[Acute optic neuritis in children: clinical features and treatment. A study of 28 eyes in 20 children]. / Les neuropathies optiques aiguës de l'enfant: particularités cliniques et thérapeutiques. A propos de 28 yeux chez 20 enfants.

PURPOSE: Analyzing a personal series of children with acute optic neuritis (AON), we studied MATERIAL AND METHODS: A retrospective study of 28 eyes in 20 patients (mean age: 10;7 years), examined between 1982 and 1997, with a follow-up ranging from 6 months to 15 years (mean: 5;5 years). We recorded etiologic factors, clinical features (ocular and extra ocular), biological results, and neuroimaging findings. RESULTS: Initial involvement was uni- or bilateral with poor visual acuity (under 20/200 in 22 eyes of 28). Intracerebral inflammation was present in 9 of 13 cases where MRI was performed. We found a cause in only 7 cases (5 viral diseases and 2 recent vaccinations against hepatitis B). Visual recovery was good (over 20/25 in 20 eyes of 28) whatever the treatment, but AON recurred in 5 children. Four children later developed multiple sclerosis. CONCLUSIONS: The cause of AON is rarely found. After eliminating an infection, we retained viral disease, complication of a recent vaccination against hepatitis B, and neurological diseases. MRI was the imaging study of choice. Development of multiple sclerosis occurred in 4 cases of 20, the same frequency as in the literature. The risk of later development of multiple sclerosis was 20%. Progression of AON was often excellent. Nevertheless, corticotherapy was added, in form of intravenous boluses followed by decreasing oral therapy for one month.

[Exploration of retro-chiasmatic visual pathways in human albinism]. / Exploration des voies optiques rétro-chiasmatiques chez l'albinos.

PURPOSE: Several research studies have explored the abnormal crossing of the retinogeniculate and geniculocortical optic pathways in human albinos. This prospective study has dealt with visual evoked potentials (VEPs) of human subjects to identify the percentage of albinos with asymmetric VEPs. PATIENTS AND METHODS: A series of 16 albino patients ranging in age from 6 to 37 years were examined. They had measurable visual acuity, with or without nystagmus. Diffusion of flash stimuli not allowing selective study of the two visual pathways (direct and crossed), two stimulation patterns were used for VEP recordings: monocular full open field then hemi-field stimulation to isolate the activity of each visual pathway. ANALYSIS: In the normally pigmented subject, fibers derived from the nasal half of the retina of each eye decussate at the chiasma, while temporal retinal fibers are uncrossed and project to the ipsilateral hemisphere. In albinos, the majority of temporal retinal fibers subserving the nasal field (from fixation to an eccentricity of about 20 degrees ) anomalously cross with the nasal retinal fibers. Therefore with monocular stimulation, the evoked visual response should be obtained only in the contralateral hemisphere. The asymmetry, morphology and latency for the first major positive peak and the amplitude of the VEP were examined and compared with the normal population. CONCLUSION: We managed to demonstrate the characteristic VEP asymmetry only in 3 out of the 16 patients. The results presented herein lead to question the absolute validity of VEP abnormality in diagnosis of albinism for clinical purposes.

[Electrophysiologic diagnosis of 2 psycho-visual syndromes: Balint syndrome and cortical blindness. A propos of a case of Benson progressive posterior atrophy]. / Diagnostic électrophysiologique de deux syndromes psycho-visuels: syndrome de Balint et cécité corticale. A propos d'une observation d'atrophie postérieure progressive de Benson.

Cortical blindness and Balint's syndrome are two pathologies not well-known. It seems therefore interesting to report a typical patient case, suffering from Benson's posterior cortical atrophy, who presented successively both syndromes. The Balint's syndrome, which results from a bilateral parieto-occipital junction brain injury, and combines clinically a specified triad defects: a spatial disorder of attention, a psychic paralysis of gaze and an optic ataxia. The cortical blindness, which is caused by bilateral damage of the occipital lobes (Broadman area 17). Electrophysiologically, the abolition of short-latency components of visual evoked potentials and the presence of long-latency potentials are recorded. Visual strategy and visual evoked potentials are thus the only objective examinations allowing to diagnose and follow up these patient's evolution. In any case, an adequate visual rehabilitation has to be carried out in order to help the patient recovering his autonomy.

