Extraocular Muscle Biopsy: Surgical Technique and Indications.

Extraocular muscle biopsy is a technique used for the histological diagnosis of several orbital diseases; it could bring valuable assistance to the diagnostic process. The purpose of this article is to review the indications, surgical technique, and complications of this biopsy. Extraocular muscle biopsy is frequently used in tumoral pathology, however, in inflammatory diseases, it is only used when facing a poor reaction to the treatment or in case of chronicity. The surgical procedure must be precise and least traumatic, in order to avoid intra- and post-operative complications, but also to preserve the integrity and function of the muscle. This procedure remains non-standardized and not devoid of complications, hence the need for a careful evaluation of the benefit/risk ratio before considering it.

Optic Disc Drusen (ODD), an Often Misdiagnosed Disease: A Case Report.

Optic disc drusen (ODD) are abnormal collections of protein and calcium that accumulate within the optic nerve. We report a case of a 17-year-old girl who presented to the Department of Ophthalmology at the Cheikh Khalifa International University Hospital, Casablanca, Morocco, with a decline in visual acuity, visual field deficiency, and color vision abnormalities. The patient was misdiagnosed and mistreated for optic neuritis given the presence of bilateral Stage III papilledema solely. After many months of diagnostic wandering, a fundus examination revealed a white atrophic papilla with calcified deposits grouped in a crown around the papillary excavation, suggesting papillary drusen. When the deposits are visible on ophthalmoscopy and manifest as an elevation and a blurring of the optic disc's margins, their diagnosis remains straightforward. However, their identification might be problematic when they are firmly lodged in the optic disc or with the presence of papilledema, leading to confusion with other differential diagnoses, particularly if the condition affects both eyes. The purpose of this case report is to increase neurologists' and ophthalmologists' knowledge of the incidence of drusen in order to prevent excessive biological and imaging investigation in addition to harmful effects from needless drugs.

[Epidemiological, clinical, therapeutic and evolutionary profile of ocular manifestations in patients with Behçet's disease]. / Œil et Maladie de Behçet: profil épidémiologique, clinique, thérapeutique et évolutif.

This study aims to analyze the epidemiological, clinical, therapeutic and evolutionary profile of ocular manifestations in patients with Behçet's disease. We conducted a retrospective, descriptive study of the medical records of 121 patients managed by specialists with expertise in this disease over a period of one year and a half between January 2015 and June 2016. The average age of patients was 35 years, 63.6% of patients were male, ocular involvement was inaugural in 24% of cases. Patients had anterior uveitis (7.4%), posterior uveitis (15.7%), vasculitis (19%), irido-crystalline synechias (17.5%), macular edema (7.4%), optic atrophy (4.1%), papillary edema (2.5%) and peripheral retinal ischemia (1.7%). In our series, 41.3% of patients were under colchicine, 23.1% under oral corticosteroids, 9% under intravenous corticosteroids, 4.9% under topical corticosteroids, 8.2% under immunosuppressive drugs and 5.8% under vitamin K antagonists. After an average follow-up of 1 year, 40% of patients had stable visual acuity while receiving treatment, 23% had a significant decrease in visual acuity and 5% of cases had complete vision loss. Adequate therapy enables quick containment of the infection and decreases the frequency and severity of recurrences, thus leading to an improvement of the visual prognosis in our patients compared with outcomes in some previous case serie.