[Management of hyperopia in children]. / Prise en charge de l'hypermétropie de l'enfant.

PURPOSE: To study the prevalence of hyperopia in school-aged children and to analyze the factors that increase the risk of squint or amblyopia in a retrospective study. METHODS: Three hundred eyes of 150 children with hyperopia who did not have anisometropia > or =1.5 D were selected. Complete ophthalmological examination was performed for all children. Hyperopia was defined when spherical equivalent was +0.5 D or greater. Amblyopia was screened and treated by patching therapy and then penalisation. Complete spectacle correction was achieved in children with high hyperopia (+3.5 D or greater) or in presence of squint or amblyopia. A statistical analysis compared the results using the Mann-Whitney test and the chi square test. RESULTS: The mean age was 9.5+/-2.7 years. Girls were statistically more represented than boys. The mean sphere measured overall was +2 D (+/-1.65). Severe hyperopia was detected in 19% of the children; it was latent in 35% of children. Strabismus was detected in 7% and was accommodative in 25%. Esotropia was the most prevalent deviation (72.8%). The prevalence of amblyopia was 12%. The mean sphere measured in amblyopic children was 5.66 D (+/-1.64 D). Initial depth of amblyopia was mild to moderate and 98% of the children achieved iso-acuity after patching therapy. The correlation between severe hyperopia, amblyopia, and squint was statistically significant. Indeed, the risk ratios of squint and amblyopia, 5.2 and 3.70, respectively, were significantly high in children with severe hypermetropia. Complete spectacle correction improved final visual acuity and reduced the angle deviation in accommodative esotropia. CONCLUSION: Children with hyperopia of +3.5 D or greater have an increased risk of amblyopia and squint that threatens their visual function. Hyperopic correction should be prescribed even if no strabismus or amblyopia is detected in order to prevent this risk. Screening programs should also be promoted to detect these children at an early age.

[Risk factors for diabetic macular edema]. / Facteurs de risque de l'oedème maculaire diabétique.

AIM: To determine the risk factors involved in the development of macular edema. PATIENTS AND METHODS: A retrospective, case-control study conducted on 200 diabetic patients with diabetic retinopathy: 100 patients with macular edema and 100 control patients. All patients were examined using slit-lamp biomicroscopy completed by fluorescein angiography. A physical examination and the appropriate biological investigations were also carried out. Statistical significance was determined by the chi square test and Fisher's exact test. A value of p<0.05 was considered statistically significant. RESULTS: The incidence of macular edema was significantly associated with longer duration of diabetes, a higher level of glycemia, the type of diabetes in the older onset group using insulin, the severity of diabetic retinopathy at baseline, and old age. Panretinal photocoagulation was also found as a risk factor for macular edema. CONCLUSION: These data suggest that laser photocoagulation, reduction of hyperglycemia and better control of other factors may result in a beneficial decrease in macular edema.