[Canine leishmaniasis from Leishmania infantum: value and production of the latex test. Ecoepidemiologic applications]. / Leishmaniose canine à Leishmania infantum: intérêt et réalisation du test au latex. Applications en éco-épidémiologie.

The authors relate the realization, evaluation and eco-epidemiological applications of a "field-test": the agglutination of latex particles coated with a soluble antigen of Leishmania infantum in the presence of homologous antibodies. Evaluated on 1,035 canine sera, the sensitivity of the latex agglutination test (LAT) was 93.4% compared to the indirect fluorescent antibody test (IFAT). 90 node cultures were carried out on dogs with positive or negative LAT and/or positive or negative IFAT. The frequency of positive node cultures (70%) as versus positive LAT came between the results obtained for an IFAT > 1/40 (64%) and IFAT > 1/80 (73%). 32/33 (97%) dogs had positive node culture, LAT and IFIAT(> 1/80). 6 dogs had negative LAT but positive node culture: 5 of these had also an IFAT < 1/160. This test was used in the field on several eco-epidemiological surveys in leishmanian enzootic areas. Node cultures were made on the dogs with positive TL. 39 strains were isolated: 18 in Algeria, 15 in Morocco, 2 in Syria and 4 in Yemen. 13/39 strains were obtained from dogs with IFI < 1/160: 2 at 1/20, 8 at 1/40 and 3 at 1/80. In Algeria this test was also used for the diagnosis of human visceral leishmaniasis in a child. This quick, simple, sensitive and specific test could be usefully carried out on "field" surveys for the diagnosis of visceral-leishmaniasis in animals and human beings.

[Rigid endoscope with Gradient-index lenses. Preliminary studies]. / Endoscope rigide à lentilles de GRIN. Premiers essais.

PURPOSE: Endoscopes for use in ophthalmology can be manufactured in dimensions smaller than 0.89 mm. MATERIALS: Gradient-index lenses that give a higher resolution than fiber bundles can be miniaturized down to 0.35 mm. RESULTS: We used this new endoscope in 6 eyes of 6 patients during anterior segment surgery. Preliminary clinical experience has demonstrated the usefulness and practical application of this new instrument. CONCLUSION: The clear views the instrument provides of the ciliary sulcus and ciliary body behind the iris make it useful in secondary posterior chamber intraocular lens implantation, retroprosthetic membrane behind keratoprosthesis, Molteno valve, and in endolaser photocoagulation.

[Dirofilariasis in France: a case in Languedoc in an HIV-seropositive patient]. / La dirofilariose en France: un cas languedocien chez un sujet sérologiquement positif pour le VIH.

Dirofilaria repens is an endemic canine parasite in the Mediterranean area. Human infestation is rare. We observed a case in an HIV-positive patient who presented an ocular filaria which was successfully removed under local anesthesia. In man, filariae may be expulsed without a parasite cycle or complete a growth cycle, depending on the individual's immunological status. The disease has been known in southern France for several centuries, mainly in lagoons near the Mediterranean seaside. A review of the literature however shows that observation of clinical cases is rare, only 46 cases having been reported to date. Outcome is favorable.

Fetal diagnosis of toxoplasmosis in 190 women infected during pregnancy.

One hundred and ninety women who contracted toxoplasmosis after the seventh week of pregnancy underwent antenatal diagnosis, including ultrasound examination and biological tests. Tests included Toxoplasma isolation in fetal blood and amniotic fluid by mouse inoculation, specific IgM and IgA in fetal blood, and non-specific tests. Twenty fetuses had positive specific as well as non-specific tests for Toxoplasma infection. At birth, four of these presented with clinical congenital toxoplasmosis and 12 with subclinical forms. Antenatal diagnosis enabled the detection of 83 per cent of the infected fetuses. Under specific conditions, cordocentesis permits early diagnosis and considerably reduces the number of terminations of pregnancy.

