[Anterior uveitis and cidofovir]. / Uvéite antérieure et cidofovir.

PURPOSE: This retrospective study was designed to determine the different parameters involved in the occurrence of uveitis during treatment with codofovir. PATIENTS AND METHODS: This study included 10 patients out of 13 treated with cidofovir for cytomegalovirus (CMV) disease. Ocular examination, CD4+ lymphocyte count, and creatinine clearance were performed for each case of uveitis. RESULTS: During the 17-month study, 20 uveitis cases were analyzed. The first attack occurred after a median interval of 7.6 doses. At the time of ocular inflammation, 65% of the cases had a CD4+ lymphocyte count >=100x10(6)/L, the patients thus had an improved immune function. Half of the patients had a normal creatinine clearance. The patients with a CD4+ lymphocyte count<100x10(6)/L who presented one or more incidents of uveitis had an abnormal clearance, thus probably inducing intraocular storage of the drug. CONCLUSION: The occurrence of anterior uveitis during treatment with cidofovir is induced by the association of several parameters: a previous history of CMV retinitis, improvement of the immune function state, and intraocular storage of the drug.

[Bilateral anterior acute ischemic optic neuropathy complicating optic nerve head drusen. Apropos of a case]. / Neuropathie optique ischémique antérieure aiguë bilatérale compliquant des druses de la papille. A propos d'un cas.

A case of bilateral Anterior Ischemic Optic Neuropathy (AION) which is related to buried optic nerve head drusen is presented. Such an etiology has rarely been described and is poorly-documented in the literature. This etiologic diagnosis is brought by the imaging techniques: fluorescein angiography, B-scan ultrasonography and computed tomography. The pathogenesis may be related to the compressive effects encountered in a small scleral canal. The other complications of optic nerve head drusen are described and their similar mechanisms discussed.

[Melanoma-associated retinopathy. Apropos of a case and review of the literature]. / Rétinopathie associée au mélanome cutané. A propos d'un cas et revue de la littérature.

We describe here a case of melanoma-associated retinopathy. In 1993, a 60 year-old man had a cutaneous malignant melanoma surgically removed from the third right toe (thickness 3.15 mm; level IV). One year later he complained suddenly of photopsias, shimmering lights and night blindness of the left eye. Visual acuity and fundus examination were normal. The left visual field showed a tubular aspect. The photopic electroretinogram (ERG) was negative, and the scotopic one was flat. Six weeks later the same symptoms occurred in the right eye. One month later, inguinal lymph nodes were invaded with cancer cells. The association of metastatic melanoma, ocular functional signs and ERG's abnormalities suggested the diagnosis of melanoma-associated retinopathy. This paraneoplastic syndrome is very rare: only seven cases have been described. Antibodies against retinal bipolar cells have shown up in three cases. Treatment is yet to be discovered.

Fixed combination of carteolol and pilocarpine eye-drops: a double-blind randomized cross-over trial versus carteolol alone on intra-ocular pressure. The Study Group.

The effects of carteolol 2% and a fixed combination of carteolol 2% and pilocarpine 2% (CBS 341 A) eye-drops on intraocular pressure (I.O.P.) were compared in a multicenter double-blind, cross-over prospective trial. Twenty-eight patients were initially selected after at least three weeks of carteolol 2%, with a morning I.O.P. greater than 21-mmHg. They received 2 drops a day (b.i.d.), in a random order, alternating two weeks of carteolol 2% alone or two weeks of CBS 341 A. After each two-week period a 12-h I.O.P. curve was plotted. Compared to carteolol the combination reduced I.O.P. on average by around 20% (4 mmHg), with maximum effect 4h after instillation. The effectiveness was confirmed after twelve hours. Some side effects were reported with CBS 341 A, due to the well known pharmacological effects of pilocarpine. The new combination could be useful for second-line therapy in glaucoma.

[Paraneoplastic retinopathy associated with cutaneous melanoma. An update apropos of a case]. / Rétinopathie paranéoplasique associée au mélanome cutané. Mise au point à propos d'un cas.

BACKGROUND: Ocular paraneoplastic syndromes are rare, and consist of optic neuropathy or retinopathy. Classically, these syndromes are related to carcinoma. Melanoma-associated retinopathy is extremely rare, and unrecognized. METHODS: A patient with metastatic cutaneous melanoma discovered and operated 18 months before. Visual complains consisted of xanthopsia and shimmering light vision, then hemeralopia, which dramatically worsened. Classical clinical examination, visual field and electroretinogram were performed. RESULTS: Visual acuity was 20/25, and fundus examination was normal. The visual field showed a tubular aspect, with V4 isopter remained, like an advanced retinitis pigmentosa. The photopic electroretinogram was negative, and the scotopic one was flat. CONCLUSION: This recent hemeralopia with normal fundus and "negative" electroretinogram, ruled out congenital stationary night blindness diagnosis, and suggested the diagnosis of melanoma-associated retinopathy. This is a rare paraneoplastic syndrome since to date only 7 cases have been reported. Immunochemistry studies, that show antibodies directed against bipolar cells, are consistent with selective reduction of the electroretinogram b wave.

