Revue internationale du trachome et de pathologie oculaire tropicale et subtropicale et de sante publique : organe de la Ligue contre le trachome avec la collaboration de l'International Organization against Trachoma et des organisation...最新文献

1000 cataracts were cured thanks to surgery at the Ophthalmological Centre of BOPP in Dakar. The authors analyzed them according to several aspects (age, sex, aetiology and anatomical shape of the cataracts), according to the therapeutical results and complications. When having compared extracapsular and intracapsular, they stress the double problem of prevention and treatment of endophthalmia and of optical correction of aphakia at a health centre.

A conjunctival sample for the research of chlamydiae was made on 87 persons (44 patients and 43 control persons). Clinical examination shows that 27 patients (61.4%) were suffering from a Trachoma. Direct examination with IF was positive for 9 patients (20.4%) and negative for all control people (P 0.001). A link between the positivity of the direct examination and the serology was found for 9 patients. The antibody anti-chlamydiae rate was higher or equal to 1/256 for 12 patients (44.4%).

The main epidemiologic characteristics of primary angle glaucoma in Tunisia were studied in 5000 patients of Pr. AYED's external consultation at the National Institute of Ophthalmology. It appeared that POAG is a frequent and serious disease in Tunisia: a true problem of public health. The importance of the early diagnosis based essentially on a systematic intraocular pressure test together with the examination of optic disc and the visual field investigation using automated perimetry in suspected cases is discussed.

Micro-immunofluorescence test with type specific antigens of ocular Chlamydial infection types A-D was used for serotyping the causative C. trachomatis serotypes in 32 inclusion positive school children suffering from trachoma. Single serotype associated infection was seen in six of the patients. The rest of them had antibodies against more than one serotype indicating simultaneous or previous infection by more than one serotype. By geometric mean titre determination, type C appeared to be the most prevalent serotype. However the highest antibody titres in individual cases were most frequently observed for serotype A. The use of geometric mean titre versus highest titre against specific serotype observed in individual cases for population survey is discussed. Isolation of organism for absolute determination of causative serotype from each patient is emphasised.

173 nontrachomatous conjunctivitis studied at the I.O.T.A. in Bamako, Mali, have shown a majority of bacterial aetiology, especially gram-negative. 1 out of 10 conjunctivitis was due to virus, mostly to adenovirus. 4% of the cases were due to Chlamydia Trachomatis. The try of validation of the clinical characters in comparison with the etiology has shown that Chemosis was an indicator of a bacterial conjunctivitis (OR = 2.4) and that the lack of purulent discharge was in connexion with the presence of a keratitis (OR = 7.7). On the one hand the frequency of gram-negative bacteria, on the other hand the potential gravity of the conjunctivitis in tropical area, would justify the use of gentamycin at first in nontrachomatous conjunctivitis.

The Transferred Conjunctival Impression test (test d'Impression Conjonctivale Transférée) is a simple, sensitive and non-invasive method enabling populations at risk from Xerophthalmia to be identified. Nevertheless, the results of the test do seem to be influenced by the conjunctival pathology, trachomatous in particular. It appears that conjunctival deficit is noticeably more frequent in trachomatous than non-trachomatous subjects. The trial, involving a random sample of 450, four- to six-year-old children living in the Sahelian zone, enabled us to confirm and quantify this relation. In terms of relative risk, with age, place of residence and nutritional state all being equal, the rate of abnormal TCI tests was 1.7 times higher in trachomatous than non-trachomatous children. Using the Transferred Conjunctival Impression test is thus especially indicated in zones with a low prevalence of trachoma. When high, an eye examination must be carried out during the trial in order to present the results in two categories: trachomatous and non-trachomatous. Failing this, estimates may be obtained using the formulae put forward by the authors.

The "keratopathie de Bietti" or climatic droplet keratopathy or keratopathie climatique (KC) is a degenerative disease of the cornea which is probably due to the exposure to ultraviolet rays. Usually the evolution is a progressive invasion of cornea by amber nodules which lift up the corneal epithelium. We observed that numerous patients suffered from severe corneal ulcerations which appeared to be spontaneous and which evolution was frequently disastrous. The aim of this work was to pick up epidemiologic data on KC in order to check the following hypothesis: the corneal opaquenesses, due to non traumatic perforations, would be more frequent among patients suffering from KC than among the rest of population. The study, carried out in Republic of Djibouti, dealed with two groups of people: an hospitable group of 217 patients suffering from a KC and a random sample of 2,446 persons among Djibouti people, from which a study ill-healthy was carried out among people from 40 years old. The mistakes were controled by adjustment on age and climatic conditions. The result is that corneal blindnesses which seemed to be spontaneous were more frequent in a significative way among people suffering from KC than among healthy people as old as ill people and living in the same conditions (12% against 0.7%; p = 0.003; Odds ratio adjusted on age: 31.8 IC: 8.8-115.20). On the etiopathogenic point of view the bacterial, fungal and deficiency causes could scarcely be accepted. The unfavourable evolution, resisting to all the treatments, drove to several hypothesis among them is responsibility of free amoebas as acanthamoeba.

Electron-microscopic examination of conjunctival and corneal biopsies from six apparently healed trachomatous patients demonstrated chlamydiae in situ. Nine previously trachomatous patients were submitted to the same biopsies; all biopsies were positives. After two months specific anti-chlamydial treatment, we observed the same result before anterior segment surgery. Nevertheless surgery was performed without consequences except for the two corneal grafts which failed. We must ask for two questions: how long chlamydial particles persist in trachomatous tissue? What is the real efficacy of topical anti-chlamydial drugs?