[Invasive aspergillosis of sphenoidal sinus in a patient in Djibouti, revealed by palsy of cranial nerves: a case report]. / Aspergillose invasive du sinus sphénoïdal révélée par une paralysie de paires crâniennes : à propos d'un cas pris en charge à Djibouti.

The authors report a case of invasive aspergillosis of a sphenoid sinus mucocele revealed in a patient with diabetes in Djibouti by homolateral palsy of the 3rd, 4th, 5th and 6th nerves. This rare condition occurs preferentially in immunodeficient subjects. Because of its clinical polymorphism, its diagnosis is difficult and is often not made until complications develop. Endonasal surgery with anatomopathological and mycological examination is both a diagnostic and therapeutic procedure. It must be performed early, to avoid functional or even life-threatening complications.

[Oedema with acute pseudokeratoconus corneal aspect in a case of Kearns-Sayre syndrome]. / OEdème avec déformation cornéenne d'aspect pseudo-kératoconique aigu au cours d'un syndrome de Kearns-Sayre.

INTRODUCTION: Mitochondrial encephalomyopathy is a set of rare diseases in which corneal involvement is exceptional. CASE REPORT: A 34-year-old patient, a known carrier of Kearns-Sayre syndrome, was hospitalized for acute corneal decompensation, with a keratoconus-like hydrops stemming from an endothelial-Descemet membrane disruption. Under local hypotonic treatment, the favorable progression was fast with a decline in the edema and coaptation of the endothelial-Descemet membrane disruption. CONCLUSION: The possible physiopathologic mechanisms are debated; the preferred hypothesis was a dysfunction of endothelial cell pumps. We emphasize the extremely complex medical management of these fragile patients presenting mitochondrial encephalopathy. General corticotherapy is contraindicated and beta-blockers including in eye drops must be used extremely carefully because of cardiac abnormalities such as conduction disturbance and/or arrhythmia and dilated cardiomyopathies.

[Effects of mobile phones and radar radiofrequencies on the eye]. / Effets des ondes hyperfréquences des téléphones mobiles et des radars sur l'oeil.

The increasing applications of microwaves, mainly in mobile phones and radar, induce a higher rate of exposed people, sometimes cause of worry. Eyeballs are hotspots of radiofrequency field radiation because of their anatomy and composition. We propose a review of the various effects on the eye. The studies are hardly comparable because the exposure systems, power densities and dosimetries are different. While the thermal effects on the eye are well known including cataracts, corneal edema, endothelial cell loss and retinal degeneration, the non-thermal effects are still controversial. Cell cycle abnormalities, early apoptosis were reported in experimental conditions likely due to oxidative stress, but the studies could not show any significant effect on human eyes when exposed to long-term and low-dose radiation. Next studies need to be closer to human exposure.

[Devic's neuromyelitis optica: diagnosis after 10 years of bilateral severe relapsing optic neuritis]. / Neuromyélite optique de Devic: discussion diagnostique après dix ans d'évolution d'une neuropathie optique bilatérale sévère.

INTRODUCTION: Neuromyelitis optica, also known as Devic's disease, is a severe idiopathic inflammatory demyelinating disease of the central nervous system that preferentially affects the optic nerve and spinal cord. Neuromyelitis optica has long been thought of as a variant of multiple sclerosis; however, clinical, laboratory, immunological, and pathological characteristics that distinguish it from multiple sclerosis have now been recognized. CASE REPORT: A young man presented isolated severe bilateral relapsing optic neuritis. After having evolved over 10 years, the appearance of multiple sclerosis-like lesions on the brain led to the diagnosis of multiple sclerosis. Acute myelitis and the presence of NMO-IgG antibodies in the serum finally led to the diagnosis of neuromyelitis optica. CONCLUSION: This case is an illustration of the new criteria in the diagnosis of NMO, underscoring the importance of the positive serum NMO-Ig G antibody to distinguish multiple sclerosis from NMO. It also emphasizes that asymptomatic brain lesions are common in NMO on brain MRIs and symptomatic brain lesions do not exclude its diagnosis.