[Cyclic strabismus. Presentation of two new cases and critical review of the literature]. / Le strabisme cyclique. Présentation de deux nouveaux cas et revue critique de la littérature.

Description of cyclic strabismus has been restricted for a long time to circadian esotropia. In this mysterious phenomenon, the eyes are crossed every other day with no binocular vision, but remain perfectly normal during the straight days. The usual characteristics are those of a non-accommodative and non-paretic strabismus, with onset in early childhood. There is no response to conservative treatment, and the cycles become irregular with time until the deviation becomes constant, with an excellent functional result after surgery in every case. Recently, other papers comprising data irrelevant to the classic picture suggest that cyclic strabismus includes, in fact, several different entities. The only common point is the existence of ocular motility disorders that recur more or less regularly, and whose pathologic substrate is primarily heterogeneous, whether it is thought as a mere hypothesis or a likely mechanism. Two new cases of circadian esotropia are presented together with a review of the literature relating to the criteria of the syndrome.

[Anisocoria disclosing malignant lymphoma]. / Anisocorie révélatrice d'un lymphome malin.

Intraocular lymphoma is a rare disease. We present a patient in which anisocoria led to the diagnosis of iris lymphoma and systemic malignant non Hodgkin's lymphoma.

[Accuracy and reproducibility of the Eyesys corneal topographic analysis system]. / Fiabilité et reproductibilité du système d'analyse topographique cornéenne Eyesys.

Corneal topographic analysis has become quite useful for corneal surgery. Quantitative data on the quality and accuracy of the available instruments are not well known. We studied the accuracy and the reproducibility of the Eyesys machine using 4 calibrated balls: 8.99 mm, 7.93 mm, 7.10 mm, 6.13 mm. The machine is accurate (precision less than 0.1D for all the balls) and reproducible (4 measurements) with a SD less than 0.05 diopter for all the balls except for the 55.04's ball (0.06 to 0.1). We also studied reproducibility with six normal corneas using the same method. SD was 0.26 diopter for keratometry and 0.50 diopter for the astigmatism value.

[Is A29, B12 vasculitis caused by the Q fever agent? (Coxiella burnetii)]. / La vascularite A29, B12, est-elle déclenchée par l'agent de la fièvre Q? (Coxiella burnetii).

The authors describe the first two cases, to their knowledge, of retinal vasculitis, associated with Q fever. The first case was a chronic infection induced by Coxiella burnetii associated with HLA group A29 and B12; in the second case, the phenotype was B12. The authors tried to determine whether this agent could be the "Birdshot chorioretinopathy" promoting factor. Several epidemiologic findings tend to prove that Q fever is not the only cause. On the other hand, its similarity with rickettsia, the fact that it is found in patients with vasculitis, suggest that it could be one of the initial causal factors.

[Accuracy and reproducibility of Nidek's photokeratoanalyser]. / Fiabilité et reproductibilité de photokératoanalyseur de Nidek.

We studied the accuracy and reproducibility of the keratoscope PKS 1,000 and keratoanalyser PKA 1,000 (Nidek laboratory). When calibrated steel balls are studied without any precaution, the system is unreliable. The photokeratoscope and the keratoanalyser provide good results only if they are used with care. To use the system, we propose the following schedule. Firstly, take a photograph of a steel ball, then set this picture under the video camera and vary the illumination until the accuracy remains unchanged during repeated calibration. With homogenous and constant illumination, the accuracy is about 0.5 diopter.

[Quality of corneal incisions of ceramic and diamond blades. Comparison in optic microscopy]. / Qualité de coupe cornéenne des lames céramique et diamant. Comparaison en microscopie optique.

Six radial keratotomies were performed using a ceramic blade on corneas obtained from cadavers. These incisions were compared by light microscopy with 6 sections performed on the same corneas using a diamond blade. Microscopic examination showed no significant difference in the quality of the incision between the two blades studied.

[Biocompatibility of hydroxypropylmethylcellulose as a vitreous substitute in rabbits]. / Etude de la biocompatibilité de l'hydroxypropylméthylcellulose comme substitut du vitré chez le lapin.

We have studied the biocompatibility of the hydroxypropylmethylcellulose in ten rabbits' eyes after lensectomy and posterior vitrectomy. In seven eyes the inflammatory reaction was severe. The reason why the hydroxypropylmethylcellulose is biocompatible in the anterior segment and not in the vitreous body seems to be explained by its quantity and its concentration in the eye at the end of the surgical procedure.

[Malaria and retinal hemorrhages]. / Paludisme et hémorragies rétiniennes.

A 24-year-old woman presented with retinal hemorrhages, back from a travel in Cameroon. She took a chloroquine chemoprophylaxis. We diagnosed a malaria due to Plasmodium falciparum with anemia, splenomegaly and low parasitemia. A speedy clinical and ophthalmological recovery was obtained with mefloquine therapy. We discuss physiopathology of such uncommon retinal damage during malaria.