Ophtalmologie : organe de la Societe francaise d'ophtalmologie最新文献

An analytic study of electroretinogramms (ERG) from 280 patients under antimalarial therapy has been made. The pratician has stopped treatment in 4.8% of the ERG. Among the investigated parameters, the only statistic difference is the cumulative doses.

We have studied the biocompatibility of the hydroxypropylmethylcellulose in ten rabbits' eyes after lensectomy and posterior vitrectomy. In seven eyes the inflammatory reaction was severe. The reason why the hydroxypropylmethylcellulose is biocompatible in the anterior segment and not in the vitreous body seems to be explained by its quantity and its concentration in the eye at the end of the surgical procedure.

We report two personal cases of intra ocular cysticercosis typical by their sub retinal and intra vitreous localization. After a short review of epidemiology and biological diagnostic we propose a treatment which associates a medical part with Praziquantel, killing the larva and a surgical part with pars plana vitrectomy allowing the control of the inflammation, contemporary of the larva's death and the intra-vitreous cysticercosis extraction.

The eye plays a double role: on the one side it is the optic camera, on the other side independent of the optic path ways it is the light receptor which stimulates the retino-hypothalamique pathway of the endocrine-visceral system. To determine this influence, we compared the metabolisme (water balance, blood sugar and blood cell count) as well as the hormones (ACTH, Cortisol) of fifty patients with bilateral almost total cataract, before (practically blind) and after cataract surgery (regain of light). There was a significant difference between the metabolic and hormonal values before and after cataract extraction, reaching physiologically normal levels due to the stimulating influence of light after the operation.

The authors have examined a protocole in automatic perimetry. On glaucoma they have measured, with different instruments, deficits in visual fields in Bjerrum's area. The perimetric score gives them a numeric data which determines rapidly the patient's state. This data may be used on graphics.

The symptoms of infantile strabismus are triggered by fixation, chiefly monocular fixation. On the excluded eye, "occlusion deviations" (elevation, esodeviation, extorsion) are well observed through a "translucent" unilateral cover. These deviations are super-imposed upon a position of rest without fixation which may be an orthoposition, well observed through bilateral translucent occluders. They are caused by a rupture of binocular retinal stimuli which does not mean rupture of fusion (ex: the darkening Bielschowsky test). Electro-oculographic studies confirm the prevalence of adduction during fixation (nystagmus, pursuit, optokinetic nystagmus). This directional asymmetry is typical of the infant's immature system of fixation. In infantile strabismus, it persists because of missing binocular links (corpus callosum--cortex----midbrain) as shown by the study of the so-called congenital monophthalm syndrome (unilateral congenital blindness).

We have used the scanning laser opthalmoscope (SLO) with a personal computer to develop static microperimetry techniques. They allow to see in real-time on a television monitor the precise retinal localization of the stimulus and fixation. The testing is performed under strict conditions. The size of stimuli can vary between 6 and 30 minarc on a side. 255 different intensity levels are possible with the instrument. We have selected 12 of them, representing a logarithmic scale. Stimulus duration can vary between 50 and 500 ms. Examples of macular pathology including subretinal neovascularization, drusen and macular edema are given.

A study of the speed of tumor regression in 127 uveal melanomas treated with beta-rays brachyterapy, since June 1983, allows a division into 2 groups: radiosensitive forms with a volume less than 50% in the following year, and radioresistant forms. Correlation between radio sensitivity and tumor cell type were obtained with intraoperative cytopunction, and showed the prevalence of epithelioid type. The results of enucleation indicate the prevalence of fusiform type inside the radioresistant tumor group. No precise correlation could be brought between death and the previous data, the most important negative criteria being the level of initial tumor height equal or superior to 7 mm.

Hemorrhages in the premacular bursa may cause an important loss of the visual acuity due to their localization. Several treatments, going from a conservative attitude to prompt vitrectomy, have been proposed. Three cases of premacular hemorrhage, treated by Nd-YAG laser puncture, are reported. One or two impacts are sufficient to empty the blood collection into another vitreous compartment. The blood is dispersed through the vitreous on the second day after treatment and is resorbed within the ten to fifteen following days. With the help of ultrasound, the blood volume was estimated to be equal to or less than 10 microliters in the three cases. In all cases the YAG laser puncture allows a faster recovery of the visual acuity as compared to the conservatively treated cases. In no instance a recurrence, macular degeneration or preretinal proliferation was observed. The new concepts of vitreo-macular relations and vitreous anatomy are well illustrated by this therapeutic indication. Although the precise localization of a blood collection in the premacular area remains controversial, we consider it of no consequence to the outcome of the treatment.

We made a study of the effect on the corneal endothelium of rabbits of the introduction of 5-Fluorouracile into the anterior chamber. An EECC was performed on 24 rabbits, using BSS-Plus for right eye and 5-Fluorouracile dissolved in BSS-Plus for the left eye as irrigation solutions. We calculated the individual endothelial cell surface and form factor, finding no statistically significant differences between the two groups.