[Quality of life in patients with wet age-related macular degeneration treated with photodynamic therapy]. / Apport de la photothérapie dynamique dans la qualité de vie des patients atteints de dégénérescence maculaire exsudative.

PURPOSE: To analyze the benefit of photodynamic therapy in terms of quality of life in patients with wet age-related macular degeneration. METHODS: A retrospective study was conducted on 33 patients with subretinal neovascularization receiving visual rehabilitation in a low vision clinic (ARAMAV, Nîmes) in southern France. Twenty had been treated with photodynamic therapy (PDT group) and 13 had not (non-PDT group). In the non-PDT group, the patients had been treated with thermal photocoagulation, transpupillary thermotherapy, or external radiotherapy, or had not received any treatment. Visual acuity, reading speed, reading endurance, and quality of life were compared. Two quality-of-life scales were employed: the VF-14 and NEI-VFQ-25. RESULTS: A significant difference between the two groups in terms of quality of life was observed. The VF-14 score (p<0.01) and two parameters (near activities and distant activities) of the NEI VFQ-25 were significantly higher (both p<0.01) in the PDT group. Visual acuity, reading speed, and reading endurance were similar in both groups. CONCLUSION: Although no difference in terms of functional parameters was observed, photodynamic therapy could preserve the central retina and thus enable a better use of the residual visual function, which could explain the better quality of life perceived by the patients in the PDT group.

[Silent sinus syndrome: a rare case of enophthalmia]. / Le silent sinus syndrome : une cause rare d'énophtalmie.

INTRODUCTION: The causes of spontaneous enophthalmos, without trauma, surgical factors, or systemic illness, which can be found are rare. A particular entity called silent sinus syndrome in the Anglo-Saxon literature, which concerns the long-term effect of hypoventilation of the maxillary sinus responsible for an attraction of the sinus walls, resulting in sagging of the orbital floor, itself responsible for the enophthalmos. CASE REPORT: We report the case about a 29-year-old woman, presenting a left-side spontaneous enophthalmos, with sinus-type pains for 2 months. The clinical examination revealed a horizontal diplopia when looking leftwards. Computed tomography showed a maxillary homolateral sinusitis with characteristic attraction of the sinus walls. The draining of the sinus collection by inferior endoscopic enlargement of the maxillary ostium led to pain resolution. The enophthalmos and diplopia were stabilized. CONCLUSION: After eradicating the orbital causes of enophthalmos, the sinus causes were sought more precisely, the pauci-symptomatic causes such as the silent sinus syndrome. The recognition of this syndrome stopped the progression of enophthalmos by making the maxillary sinus permeable again. A surgical reconstruction of the orbital floor can be proposed in order to correct the motility of the eyes and esthetic considerations.