Ten years follow-up after deep sclerectomy with collagen implant.

PURPOSE: To evaluate the long-term success rate and complications of nonpenetrating deep sclerectomy with collagen implant in open-angle glaucoma. PATIENTS AND METHODS: Clinical, prospective, monocentric, nonrandomized, unmasked study on 105 patients with medically uncontrolled glaucoma. A standard procedure deep sclerectomy with collagen implant was performed. Complete examinations were performed before surgery and postoperatively at 1 and 7 days; 1, 2, 3, 6, 9, and 12 months and then every 6 months during the 10 following years. RESULTS: The mean follow-up was 101.5+/-43.1 (3 to 144) months [mean+/-SD, (range)]. The preoperative intraocular pressure (IOP) was 26.8+/-7.7 (14 to 52) mm Hg and the best-corrected visual acuity 0.71+/-0.33 (0.02 to 1.5). Ten years after surgery IOP was 12.2+/-4.7 (6 to 20) mm Hg and best-corrected visual acuity 0.63+/-0.34 (0.01 to 1.2) (number of remaining patients=52). The mean number of medications per patient went from 2.3+/-0.7 (1 to 4) down to 1.3+/-1.1 (0 to 3). An IOP

Optical coherence tomography and multifocal electroretinogram findings in chronic solar retinopathy.

PURPOSE: To correlate the structural and functional retinal defects, which are induced photochemically in chronic solar retinopathy. DESIGN: Observational case report. METHODS: Four emmetropic eyes of two patients, previously diagnosed with chronic solar retinopathy, were evaluated by optical coherence tomography (OCT), multifocal electroretinography, and fluorescein angiography. RESULTS: Visual acuity ranged from 20/80 to 20/50 and all subjects had central and steady fixation. In all eyes, OCT demonstrated a hyporeflective space at the level of outer retinal and retinal pigment epithelium (RPE) layers, which was limited to the fovea. The foveal contour was preserved with normal vitreoretinal interface. Multifocal electroretinogram (mfERG) trace array of the first-order kernel demonstrated attenuated responses extending to a larger area, the para- and perifovea. A foveal RPE window defect was angiographically evident in all cases. CONCLUSIONS: A model of centrifugal neuronal damage is proposed for chronic solar retinopathy, with more functional than structural neuroretinal defects.

Multiple evanescent white dot syndrome following simultaneous hepatitis-A and yellow fever vaccination.

PURPOSE: To report a case of multiple evanescent white dot syndrome (MEWDS) following simultaneous hepatitis-A virus (HAV) and yellow fever (YF) vaccination. METHODS: Review of the clinical, laboratory, photographic, and angiographic records of a patient suffering from MEWDS. RESULTS: A healthy 50-year-old woman presented with rapidly progressive left-eye visual loss, associated with photopsias and a para-central scotoma, one week after receiving simultaneous HAV and YF vaccination. Both anterior segments and right-eye fundus were unremarkable. Fundus examination of the left-eye disclosed papillitis with multiple, small, white, outer-retinal lesions. Angiographic tests were pathognomonic for MEWDS. Perimetry revealed left-eye blind spot enlargement. Initial inflammatory/infectious work-up was negative. Signs and symptoms resolved spontaneously within 6 weeks, with concomitant normalization of ancillary exams. CONCLUSIONS: The clinical presentation and the benign course were consistent with the diagnosis of MEWDS. No other aetiopathogenic factor than simultaneous HAV and YF immunization was identified, suggesting an autoimmune basis for MEWDS in predisposed patients.

Cavernous sinus thrombosis elicited by a central retinal vein venous stasis retinopathy.

BACKGROUND: Central retinal vein occlusion is a relatively common retinal disorder in the elderly, and those with cardiovascular or thrombophilic risk factors are at increased risk. Although still unsatisfying, some treatments for the acute and chronic phases have been established based on randomized studies. However, for rare conditions mimicking central retinal vein occlusion, treatment of the acute phase should be targeted at etiology. A rare condition mimicking central retinal vein occlusion in a 70-year-old man is presented and discussed. METHODS: A 70-year-old man was admitted to the hospital for isovolemic hemodilution related to a central retinal vein occlusion of the elderly, after a sudden decrease in visual acuity to 0.1. RESULTS: Clinical and laboratory work-up demonstrated a venous stasis retinopathy, related to an atypical cavernous sinus thrombosis of undetermined origin. The patient had experienced in the past 6 months intermittent diplopia and an irreducible conjunctival hyperemia. Hemodilution was dismissed. Soon after initiation of anticoagulation therapy, the patient's clinical signs and symptoms improved. Final visual acuity was 0.8. CONCLUSION: Venous stasis retinopathy secondary to cavernous sinus thrombosis is rare. However, careful clinical examination and extensive laboratory work-up is needed to exclude central retinal vein occlusion not associated with common vascular pathologies of the elderly.

[Morganella morganii endophthalmitis after vitrectomy: case report and review of the literature]. / Endophtalmie à Morganella morganii après vitrectomie: cas clinique et revue de la litérature.

BACKGROUND: Postoperative bacterial endophthalmitis are caused in 80 % of the cases by the patient's own flora. Most of the time, bacterial agents are Gram-positive ((2/3) of cases) and more rarely Gram-negative ((1/3) of cases). Usually, Pseudomonas sp, Proteus sp or Klebsiella sp are isolated, but very rarely Morganella morganii. HISTORY AND SIGNS: We describe a case of a Morganella morganii endophthalmitis which occurred after a vitrectomy. THERAPY AND OUTCOME: Bacterial examinations disclosed the presence of Morganella morganii in the vitreous. An aggressive treatment (intravitreous [ceftazidim, vancomycin], topical [gentamycin, chloramphenicol] and intravenous [imipenem, ofloxacin] antibiotics) was introduced. In spite of this treatment, the outcome was not favorable. CONCLUSIONS: Post-vitrectomy endophthalmitis is very rare and the isolation of a Gram-negative bacteria, in this case Morganella morganii, is infrequent. The outcome of these infections is often poor despite the introduction of a rapid, specific and aggressive treatment.