[Regressive bilateral retinoblastoma. Clinical and genetic study. Apropos of a case]. / Rétinoblastome régressif bilatéral. Etude clinique et génétique. A propos d'un cas.

The authors report the observation of a 35-year-old patient, mother of 5 children 4 of whom are carriers of bilateral retinoblastomas. Two of these children presented lesions suggestive of retinoma retinoblastoma association. The patient had peripheral retinal lesions evoking the diagnosis of regressive bilateral retinoblastoma. At present, the term retinoma or retinocytoma seems to be more adequate. The genetic study of this family was done with D esterase and DNA molecular biology.

[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.

[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.

[Recurrent corneal erosion. Apropos of a case]. / Kératalgie récidivante. A propos d'un cas.

Recurrent corneal erosion (RCE) is a disease which often occurs in women. The authors report one case of RCE in the right eye of a 38 year old woman age. Clinical signs and clinical course under treatment are described. The pathogenesis and treatment of RCE are also described.

[The cornea and synthetic antimalarials]. / Cornée et antipaludéens de synthèse.

The main targets of antimalarial ocular toxicity are the cornea, ciliary body and retina. In sixty patients treated with chloroquine (Nivaquine) 73% showed keratopathy. The clinical features and clinical course of this keratopathy and its relationship with retinopathy were described. In contrast with retinopathy, keratopathy is not contraindication to antimalarial treatment.

[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.

[Developmental aspects of diabetic retinopathy during pregnancy]. / Aspects évolutifs de la rétinopathie diabétique pendant la grossesse.

The course of diabetic retinopathy (DR) was studied in 93 pregnant patients. Results were compared with data from 98 diabetic non pregnant women. Worsening of initial retinal lesions was observed in 16% of the pregnant group whereas only 6% of the control group showed a similar aggravation. The difference between the two groups was statistically significant (p < 0.05). Argon laser panretinal photocoagulation of pre-proliferative and proliferative DR resulted in no subsequent DR-induced complications. On the other hand, the risk of appearance of DR and/or its worsening during pregnancy depends on initial network but mostly on the duration of diabetes mellitus. In conclusion, regular ophthalmologic examination of diabetic patients especially during pregnancy seems crucial for the early screening of any worsening. Furthermore, the importance of pregnancy planning is emphasized.

[Senile cataract and trachoma in Tunisia]. / La cataracte sénile en Tunisie et trachome.

Senile cataract is the major cause of curable blindness in Tunisia (51%). Other factors than advanced age seem to play a role in senile cataract. The simultaneous of senile cataract with the trachoma makes the surgical operation problematic. In order to evaluate the frequency of such risk factors, we have realized a prospective study in two groups of patients recruited in 4 hospitals centers in Tunisia. The two groups of patients were homogenous regarding to age (more than 45 old year) sex and geographic origins. Cataract was present in the first group (287), but not in the second group (169) risk factors which were evidenced are: diabetes or abnormal glucose test tolerance, high systemic blood pressure, especially diastolic, low education and non professional occupation, family history of cataract. Evolutive trachoma was found in 5.1% of cases compared to only 0.6% in controls (p = 0.02). Trachoma sequela were found in the two groups. The importance of an evaluation of such risk factors in senile cataract is raised.

[Causes of blindness in Tunisian children]. / Les causes de cécité de l'enfant Tunisien.

Among 214 children living at Blindness Institute of Bir El Kassaa the causes of blindness were determined. Main causes were: congenital glaucoma, tapeto retinal degeneration and congenital cataract because of high prevalence of consanguinity. The importance of prevention based on genetic council is raised.

[Current epidemiologic profile of trachoma in Tunisia. Results of an evaluation of the program of prevention of blindness]. / Profil épidémiologique actuel du trachome en Tunisie. Résultats d'une évaluation du programme de prévention de la cécité 1980-1989.

The authors set up an evaluation of the Prevention Program against Blindness in the Center and South areas of Tunisia. They point out an important improvement of the endemo-epidemiological situation, but, nevertheless, they stress the necessity of carrying on the measures of the campaign.