[Parasitic fecal analyses. Prescription, application and interpretation of results]. / Les analyses coprologiques parasitaires. Prescription, mise en oeuvre et interprétation des résultats.

The increasing ease of intercontinental travel, immigration and the multiplication of cases of immune depression are such that European physicians are now frequently required to prescribe stool examinations for parasites. This article defines the laboratory approach to the diagnosis of intestinal parasites: indications for tests, based upon clinical and epidemiological data; methods of prescription and recommendations to patients; techniques used in the laboratory and their cost; minimum answer times; interpretation of results, in particular in the immune depressed.

[Notes on the phlebotomus of Aïr (Niger)]. / Notes sur les phlébotomes de l'Aïr (Niger).

238 phlebotomine sandfly belonging to seven species have been collected in four localities of Niger, in the Aïr mountain range. Phlebotomus bergeroti was the dominant species in animal bait and in collections inside dwellings. Some attention has to be paid to P. alexandri, a recognized vector of kala-azar elsewhere.

[Isolation of Leishmania major Yakimoff and Shokhor, 1914 (Kinetoplastida-Trypanosomatidae) in Meriones shawi-shawi (Duvernoy, 1842) (Rodentia-Gerbillidae) in Tunisia]. / Isolement de Leishmania major Yakimoff et Schokhor, 1914 [Kinetoplastida-Trypanosomatidae] chez Meriones shawi shawi (Duvernoy, 1842) [Rodentia-Gerbillidae] en Tunisie.

Leishmania major, agent of zoonotic cutaneous leishmaniasis, has been isolated from the rodent Meriones shawi shawi in central Tunisia. As a result, the North saharan arid mediterranean area can be considered as epidemiologically homogeneous.

[Ecology of leishmaniasis in Southern France. 18. Enzymatic identification of Leishmania infantum Nicolle, 1908, isolated from Phlebotomus ariasi Tonnoir, 1921, spontaneously infected in the Cévennes]. / Ecologie des leishmanioses dans le Sud de la France. 18. Identification enzymatique de Leishmania infantum Nicolle, 1908, isolé de Phlebotomus ariasi Tonnoir, 1921 spontanément infesté en Cévennes.

Out of 187 female Phlebotomus ariasi caught in the Cévennes focus of leishmaniasis 3 were found naturally infected with Leishmania. The infection in one of the three had spread from the midgut to the pharynx and proboscis. Stocks of Leishmania were isolated from two of the flies and 8 isoenzymes were examined. The newly isolated parasites were found to be indistinguishable from zymodeme 1 of Leishmania infantum s. st.

[A new Phlebotomus for Spain. Phlebotomus (Adlerius) mascittii Grassi, 1908]. / Un phlébotome mouveau pour l'Espagne. Phlebotomus (Adlerius) mascittii Grassi, 1908.

The authors have made the first discovery of Phlebotomus mascittii in Spain. The species was caught in Catalonia in the provinces of Gerona and Barcelona. Altogether 7 individual sandflies (4 male, 3 female) were collected (using oiled paper traps) in four separate sub-mediterranean sites (between 650 and 780 m).

[Suburban biotopes of Rhipicephalus turanicus (Pomerancev, Matikasvili, Lototzki, 1940). (Acarina, Ixodoidea). Preliminary study (author's transl)]. / Biotopes suburbains à Rhipicephalus turanicus (Pomerancev, Matikasvili, Lototzki, 1940) (Acarina, Ixodoidea): étude préliminaire.

Investigations carried out on the waste grounds of a certain number of large Mediterranean towns in Provence and Languedoc (France) show the prevalence of Rhipicephalus turanicus in such an environment. The authors analyse the conditions favourable to the installation of the species, and make a comparison between the suburban biotopes with Rhipicephalus turanicus and the homologous biotopes with Dermacentor reticulatus.