Bulletin des societes d'ophtalmologie de France最新文献

Retinochoroidal coloboma results from an incomplete closure of the ocular embryonic fissure. Uni or bilateral, the coloboma can be associated with cataract, microphthalmia, retinal detachment... but rarely with neovascularization. This association is comparable with subretinal neovascularization in high myopia, angioid streaks, choroiditis and choroidal ruptures. The disruption of the normal anatomy of the Bruch's membrane is a possible entry site of choroidal blood vessels. But the reason why only rare cases are reported is unknown.

After the era of antibiotics, a real improvement has been stated in the percentage of endophthalmis following cataract surgery which has fallen from 1% between 1950 and 1977, to 0.2-0.3% now. Since 10 lenses have been implanted, the incidence of acute bacterial endophthalmitis due to pathogenic organisms has not increased. But we now encounter many cases of "cold endophthalmitis", with a lowered symptomatology, a delayed onset, and which are due to organisms of low virulence. Their prognosis can be improved by early vitrectomy combined to intraocular antibiotics in the more severe cases, and by using antibiotics of high intraocular penetration in the milder cases. We report fifteen cases of pseudophakic endophthalmitis. The clinical course was acute in one case, sub acute in eleven cases, and chronic in three cases. In the latter fourteen cases a vitrectomy was performed in 60% of the cases. Aqueous and vitreous taps have found cocci gram + in five cases. Visual results are superior to 1/20 in 2/3 of the cases.

Authors analyse the anatomic findings in the anterior chamber cleavage syndrome and emphasize necessity of genetics (heredity being well known) and supervision for detecting glaucoma which occurs in about 50% of these patients and usually appears between 5 and 30 years of age. (Juvenile glaucoma).

Contrast sensitivity has been assessed in 24 diabetic patients in order to test the hypothesis that contrast sensitivity is impaired in the early stages of diabetes mellitus. All patients had 20/20 vision. Some evidence of visual dysfunction was observed in 33% of the diabetics with no retinopathy and 83% of the 6 patients with retinopathy when compared to 48 age-matched controls. Contrast sensitivity was mainly reduced in the mid-range spatial frequencies and correlated with the degree of retinopathy. The accurate assessment of visual dysfunction in diabetes is very important, as new drugs (i.e. aldose reductase inhibitors) are currently under evaluation.

Pseudophakic Retinal Detachment (PRD) is of major concern, because since 1981, the number of patients receiving implants per year has been higher than that not implanted in the United States. Recently, the number of PRD has exceeded that of Aphakic Retinal Detachment (A.R.D.). This has been observed over the last two years in our unit. We report on 39 cases treated in the unit of Pr METGE between April 1986 and April 1988; P.R.D. characteristics, surgical procedures and anatomic results are presented. We have distinguished 4 types of P.R.D. Differences in prognosis may be imputed to the larger number of undetected tears and the more advanced vitreo-retinal proliferation in PRD as compared with A.R.D. Surgical procedures in PRD are identical with those of A.R.D., and implant may be maintained. Reinterventions, vitrectomy, and internal tamponnement are more frequently needed. The best prognosis observed in our patients occurred for PRD following ECCE + posterior chamber lens without peroperatory complications.