[Anterior-segment indocyanine green angiography in the management of anterior scleritis]. / Intérêt de l'angiographie de segment antérieur au vert d'indocyanine dans la prise en charge des sclérites antérieures: à propos de 5 cas et revue de la littérature.

PURPOSE: To assess the value of anterior segment indocyanine green (ICG) angiography for the diagnosis, prognosis, and treatment of anterior scleritis. PATIENTS AND METHODS: Anterior segment ICG angiography was performed in five patients presenting with diffuse or nodular scleritis. Angiographic findings before and after treatment were described with special emphasis on dye leakage, vessel abnormalities, and perfusion defects. A systemic medical workup (laboratory tests, imaging investigations, and systemic examination) was performed in all cases to rule out underlying systemic disease. RESULTS: ICG leakage is a sign of vascular inflammation and reflects the severity of the disease. Intense vascular dilation and late ICG leakage can be observed in the anterior segment angiograms of patients with scleritis. Favorable response to treatment is associated with partial or total disappearance of these perfusion abnormalities. CONCLUSION: Anterior segment ICG is a valuable tool for the evaluation and the follow-up of anterior scleritis. It may provide valuable information that is not clinically apparent, particularly a more precise assessment of the vasculitis.

[Acute posterior multifocal placoid pigment epitheliopathy, serpiginous and multifocal choroiditis: etiological and therapeutic management]. / Epithéliopathies en plaques, choroïdites serpigineuses et multifocales: analyse étiologique et prise en charge thérapeutique.

PURPOSE: To highlight the importance of an extensive medical work-up in serpiginous and multifocal choroiditis, and acute posterior multifocal placoid pigment epitheliopathy before therapeutic management. PATIENTS AND METHODS: Records of patients referred to our department, between January 2000 and January 2002, for the diagnostic and therapeutic management of choroiditis or acute posterior multifocal placoid pigment epitheliopathy were retrospectively reviewed. All patients had a complete ophthalmologic examination, fluorescein and infrared angiographies. An extensive work-up was performed in order to exclude an infectious etiology. RESULTS: Fourteen patients were included (six cases of serpiginous choroiditis, four cases of multifocal choroiditis, and four cases of APMPPE). The mean age was 42.1 years and the sex ratio was 9: 5. Six patients presented with a history of tuberculosis in the family or with a tuberculosis primary infection. Toxoplasmic retinochoroiditis was confirmed in one case by a positive PCR applied to the aqueous humor. In the serpiginous choroiditis group, two patients have been treated with antituberculous drugs, one of whom was initially resistant to immunosuppressive regimens. In the acute posterior multifocal placoid pigment epitheliopathy group, one patient was treated with antituberculous drugs and another received antibiotics. CONCLUSION: An infectious agent may be associated with this group of clinical presentations. All patients presenting with severe forms of ocular inflammation, who resist to corticosteroids or immunosuppressive regimens, must undergo an extensive infectious work-up in order to propose a specific treatment.