Bulletin de la Societe belge d'ophtalmologie最新文献

Rhabdomyosarcoma is a malignant mesenchymal tumor of childhood. The eyelid localization is unusual. We report the case of a 7-year-old child with upper palpebral rhabdomyosarcoma revealed by an isolated blepharoptosis. The CT-scan revealed a well delimited enhancing soft tissue mass involving the upper eyelid. The tumor was excised totally by an upper eyelid incision under general anesthesia. It was limited in preseptal eyelid without extension to the orbit. Histopathologic examination confirmed the diagnosis of embryonic rhabdomyosarcoma. Postoperatively, the upper eyelid regained its motility. The visual axis was cleared. After surgery, three cures of chemotherapy including ifosfamide, vincristine, and actinomycin were administered. After a 4 months follow up period, there was no sign of tumor recurrence.

We report a 62-year-old caucasian woman with bilateral choroidal metastases as only clinical presenting sign of advanced metastatic tumour disease. She presented with decreased vision in the left eye since 5 days. She was treated for breast cancer 31 years before. Fundoscopy and ultrasound analysis showed a large choroidal metastasis in the left eye and one asymptomatic lesion in the right eye. Systemic screening revealed multiple lung and bone metastases. Health practitioners should be aware that choroidal metastasis from breast carcinoma can present throughout life. Small asymptomatic lesions may be detected that still can be treated effectively.

Purpose: To report a family diagnosed with Stickler syndrome. To emphasize that early recognition of patients with Stickler syndrome could improve the visual outcome.

Methods: Case report.

Results: A 14 year old girl of Mahgrebian origin presented with a longstanding subtotal RRD in the right eye. Subsequently 6 family members in 3 generations have been identified with the same COL2A1 mutation. 4 eyes lost perception of light and 1 eye was enucleated. Stickler syndrome is the commonest inherited cause of rhegmatogenous retinal detachment (RRD). These tend to be complex and to occur at young age, frequently affecting both eyes. Other ocular features consist of high myopia, optically empty vitreous cavity, posterior radial paravascular lattice-type degeneration, cataract and glaucoma. Non-ocular findings include midface hypoplasia, musculoskeletal changes and hearing loss. In severe cases the disorder will readily be suspected. In mildly affected patients, clinical diagnosis can be quite difficult. Therefore, all family members of a Stickler patient should be offered molecular genetic testing. Stickler patients benefit from a multidisciplinary approach, including audiologic examination. They should be informed about the symptoms associated with retinal tears and retinal detachment and have priviliged access to the ophthalmic care unit. In case of RRD, vitrectomy is the preferred surgery. Prophylaxis of RRD in Stickler syndrome patients consisting of a 360 degrees peripheral cryotherapy or photocoagulation has been proposed. Practical guidelines for follow up or thresholds for initiating treatment have not been formulated.

Conclusions: Stickler syndrome remains under-diagnosed. Hightened awareness of Stickler syndrome could improve visual outcome in affected individuals and makes genetic counseling possible

We report the dramatic ophthalmological findings in a newborn baby consisting of a perforated right eye and a protruding buphthalmic opacified left eye. The diagnosis of congenital corneal staphyloma was suspected and was confirmed on histopathological examination of the right eye remnants, and of the left cornea after a corneoscleral keratoplasty was performed. This case report describes one clinical spectrum of Peter's anomaly.

We present a case dealing with an uncommon presentation of retinoblastoma. An 4-year-old boy presented to the ophthalmic department for a red painful eye following trauma. The examination showed decreased visual acuity, total hyphema and ocular hypertony. Ocular ultrasonography revealed an intraocular process. CT-scan of the orbit was consistent with a retinoblastoma. Treatment consisted of an enucleation and chemotherapy. This paper stresses the fact that presentation of retinoblastoma is not stereotypic. Every effort should be made to exclude a tumoral intraocular process in all cases of hyphema, even in cases of well documented ocular trauma.

Giant cell arteritis (Horton's disease) is an inflammatory panarteritis occurring most frequently in the elderly. Its common ocular manifestations are anterior ischemic optic neuropathy, choroidal ischemia and central retinal artery occlusion. We describe a case of Horton's disease revealed by a retinal detachment, optic neuropathy and severe choroidal ischemia. Prompt treatment with corticosteroids led to preservation of vision and resolution of the retinal detachment. This observation of a retinal detachment revealing a giant cell arteritis had not been yet reported in the literature.

Purpose: The benefit of cataract surgery in the general population concerning visual acuity and subjective visual function has been well established. However, a small proportion of patients are dissatisfied after cataract surgery. Our study aims to evaluate patients' dissatisfaction after phacoemulsification cataract surgery related to low visual function and to analyze the factors associated with this outcome.

Methods: 397 patients, who underwent uneventful phacoemulsification cataract surgery, participated in the study. All the participants completed a self-administered questionnaire which evaluated their visual function pre- and post-operatively. Best Corrected Visual Acuity (BCVA) was measured before and after cataract surgery and patients' contentment if they were satisfied or not with the result of the surgery was also recorded.

Results: Macular disease, diabetic retinopathy and glaucoma were the main factors limiting the final visual result after phacoemulsification cataract surgery.

Conclusions: It is very important for the patients to be preoperatively fully aware of the presentation of the aforementioned fundus pathology and to be warned about the predicted visual outcome after cataract surgery.

Introduction: Cataract caused by high tension electric trauma remains a rare entity. It is often bilateral and late-onset especially if the electric current passes through the head.

Patients and methods: We report a case of a bilateral cataract secondary to high tension electric trauma.

Results: A 13-year-old child presented with bilateral cataract secondary to high tension electric trauma (22 000sVolts) two years earlier accidentally on the railroad. The electric current has crossed the head and both upper limbs. This had resulted in immediate burns on the right scalp and hand. Ophthalmological examination found a total white cataract in the RE and anterior subcapsular lens opacities in the LE.

Conclusion: Cataract is a rare but serious complication of severe electric trauma requiring regular and prolonged eye monitoring owing to its possible late occurrence.

Introduction: External dacryocystorhinostomy (DCR) has been the gold standard for treatment of epiphora. Currently several endoscopic DCR techniques are described. We evaluated results of endonasal DCR in our institution.

Methods: A retrospective chart review of a consecutive series of DCR procedures. Patients were subjected to a questionnaire a minimum of 6 months postoperatively to assess longer-term results.

Results: 19 DCR procedures in 16 patients (6 males) by a single surgeon (LD) were reviewed. Mean age was 60 (range 32 - 79). All patients suffered from epiphora (4-60 months), 7 had recurrent dacryocystitis. The technique involved the creation of a large rhinostomy using a microdebrider with a rough diamond burr and apposition of nasal mucosal and lacrimal sac flaps with Gelfoam. A silicone tube was placed in the nasolacrimal system. Patients were discharged day 1 and all patients reported immediate improvement of symptoms. Postoperative complications were limited to epistaxis in one patient. Patients were seen at week 1, 3 and 6 at clinic to perform suction cleaning until complete internal healing. The silicone tube was removed (at the last but one visit) after a median of 15 weeks (range 9-26 weeks) postoperatively. After a median follow-up of 19 months 13 patients were completely symptom free. Two patients reported minor symptoms sporadically. One patient reported recurrence of symptoms.

Conclusion: Powered endonasal DCR with internal marsupialisation of the lacrimal sac is a safe and successful procedure for the treatment of nasolacrimal duct obstruction.