[Devic's neuro-optic myelitis and pregnancy]. / Neuromyélite optique de Devic survenue au cours d'une grossesse.

INTRODUCTION: Devic's neuromyelitis optica associates optical neuritis that is either unilateral or bilateral and acute transversal myelopathy. This disease seldom occurs and is rarely associated with pregnancy. OBSERVATION: We report the case of a young 20-year-old woman who was 8 weeks pregnant. She was admitted to our ophthalmological department for a profound and bilateral drop in visual acuity. The ophthalmological examination showed bilateral optic disc swelling. Three days later, the patient presented a spastic paraplegia with sphincter disorders. Devic's neuromyelitis optica was suspected and then confirmed by examination of cerebrospinal fluid and cerebrospinal MRI. Corticoid treatment in bolus of prednisolone methyl relayed by prednisolone per bone was established. The neurological and visual defects were clearly improved and the case was stabilized at 1 year. DISCUSSION: Devic's neuromyelitis optica is related to nosologic problems with multiple sclerosis. Clinical, immunological, and pathological elements provide arguments in favor of a separate entity.

[Macular serous detachment revealing acute lymphoblastic leukemia]. / Décollement séreux maculaire révélateur d'une leucémie aiguë lymphoblastique.

BACKGROUND: Leukemias are a group of malignant diseases caused by immature hematopoietic cells proliferating in the blood marrow. Some manifestations result from ocular-orbital involvement, which usually occurs through the central nervous system. Other manifestations stem from vasculopathy and/or hemorheologic disorders (anemia, thrombocytopenia, hyperviscosity). OBSERVATION: We report a case of a 42-year-old women presenting with loss of vision caused by serous macular detachment. The investigations showed the diagnosis of acute lymphoblastic leukemia. Steroids and chemotherapy led to complete remission with normal visual acuity during a follow-up of 29 months. DISCUSSION: Ocular involvement is seen in 28%-80% of leukemia cases. The most obvious findings are the presence of retinal hemorrhages, which are most commonly located in the posterior pole. The intraretinal hemorrhage may contain a white component that usually is a white dot in the center of the hemorrhage, but other clinical features are described. Serous detachment of the neuroepithelium is seldom reported, and can be the first symptom of the disease. Other ocular findings include infiltrative involvement of the chorioretina, anterior segment involvement, and orbital location. Ocular location is estimated to be an equivalent of central nervous system involvement, and subsequently requires adequate treatment (steroids, chemotherapy and radiotherapy of the central nervous system). CONCLUSION: Ocular manifestations of leukemia are frequent but rarely reveal the disease. Serous detachment is rarer. However, the diagnosis of leukemia should be considered in case of pigmentary epithelium involvement.

[Inflammatory pseudotumor of the lacrimal gland. Apropos of 2 cases]. / Les pseudo-tumeurs inflammatoires de la glande lacrymale. A propos de 2 cas.

BACKGROUND: Inflammatory pseudotumors of the orbit are relatively common accounting for 12 to 15% of all orbital diseases. Lacrimal gland location is exceptional. CASE REPORTS: We report 2 patients aged 30 and 25 years who underwent surgery for an isodense tumor of the lacrimal gland. Immunohistochemistry revealed an inflammatory pseudotumoral process. Both patients are recurrence-free 2 years follow-up. DISCUSSION: Inflammatory pseudotumors of the orbit, particularly those located in the lacrimal gland still raise unresolved questions concerning the pathogenesis, diagnosis and treatment. CONCLUSION: Lacrimal gland localizations of inflammatory pseudotumors must be recognized due to difficulties in diagnosis and therapeutic management.

[Tumor of the lacrimal sac. Dangers of simple excision biopsy]. / Tumeur du sac lacrymal. Dangers de la biopsie exérèse simple.

Lacrimal sac tumors are relatively uncommon tumors which recur readily and have poor prognosis if adequate care is not provided early. We report here a case of lacrimal sac tumor in a 56-year-old patient with bilateral pseudophakia and an atypical chronic dacryocystisis aspect of the left eye. After clinical and paraclinical investigations, the patient underwent surgical excision of the tumor followed by external radiotherapy. During follow-up, the patient developed a local recurrence which required surgical removal and radiotherapy. Despite early and adapted management, the prognosis of this tumor remains poor.