[Bilateral retinal detachment and high myopia: report of nine cases]. / Décollements de rétine bilatéraux sur forte myopie, à propos de neuf cas.

INTRODUCTION: Bilateral retinal detachments are rare, but their occurrence increases in cases of high myopia. The objective of our research is to study their incidence, management and postoperative results. This is a study of the medical records of nine patients with high myopia and simultaneous or consecutive bilateral rhegmatogenous retinal detachment. MATERIALS AND METHODS: This is a retrospective study of the medical records of nine patients (18 eyes), aged 11-38 years old, with high myopia and simultaneous or consecutive bilateral retinal detachment. All had surgery on our medical service between September 1, 2010 and September 1, 2011. RESULTS: Bilateral retinal detachments represented 4.11% of the total cases operated during this period (219 patients) and 9.17% of the retinal detachments with high myopia (98 patients). The sex ratio is 1 male to 8 females, with an average age of 31 years old. The detachments were simultaneously bilateral for 3 patients. The initial corrected visual acuity varied between 1/40 and 4/10, macular retinoschisis was found in one case, and the breaks found were atrophic holes and horseshoe breaks. Scleral buckling with cryotherapy was performed in all patients, with a primary reattachment rate of 88.8%; and no vitreoretinal surgery was performed. The final visual acuity varied between 1/20 and 6/10. CONCLUSION: The incidence of bilateral retinal detachment increases in cases of associated high myopia; it is observed essentially among young patients. Management is difficult because of the risk of associated vitreoretinal proliferation, and the final visual recovery depends on the type of detachment and the degree of myopia. Classical surgery performed correctly and early allows for satisfactory results in most cases.

[Effect of corticotherapy on interleukin-8 and -12 and nitric oxide production during Behçet and idiopathic uveitis]. / Effet de la corticothérapie sur la production des interleukines 8, 12 et du monoxyde d'azote au cours des uvéites Behçet et idiopathique.

OBJECTIVES: To investigate the effect of corticotherapy on IL-8, IL-12, and nitric oxide (NO) production during idiopathic and Behçet active uveitis. METHODS: Peripheral venous blood was drawn from 70 patients with active uveitis before and during corticotherapy (32 with Behçet uveitis and 38 with idiopathic uveitis) and from 30 controls. Plasma was collected and peripheral blood mononuclear cells were separated immediately and cultured with or without Concanavaline A. IL-8 and IL-12 levels in plasma and culture supernatants were measured by specific enzyme-linked immunosorbent assay (ELISA). Nitric oxide levels were evaluated using a modified Griess method. RESULTS: Before therapy, the two groups of patients showed highly significant elevation of IL-8, IL-12, and NO levels compared to control subjects. During therapy, IL-8 and nitric oxide levels were significantly lower in active idiopathic and Behçet active uveitis both in vivo and in vitro. This effect was correlated with therapy duration. In contrast, while significant reduction of IL-12 levels was observed both in vivo and in vitro in idiopathic active uveitis during therapy, this effect was observed in vitro in Behçet active uveitis but not in vivo. CONCLUSION: Our results suggest that IL-8, IL-12, and NO are involved in the physiopathological mechanisms of idiopathic and Behçet uveitis. These three molecules showed different degrees of sensitivity to the inhibitory effect of corticoids, reflecting their different regulation by corticotherapy during active phases of the two diseases. According to our study, IL-8 can serve as a marker of inflammatory responses, while IL-12 should be used as a marker of the specific immune responses during active uveitis.

[Production of Th1/Th2 cytokines and nitric oxide in Behçet's uveitis and idiopathic uveitis]. / Production des cytokines Th1/Th2 et du monoxyde d'azote au cours de l'uvéite "Behçet" et de l'uvéite "idiopathique".

INTRODUCTION: The aim of this study was to investigate the role of Th1 (IFN-gamma and IL-12), Th2 (IL-10) cytokines and nitric oxide (NO) in the immunopathologic mechanisms of uveitis related to Behçet's disease and isolated idiopathic uveitis. PATIENTS AND METHOD: This study was conducted on 24 patients with Behçet's syndrome who had active uveitis, ten of whom showed isolated uveitis classified as idiopathic uveitis, and 13 healthy controls. The levels of IFN-gamma, IL-12 and IL-10 in sera and supernatants of PBMC cultures stimulated by PHA were estimated using immunoenzymatic dosage (ELISA sandwich according to the methods recommended by Immunotech France). The production of NO was measured in vivo and in vitro for the same patients using the modified Griess method. RESULTS: The induction of IFN-gamma and IL-12 was higher in the two groups of patients than in the controls (P<0.001). Significant IL-10 levels were recorded in 56.5% of patients with Behçet's disease presenting uveitis versus 30% of patients with idiopathic uveitis. NO production was more pronounced in idiopathic uveitis than in Behçet's syndrome (P<0.02). CONCLUSION: The predominance of the Th1 profile was associated with high production of NO in idiopathic uveitis. A Th1/Th2 profile with a moderated increase in NO production was observed in Behçet's disease. Our data have a clinical impact. The observation of combined Th1/Th2 cytokines and NO elevation in both in vivo an in vitro experiments could have a predictive value in characterizing uveitis associated with Behçet's disease.

[Effect of nitrites and nitrates on bovine retina in vitro]. / Effet des nitrites et des nitrates sur les rétines de boeuf in vitro.

BACKGROUND/AIM: Uveitis is an endocular inflammation that forms one of the most serious manifestations of Behçet disease. Nitric oxide (NO) is a molecule that expresses important immunoinflammatory properties and is produced by NO synthases (NOS). In previous studies, we showed an elevated production of endogenous NO during Behçet's and idiopathic uveitis. These results led us to investigate the effect of nitrites (NO2-) and nitrates (NO3-) (physiologically stable metabolites of NO) on fragments of bovine retina in order to determine the role of nitric oxide (NO) in the genesis of retinal lesions during uveitis. MATERIAL AND METHODS: Retinas were removed from freshly enucleated bovine eyes and cultured in DMEM, 10% CFS in presence of nitrites (NaNO2) or nitrates (NaNO3) at different concentrations. The cultures were processed at 37 degrees C, 5% CO2 in a humidified chamber. Cultured retinas were observed by inverse microscopy and then fixed in formaldehyde. Histological studies were conducted after H & E staining. RESULTS: Cultured retina showed alterations when exposed to concentrations of nitrites and nitrates higher than 200 microM and 250 microM, respectively. These alterations were dose-dependent and affected the cellular and tissular structures. Morphological and histological studies suggested that the toxic effect is apoptotic and/or necrotic for both effectors. CONCLUSION: Our investigations showed that nitrites and nitrates, two physiologically stable metabolites of NO, have a deleterious effect on cultured retina. NO, produced in inflammatory processes during uveitis may be implicated in the genesis of the retinal lesions observed during the exacerbation phase of the disease.

Disseminated cryptococcosis after transurethral resection of the prostate.

A 63-year-old man presenting with acute retention and dysuria underwent transurethral resection of the prostate for suspected benign prostatic hypertrophy. Ten days postoperatively he developed disseminated cryptococcosis. Re-examination of the prostatic chips revealed cryptococcal prostatitis. Treatment consisted of amphotericin, flucytosine and transfer factor along with wedge resection of a pulmonary toruloma. He remains well 12 months after cessation of treatment. This appears to be the first case report in Australia of cryptococcal prostatitis with dissemination after transurethral resection of the prostate.