia, glaucoma, and microcoria, and the disorders are associated with the condition in a nonfortuitous way. The functional prognosis for microcoria appears to be extremely poor because of refractive disorders and, particularly, a link between microcoria and glaucoma that is difficult to explain.

[Langerhans cell granulomatosis of the orbit. Apropos of an anatomo-clinical case]. / Granulomatose à cellules de Langerhans monotissulaire de l'orbite. A propos d'une observation anatomo-clinique.

Langerhans' cell granulomatosis of the orbit was observed in a 7-year-old boy successfully treated by a simple biopsy. Recovery can be established one year after the biopsy on the basis of bone defect healing on the standard X-ray of the skull.

[Comparative study of propofol versus thiopental-halothane in the occurrence of oculocardiac reflex and postoperative vomiting after surgery for strabismus in children]. / Etude comparative propofol versus thiopental-halothane dans la survenue des réflexes oculocardiaques et des vomissements postopératoires lors de la chirurgie du strabisme chez l'enfant.

Strabismus surgery in children is associated with side-effects, intraoperative oculocardiac reflexes in relation with muscular tractions and postoperative vomiting. Studies with propofol anaesthesia in this surgery have shown a lower incidence of these side-effects. So, a prospective study compared these incidences with propofol (P) versus thiopental/halothane (T+H) anaesthesia. Propofol appears to be efficient in reducing postoperative vomiting but might be associated with more frequent OCR.

[Keratomycosis, from head injury to aspergillosis]. / Kératomycose, du traumatisme initial à la tête aspergillaire.

Keratomycosis due to Aspergillus fumigatus occurs most often in immuno-competent patients who live and work in a fungus-rich atmosphere. Previous trauma with epithelial lesion are reported by most authors. While the new antifungal drugs may be effective, corneal graft is the most effective solution in uncontrolled cases. When performed early, good visual recovery was observed in most cases as reported in the literature and in our case.

[Orbital rhabdomyosarcoma in children. Apropos of 2 cases]. / Rhabdomyosarcome orbitaire de l'enfant. A propos de 2 observations.

Rhabdomyosarcoma accounts for 5% of childhood malignant tumours; in 10% it occurs in the orbit where it is the most frequent malignant tumour. Rhabdomyosarcoma is a mesenchymatous tumour with striated muscular differentiation. However, this myogenous differentiation is sometimes undiscernable on standard histological examination and requires immunohistochemical and ultrastructural studies to be shown. Treatment depends on the assessment of local extension, principally based on tomodensitometry. When the tumour is limited to the orbit, survival rate may reach 100% with todays therapeutic protocols. When the orbital walls are invaded the tumour is parameningeal and recovery can only be achieved by increasing chemotherapy at the cost of long-term side effects. Hence, this tumour must be diagnosed and treated very early. The authors report two cases of rhabdomyosarcoma dealing with the two main histological forms of the tumour and with their evolutive risks.

[Probability studies on the variations of anterior corneal astigmatism]. / Approche probabiliste des variations d'astigmatisme cornéen antérieur.

The probability method of analysis of astigmatism variations respects both astigmatism components, quantity and axis. The two random variable model that we introduce here analyses cylinder variations and axial variations. After describing the contingency table and the probability table. Expectation of each component and its confidence interval are calculated together with the variance and the standard deviation. Covariance and correlation are calculated. If we want to compare different groups we test cylinders with cylinders and axes with axes. This method does not distort reality and is applicable to the semi meridians from 0 degree to 360 degrees. Only large samples of patients can be studied by this method.

[Vectorial models for analyzing variations of anterior corneal astigmatism]. / Modèles vectoriels d'analyses des variations d'astigmatisme cornéen antérieur.

Several studies have analysed postoperative or spontaneous variations in astigmatism. The methods of quantification of these variations, frequently used in these studies, are based on different ways of calculating: subtraction, vectorial or polar methods: Naylor, Jaffe and Clayman, Cravy, Naeser, Russell et al. and recently, Holladay et al. Although these methods have the advantage of taking into account the axial component of astigmatism and are useful for a single patient, they have many problems and they are more and more numerous (five in the last three years). We have computerized these formulae on a personal computer and studied their performances when the cylinder power decreases without modification of the axes, when the axes are modified without modification of the cylinder power and when the two axes change with the same angular difference. These calculations demonstrate that these formulae are not linear and introduce statistical errors before the statistical decision tests. Moreover, their application is only possible for evaluation of astigmatism axes between 0 degree to 180 degrees and not for semi meridians and corneal topography.

[Alprazolam as premedication in ophthalmologic surgery]. / Alprazolam en prémédication orale en chirurgie ophtalmologique.

Oral premedication with alprazolam was studied in 83 patients before eye surgery. Alprazolam appears to be an excellent anxiolytic drug, with minor cardiovascular and respiratory side effects. A double blind study should be carried on to assess these properties.

[Importance of studying deficiencies of IgG subclasses (IgG2 and IgG4) in immuno-allergologic practice]. / Intérêt de la recherche d'un déficit en sous-classes d'IgG (IgG2 et IgG4) en pratique immuno-allergologique.

Levels of the sub-classes of immunoglobulins IgG2 and IgG4 have been established by radial diffusion with monoclonal antibodies in 150 subjects. 49 (42 adults and 7 children) showed either a low level of IgG2 (less than 0.42 g/l n = 11) or a reduced level of IgG4 (less than 0.05 g/l n = 38). A single patient had a double deficit, 38 subjects had a superinfection of which 17 had a severe form and in 77% of these cases a level of IgG4 of less than 0.05 g/l.

[Surgery of 6th nerve paralysis. 74 cases]. / Chirurgie des paralysies du VI. Soixante-quatorze cas.

85% of abducens palsies recover spontaneously; then their surgical treatment has not to be hastened. However many non regressive cases are frequently observed. Whatever they may be, partial or complete, uni or bilateral, always they give a great functional handicap which warrants a surgical care. The analysis of 74 successive cases allows to reveal some rules concerning the operative plan. In that respect the electro-oculographic recording often provides many essential informations. The recovery of a normal oculo-motor balance is usual in monolateral paresis. In bilateral complete palsies, in spite of muscle transposition procedures, we can only expect to reduce torticollis and to restore the ocular alignment in primary position, but abduction remains always impaired or fully impeded.