Bulletin de la Societe belge d'ophtalmologie最新文献

Purpose: To report a case of intermittent palpebral oedema secondary to a cerebrospinal fluid (CSF) leakage, following encephalocele surgery.

Clinical case: A 9-year-old girl consulted with a history of intermittent swelling of the left upper and lower eyelid. The symptoms started at the age of one. As a relevant fact in her medical history, a neurosurgical repair of a nasofrontal encephalocele at the age of 9 months was withheld. Elaborate imaging studies demonstrated a leakage of cerebrospinal fluid (CSF) into the preseptal periorbital soft tissues, originating from a bony defect in the medial orbital wall. The patient was treated conservatively.

Conclusion: A CSF leakage in the orbital or periorbital region is a rare finding. In the literature, similar defects have been reported after trauma or associated with neoplasia. To our knowledge, this is the first case of periorbital CSF leakage after encephalocele-surgery reported in the literature.

Uveitis accounts for 5% to 10% of all cases of uveitis in children. Vogt-Koyanagi-Harada syndrome affects children very unfrequently. We report a case of a 14-year-old girl who presented with a bilateral uveitis with posterior predominance associated with an important serous retinal detachment and signs of meningeal irritation. No specific cause could be identified. The initial treatment consisted in administration of high dose steroids given in i.v. bolus at the dose of 10 mg/Kg/day then in oral steroids at the dose of 1 mg/Kg/day with slow tapering during 1 year. The evolution was marked by an excellent recuperation of the visual acuity, a total disappearance of the serous retinal detachment, the development of choroidal depigmentation and the occurrence of poliosis. This evolution was in favour of a Vogt-Koyanagi-Harada syndrome. The diagnosis of this syndrome is usually difficult to establish at its onset. Most often the evolution allows to correct and confirm the diagnosis. Megadoses of corticosteroid therapy and cytotoxic agents may be necessary. The visual prognosis may be poor in severe cases.

Risks that glaucoma medications pose to the fetus and neonate must be balanced against the risk of vision loss in the mother. There is no high level evidence for harmful effects on the fetus and neonate of medications used to treat glaucoma. All topical and systemic glaucoma medication should be avoided during the first trimester of pregnancy. Systemic carbonic anhydrase inhibitors, topical prostaglandin analogues and antimetabolites during surgery should be avoided absolutely. Some topical medications are deemed compatible with lactation by the American Academy of Pediatrics, however, caution should still be practiced.

Purpose: This study aimed to evaluate and compare outcomes of phacoemulsification surgery with purely torsional ultrasound in coaxial small incision procedures.

Methods: This study was a prospective observational series of 50 eyes of 50 patients with age-related cataracts. There were two groups each with 25 eyes. Group 1 eyes were treated with microcoaxial phacoemulsification using a 2.4 mm temporal clear corneal incision; group 2 eyes were treated with phacoemulsification using a 3.2 mm temporal clear corneal incision. Both groups underwent a standardised surgical procedure using purely torsional ultrasound. Outcome measures were best corrected visual acuity, percentage increase in postoperative corneal thickness, and surgically-induced astigmatism assessed at day 1, week 1, month 1 and month 3 postoperatively.

Results: Both groups were comparable with respect to age, cataract grading and intraoperative parameters such as cumulative dissipated energy and irrigation volume. The only statistically significant outcome difference was surgically induced astigmatism at postoperative day 1 (higher in group 2). Intraoperative and early postoperative complications were similar in both groups.

Conclusions: Coaxial phacoemulsification with purely torsional ultrasound produced satisfactory results for 2.4 mm and 3.2 mm incisions. There were no differences in outcomes between groups.

Purpose: To assess the young people's knowledge regarding the ophthalmic effects of smoking.

Methods: 198 students (111 males and 87 females) with a mean age of 27 years old (+/- 6 years) participated in the study. A simple questionnaire was used and the participants were requested to fill out the questionnaire themselves.

Results: 77% (152) of the participants were smokers. 67% (130) have never heard about the adverse effect of smoking to the eyes. 87% (172) have not heard about the relationship between smoking and thyroid eye disease. 84% (166) were not aware that smoking could ccontribute to the formation of cataract. 50% (99) have no knowledge about the association between smoking and age-related macular degeneration. 80% (158) were unaware that smoking is a risk factor for visual loss.

Conclusions: The level of knowledge of young people regarding the ophthalmic effects of smoking is not satisfactory. There is an urgent need to promote the awareness of the population regarding the adverse effect of smoking on visual function.

Purpose: To demonstrate that UVA/riboflavin crosslinking (CXL) can stop corneal melting in therapy resistant infectious corneal ulceration.

Methods: We will present a case report on a 70-year-old female patient referred for severe infectious ulcerative keratitis caused by Pseudomonas aeruginosa. After intensive treatment with fortified antibiotics, corneal melting developed. CXL was performed to avoid imminent corneal perforation.

Results: The CXL treatment was successful: the corneal melting was stopped and the lesion cicatrized, thereby avoiding emergency keratoplasty.

Conclusion: This case report highlights that CXL may be a valuable addition to our therapeutic armamentarium in the treatment of corneal melts.

We describe a case of retinitis pigmentosa, associated with bronchiectasis, as the first sign of primary ciliary dyskinesia (PCD). Only a few cases were described in the literature and the association of both diseases is not obvious at first sight, although a common ciliary dysfunction of both respiratory epithelium and photoreceptors of the retina seems to be the common factor. It is important to recognize the association and to question patients with retinitis pigmentosa about their respiratory functions, because an early diagnosis of PCD can prevent recurrent infections and development of bronchiectasis with daily physiotherapy.