One year of intravitreal injections of steroids.

Purpose: Chronic macular oedema sometimes does not respond to classic treatment such as laserphotocoagulation, periocular and systemic steroids or carbonic anhydrase inhibitors. High dose intravitreal injection of steroids can be a valuable alternative in these patients.

Methods: Sixty-four eyes of 51 patients with chronic macular oedema, refractory to conventional treatments, received an intravitreal injection of 4 mg Kenacort (triamcinolone acetonide).

Treatment of hepatitis B virus-related polyarteritis nodosa: two case reports and a review of the literature.

A substantial number of cases of polyarteritis nodosa (PAN) are related to hepatitis B virus (HBV) infection. Different treatment strategies are reported in the literature. The aim of this study was to review 15 years of literature (1988-2002) to determine the optimal treatment for HBV-related PAN at present, and to discuss the indications and mechanism of action of corticosteroids in HBV-related PAN, as many physicians are reluctant to use these in the presence of HBV infection.

Metastatic uveal melanoma: diagnosis and treatment. A literature review.

In the past three decades many efforts were done to improve the visual prognosis of patients with uveal melanoma. However, mortality has remained unchanged. The systemic prognosis depends on the size and other characteristics of the lesion.

Methicillin resistance of bacteria isolated from vitreous fluid from patients undergoing vitrectomy.

Purpose: The aim of this study was to compare the resistance patterns of bacteria in vitreous fluid from patients undergoing vitrectomy for diagnostic reasons, with bacteria of other nosocomial infections.

Methods: Vitreous fluid samples (n=144) were obtained from 133 patients undergoing vitrectomy for endophthalmitis, and 11 for uveitis as suspected endophthalmitis. They were Gram stained and cultured.

Non-diabetic and non-oculotraumatic vitreous haemorrhage treated by pars plana vitrectomy.

Background: Until the advent of pars plana vitrectomy, no efficient treatment for non-resorbing vitreous haemorrhage was at hand. Especially if the cause of the vitreous haemorrhage was not known, such as in most cases of non-diabetic and non-oculotraumatic vitreous haemorrhage, a lot of time often was lost by waiting for the resorption, because of the lack of any effective treatment modality.

Methods: All the cases (126) of non-diabetic and non-oculotraumatic vitreous haemorrhage treated with a pars plana vitrectomy for non-resorbing vitreous bleeding during a 15-year period were studied.

Drug-induced spongiform leucoencephalopathy, a case report with review of the literature.

A nineteen year-old girl developed rhabdomyolysis and central pyrexia after the ingestion of multiple drugs: amphetamines, benzodiazepines, methadone, ethanol, and cocaine. On admission, the patient was deeply comatose and during the hospitalisation asymmetrical spastic quadriparesis was noted. Brain biopsy was diagnostic of spongiform leucoencephalopathy.

Ocular non-Hodgkin's lymphoma: a clinical study of nine cases.

Background: Primary oculocerebral large cell malignant non-Hodgkin's lymphoma, formerly called ocular reticulum cell sarcoma, runs a uniformly fatal course. Once the central nervous system (CNS) is involved, survival without treatment is very limited. Although treatment does not substantially improve the long term survival, it provides short term improvement in these patients.

Pars plana lensectomy in cases of cataract with juvenile chronic uveitis.

Background: Classical cataract extraction in young patients with secondary cataract following juvenile chronic uveitis often is complicated by serious problems such as severe postoperative uveitis, hypotonia oculi and phthisis bulbi. Lensectomy with partial anterior vitrectomy might be a less inflammatory way of handling these cases.

Methods: Over a 15-year period we have treated 10 eyes of 9 young patients (age from 8 to 30 years) with secondary cataract after chronic uveitis by pars plana lensectomy with partial anterior vitrectomy.

Penetration of gentamicin and ofloxacin in human vitreous after systemic administration.

Background: Data on the penetration of antibiotics into the aqueous humor in man and animals, as well as on the intravitreal penetration in animals, are numerous. Data on their intravitreal penetration in humans, however, are sparce. The intravitreal penetration of gentamicin was studied in different ocular pathologies to see whether these alter the vitreal pharmacodynamics.

Diagnostic vitrectomy and chronic uveitis.

Background: From the introduction of vitrectomy, infectious endophthalmitis was one of the indications for this surgical technique. Vitrectomy was later found to be a valuable method in both diagnostic and therapeutic evaluation of chronic uveitis.

Methods: Twenty-eight eyes of 25 patients were operated on with purely diagnostic intent.

Therapeutic pars plana vitrectomy for chronic uveitis: a retrospective study of the long-term results.

Background: Pars plana vitrectomy has both diagnostic and therapeutic potential in chronic uveitis. In this paper the therapeutic value of vitrectomy is investigated.

Methods: This is a retrospective study on 25 eyes that underwent pars plana vitrectomy with therapeutic intent.

