Keratouveitis caused by sap of Euphorbia myrsinites plant.

BACKGROUND: Euphorbia plants grow in many gardens. Their milky latex is, however, a strong irritant which may induce various ocular lesions from keratoconjunctivitis to severe uveitis. HISTORY AND SIGNS: A 86-year-old woman developed a unilateral severe anterior chamber inflammation associated with descemtic folds after direct contact with sap of Euphorbia. Visual acuity was limited to counting fingers. Her eye was operated from filtering surgery ten years previously. The patient was closely followed to rule out the diagnosis of bacterial endophthalmitis. THERAPY AND OUTCOME: Symptoms progressively resolved after topical administration of 3 mg/mL ofloxacine and 1 % prednisolone acetate. CONCLUSIONS: Euphorbia sap toxicity may take different forms from keratoconjunctivitis to severe uveitis. Euphorbia sap-induced uveitis should be kept in mind when the patient has seen in contact with freshly cut plants.

[Optic neuropathy while taking disulfiram]. / Neuropathie optique lors d'un traitement par disulfirame.

INTRODUCTION: Disulfiram has been used since the late 1940s to treat chronic alcoholism. This drug interferes with alcohol metabolism resulting in an acetaldehyde increase. This causes painful symptoms, encouraging abstinence. Side effects include rare cases of bilateral optic neuropathies. Visual recovery occurs frequently upon cessation of therapy. METHOD AND OBSERVATION: We retrospectively studied patients referred for visual loss while treated with disulfiram between 1987 and 2005. Fourteen patients (three females, 11 males; aged 35-62 years) complained of visual loss, but a toxic, disulfiram-related, optic neuropathy was diagnosed in only five patients. Following cessation of disulfiram therapy, visual acuity and field improved in all five patients. DISCUSSION: and conclusion: When disulfiram toxicity is suspected with optic neuropathy, cessation of treatment is mandatory. Visual prognosis is good in the majority of cases, as illustrated by our series. Disulfiram toxicity can be diagnosed only after excluding all other possible causes of visual loss.

[Visual dysfunction and arterial occlusion: is there an association with factor V Leiden mutation? Four case reports]. / Dysfonction visuelle et occlusion artérielle: association à la mutation Leiden du facteur V? A propos de 4 cas.

INTRODUCTION: The Leiden mutation of the factor V gene and the subsequent resistance of factor V to inactivation by activated protein C are associated with a procoagulant state, especially in the venous bed. However, its association with arterial thrombotic disease remains unclear. OBSERVATIONS: We report four patients with visual field defects secondary to arterial occlusions and in whom we found a factor V Leiden mutation. These patients, three females and one male, aged 32-58 years, presented with various visual field defects: bilateral arciform scotomas due to multiple infarcts of the nerve fiber layer (one case), superior defect due to anterior ischemic optic neuropathy (one case), homonymous hemianopia due to stroke (two cases). An abnormal resistance to activated protein C and a heterozygous state for factor V Leiden mutation were found in all four cases. The two patients who suffered from a stroke also showed elevated antiphospholipid antibodies (one case) and a patent foramen ovale (one case). COMMENTS AND CONCLUSION: Conflicting reports on the effective role of factor V Leiden mutation in arterial thrombotic events are present in the literature. We report four cases of arterial occlusion in whom a thrombophilic predisposition was present with a heterozygous state for factor V Leiden mutation. In two cases, no other risk factor was found. We hypothesize that factor V Leiden mutation, even in a heterozygous state, might predispose to arterial occlusion in some patients.