Bulletin de la Societe belge d'ophtalmologie最新文献

We report a case of unilateral acute acquired intermittent Brown's syndrome in a 5-year-old boy, that resolved spontaneously but recurred at regular intervals afterwards. A specific cause could not be found. We discuss the possible pathophysiological mechanisms of acquired Brown's syndrome in children.

Purpose: To determine whether the diagnostic accuracy of judging serial optic disc color stereo photographs for glaucomatous change by non-expert ophthalmologists changed after a training session.

Methods: 24 ophthalmologists in training at the University Hospitals Leuven classified 50 eyes with varying severity of glaucoma as stable or progressing based on the appraisal of serial optic disc stereo photographs. A comparison between the diagnostic accuracy of residents (n=18) and trainees (n=6) was made before and after a training session.

Results: The mean agreement (kappa) with the reference standard before training was lower for the trainees than for the residents. The mean kappa before training was 0.37 for the residents and 0.29 for the trainees (p = 0.18). The mean agreement with the reference standard improved significantly after a training (from 0.29 to 0.56 [p = 0.031 for the trainees, and from 0.37 to 0.48 for the residents [p = 0.005]). The overall mean kappa was 0.35 pre-training and 0.50 post-training (p < 0.001).

Conclusions: The agreement and diagnostic accuracy of residents in training in appraising serial optic disc photos improved significantly after a training session.

Purpose: To report corneal toxicity of Mitomycin C application during filtering glaucoma surgery in two patients.

Case reports: An elderly woman, 81 years of age, developed diffuse corneal epitheliopathy with subepithelial stromal oedema seven weeks after a trabeculectomy with Mitomycin C application. Another patient, a 76-year-old man, first developed a central epithelium defect and stromal oedema in the second postoperative week after a similar procedure. Later the corneal stroma melted, what resulted in perforation in the second postoperative month.

Results: Intraoperative Mitomycin C application during trabeculectomy induced serious corneal complications several weeks after the surgery.

Conclusions: Although infrequent, serious corneal complications may arise following the intraoperative use of Mitomycin C in filtering surgery for glaucoma. The possible contributing factors to the development of the corneal toxicity will be discussed.

The authors report two cases of mid- to long-term reversal of optic disc cupping after trabeculectomy with mitomycine-C in young adult patients suffering from secondary glaucoma. The cup to disc ratio reversed from 0.80 and 0.60 to 0.65 and 0.40 respectively and remained unchanged until the last follow-up visit at 6 and 36 months respectively. Concomitantly, there was an improvement of the visual field and of the optic disc stereometric parameters on the Heidelberg Retina Tomograph.

A 54-year-old man had bilateral acute angle-closure glaucoma that resulted in severe loss of vision in both eyes the day after undergoing uneventful upper eyelid blepharoplasty. Acute angle-closure glaucoma is a rare, but potentially blinding complication after uneventful eyelid surgery. In the literature only four previous cases have been reported to our knowledge. Moreover blepharoplasty is frequently performed by plastic surgeons and dermatologists who are unaware of this serious complication. Considering that immediate appropriate therapy may reverse the angle closure and thus prevent visual loss, a better awareness and prompt recognition of this condition is imperative.

Sneddon's syndrome is a particular and rare entity that mostly affects young women and whose diagnosis is based on the coexistence of a cuteaneous livedo and a cerebrovascular ischemic attack. It had be considered as being an expression of an occlusive vasculitis or of antiphospholipid antibody syndrome. We report the case of a 20-year-old female, who had developed a left homonymous hemianopia after ischemic encephalopathy. Visual field examination confirmed the presence of a complete left homonymous hemianopia. Cerebral Magnetic Resonance Imaging revealed right occipital cerebrovascular ischemic lesions. Sneddon's syndrome diagnosis was considered on the presence of cutaneous livedo reticularis and associated cerebral ischemic events. With medical treatment, a small functional improvement could be noticed but without net improvement in the visual field defect.

Goldenhar syndrome is a rare congenital anomaly which consists of a triad of an ocular dermoid cyst, preauricular skin tags and vertebral dysplasia. We report two cases of Goldenhar syndrome, diagnosed in a 4-year-old girl and in a 20-year-old young adult. The dermoid cyst is a benign tumour with serious ophthalmologic complications.