Clinicopathologic correlation in a case of metastatic uveal tumor.

A clinicopathologic correlation is reported of an ocular metastasis from an unknown primary tumor. The tumor appeared initially confined to the choroid. The diagnosis of metastatic adenocarcinoma was obtained by choroidal biopsy.

Lung abscess due to nontyphoid Salmonella in an immunocompromised host. Case report with review of the literature.

Lung abscess due to nontyphoid Salmonella (NTS) with or without other intestinal or extra-intestinal involvement is very rare. A literature review (Medline search) revealed only 20 cases including ours with this extra-intestinal manifestation of Salmonella infection. The case of a 49-year-old, HIV-positive man from Zaire is reported.

Treatment of postoperative endophthalmitis.

Despite many advances in microsurgery, asepsis, antibiotics and intraocular lenses, postoperative endophthalmitis continues to be responsible for the loss of many eyes. In a series of 153 cases of endophthalmitis with a positive culture, 115 occurred after ophthalmic surgery. Eyes appear to be more vulnerable to this complication after extracapsular lens extraction in particular.

Choroidal biopsy in the diagnosis of a suspect intraocular lesions.

A thirty-eight year-old man, treated medically since 1985 for a chronic pancreatitis, showed a choroidal infiltrate in the superior mid periphery of the left fundus. A thorough systemic examination could not reveal an underlying cause. The differential diagnosis of the lesion included metastasis, intraocular lymphoma and sarcoidosis.

A massive, near-fatal cocaine intoxication in a body-stuffer. Case report and review of the literature.

The last decade an increase has been seen in drug smuggling. Body-packing and body-stuffing are the terms used for intracorporeal concealment of illicit drugs (mainly cocaine and heroine, but sometimes also amphetamines and cannabinoids). These body-packets are especially prone to rupture.

Filum terminale ependymoma revealed by acute cauda equina compression syndrome following intratumoral and spinal subarachnoid hemorrhage in a patient on oral anticoagulants.

A 65 year-old woman with a filum terminale ependymoma is reported, presenting with acute cauda equina compression syndrome due to intratumoural and subsequent spinal subarachnoid hemorrhage (SAH) following therapy with oral anticoagulants. Few cases of spinal ependymoma have been reported with an acute cauda equina compression syndrome as the initial and only symptom, and the unique feature of our patient's anticoagulant status has only been described once in this setting. Although intratumoural hemorrhage is very well known since the myxopapillary variant is unique to the cauda equina and consists of loose connective tissue and numerous small blood vessels that are prone to bleeding, spinal SAH is seldom seen and the different hypotheses about the pathophysiological mechanisms that might promote bleeding still remain unresolved and will be discussed in this paper, as well as the special clinical features of spinal SAH and some diagnostic and therapeutic implications.

Post-traumatic endophthalmitis.

In a group of 615 cases of perforating trauma, 25 cases (4%) of proven endophthalmitis were seen. The percentage of Bacillus infections was unusually high compared to other types of endophthalmitis (3.8% for the whole group, 31% for the group with intraocular foreign bodies).

Chorioretinal biopsy in the diagnosis of intraocular lymphoma: a case report.

A patient with non-Hodgkin lymphoma with low grade malignancy complained of gradual visual loss. Symmetric multiple deep retinal yellow dots were disseminated in both fundi. The patient developed progressive papilledema associated with further decreasing visual acuity.

Endophthalmitis after lens extraction.

This article describes most features of endophthalmitis after lens extraction: symptomatology, differential diagnosis, prognosis, treatment and prevention. Literature findings are compared to the author's proper extensive experience with endophthalmitis. Cultures have been positive in 153 cases.

Diagnostic problems in chronic vitreous inflammation.

We reviewed 188 patients with chronic vitreous inflammation initially diagnosed as intermediate uveitis, who were seen at the Ghent Eye Clinic during the period 1978 to 1988. We were able to establish a more specific diagnosis in 55 patients. The different approaches that contributed to the diagnosis were analyzed, (comprehensive history-taking and clinical examination, laboratory tests and special investigations, vitrectomy, and following the evolution of the disease).

Intranasal caffeine and amphetamine causing stroke.

A 37 year-old man with an ischaemic stroke after the nasal use of amphetamine and caffeine is reported. Transient arterial hypertension due to these agents may have been the mediator of the stroke. Mitral annular calcification was the only other abnormality found, and was thought not to play an important role in this patient.

Intracapsular and extracapsular pseudophakic endophthalmitis: a comparison.

A hundred and four cases of post cataract endophthalmitis with positive vitreous cultures are discussed. Functional results depend largely on the infecting agent but even after Staphylococcus epidermidis infections some eyes may be lost. Although post lens surgery endophthalmitis carries the best prognosis in the endophthalmitis group, 40% of the eyes are lost, sometimes caused by a delayed vitrectomy decision.