[Multifocal ERG using ERG-jet and Gold Foil electrodes in normal subjects: comparison and reproducibility]. / ERG multifocal avec électrodes ERG-jet et Gold Foil chez le sujet normal: comparaison et reproductibilité.

PURPOSE: To compare multifocal electroretinogram (mfERG) amplitudes with the Gold Foil electrode and ERG-jet electrode. To study mfERG amplitude changes between two successive records (intraindividual reproducibility). METHODS: The right eye of 27 normal subjects was examined. Two mfERG recordings using the 61-hexagon strategy (Vision Monitor, Métrovision, France) were made with both ERG-jet and Gold Foil electrodes. N1 and P1 wave amplitudes were analyzed in the central response and in four concentric rings. Bland and Altman analysis was used for the reproducibility study. RESULTS: MfERG amplitudes were significantly lower with the Gold Foil electrode, which averaged 72+/-10% of ERG-jet amplitudes. For N1 and P1 waves, the percentage change for the intraindividual reproducibility study was 9.1% and 6.7%, respectively, with the ERG-jet electrode and 18.2% and 13.5%, respectively, with the Gold Foil electrode. CONCLUSION: MfERG amplitudes were larger and more reproducible with an ERG-jet electrode than with a Gold Foil electrode. The limits of agreement of each ring can be used in clinical practice to determine whether the variation between two mfERG recordings over time is normal, which could reflect a retinal disorder.

[Scattered light and glare sensitivity after wavefront-guided photorefractive keratectomy (WFG-PRK) and laser in situ keratomileusis (WFG-LASIK)]. / Lumière diffractée et sensibilité à l'éblouissement après PKR et LASIK guidés par front d'onde.

PURPOSE: To compare glare sensitivity measured by the intraocular scattered light between WFG-PRK and WFG-LASIK at 12 months follow-up and to assess its correlation to patients' complaints. PATIENTS AND METHODS: Prospective and randomized study on 13 patients treated with WFG-LASIK, 13 patients with WFG-PRK and a control group of 35 patients. The intraocular stray light was measured by the Oculus C-Quant 12 months after surgery and before surgery for the control group. Photopic and mesopic contrast acuity and glare symptoms were reported pre- and postoperatively. RESULTS: Stray light values were normal in 79% of patients after WFG-LASIK and PRK and 86% in the control group, with mean values of 1.05 log, 1.03 log, and 0.99 log, respectively (p>0.05). All the patients with significant glare complaints had impaired stray light values versus 31.5% in the no-complaint group. Photopic and mesopic contrast acuity and glare symptoms were improved 1 year after surgery compared to preoperatively (no significant difference between groups). CONCLUSION: WFG-LASIK and PRK are safe and equivalent procedures regarding quality of vision. The measurement of stray light can be a discriminative test to assessing patients' glare complaints.

[Improved visualization of fundus with green-light ophthalmoscopy]. / Intérêt de l'examen biomicroscopique du fond d'oeil en lumière verte.

Monochromatic light accentuates details of different retinal layers because of its variable absorption and reflectance by structures both within and above these layers. Red-free light is little used, although it is an elementary method. Green-light ophthalmoscopy, with its short wavelength, enhances some fundus and vitreous structures and may make the examination of pathologic conditions (premacular pathology, vascular abnormalities, etc.) easier. Furthermore, it is often more comfortable for the patient.

[Anterior uveitis and topical brimonidine: a case report]. / Uvéite antérieure et brimonidine.

We report the case of a 66-year-old patient treated for 13 months with brimonidine, who presented granulomatous anterior uveitis associated with an increase in intraocular pressure, allergic conjunctivitis and blepharitis in both eyes. No ocular or general cause for uveitis was found. The uveitis responded rapidly to cessation of brimonidine. This report illustrates that anterior uveitis can occur when brimonidine is used after approximately 1 year of treatment. Physicians must be informed of this side effect even though it is rare, with only four similar cases having been described in the literature.