[What to think of "adjuvant" or "neoadjuvant" thermotherapy in the treatment of uveal melanomas?].

Before 810Nm laser thermotherapy has been usd for uveal melanoma, several authors especially in Essen (Germany) were asking themselves about the possibilities of xenon arc or argon laser effects on uveal melanomas. High rates of recurrences due to the non penetration of therapeutic light till the sclera had led to the conception of using adjuvant thermotherapy associated with radiotherapy, through microwaves, ultrasounds or ferromagnetic seeds. In Leyden (Netherlands) was proposed the use of 810Nm laser diode initially as an adjuvant to radiotherapy and later on as primary isolated treatment ("neo adjuvant" TTT), especially for small tumours located in the posterior pole (juxta-papillary tumours).

[Choroidal neovascularization as a complication following laser treatment of central serous chorioretinopathy].

We report the case of a 39-year old man who presented with central serous chorioretinopathy. Two months after diagnosis, argon laser photocoagulation was performed. One month later, the patient noticed distortion and a reduction in vision revealing a subretinal neovascularization above the fovea next to the laser scar.

[Ahmed valve in high-risk glaucoma surgery].

We used the Ahmed valve for the treatment of 142 eyes with high-risk glaucoma. The glaucoma was neovascular in 74 cases, aphakic or pseudophakic in 19 eyes and occurred after previous faliure of filtering surgery in 49 eyes. Preoperative mean IOP was 31.

[Neovascular glaucoma diagnosed following carotid endarterectomy].

We report a case of bilateral asymptomatic rebeosis iridis related to a bilateral obstruction of the carotid arteries. The iridocorneal angles were closed by a neovascular membrane and intraocular pressures were normal within both eyes (normotensive neovascular glaucoma). After left carotid endarterectomy, the increased perfusion of the ciliary body and the increased secretion of aqueous humor resulted in a sudden bilateral ocular hypertension.

[Translocation of the macula for retrofoveal choroidal neovascularization in age-related macular degeneration and severe myopia: first results].

Background: Subfoveal choroidal neovascularization is a main cause of blindness. The new surgical technique of macular translocation conceived by De Juan, with scleral shortening and without a retinotomy, allows to move the fovea away from the neovascular membrane with a low rate of complications. The first results obtained with this technique are presented here, in cases of submacular neovascularization due to age-related macular degeneration (AMD) or degenerative myopia.

[Sarcoid optic neuropathy].

Sarcoidosis is a multisystem granulomatous disease mostly involving the chest. Sarcoid optic neuropathy is an uncommon but serious manifestation that requires long-term corticosteroid treatment. We report here the case of a 50-year-old black patient complaining of a recent blurred vision on his left eye.

[Double irradiation for macroscopic radioresistance or recurrence of melanomas of the posterior uvea: clinical, ballistic, therapeutic and prognostic aspects. Series of 19 cases among 462 patients].

We describe two comparative series of patients treated with double-dose betaraysbrachytherapy (106 Ruthenium) between 1983 and 1994, and double-dose proton beam therapy between 1991 and 1996. The indications for double-dose irradiation with the same radio-element corresponded to "macroscopically abnormal" situations: immediate and prolonged radioresistance, recurrence or secondary radioresistance. Thirteen cases are called series 1 (Ruthenium) and 6 cases are called series 2 (protons).

[Ocular complications of hormonal treatments: oral contraception and menopausal hormonal replacement therapy].

Numerous reports have described ocular complications of sex hormone preparations, particularly after the appearance of the oral contraceptive pill. The most serious complications are vascular occlusions such as central retinal vein or artery occlusion and acute ischemic optic neuropathy. In these cases, permanent visual loss may occur.

Transient acute myopia induced by antilymphocyte globulins.

Acute onset of transient myopia may be induced by several drugs, different mechanisms having been described. We report the occurrence of such an event after intravenous administration of equine antilymphocyte globulins in a patient treated for aplastic anemia. Clinical ocular examination revealed no other abnormality, and ultrasonography disclosed no swelling of the ciliary body.

[Postoperative proliferative vitreoretinopathy in rhegmatogenous retinal detachment associated with stage B preoperative proliferative vitreoretinopathy: comparative results of trans-scleral retinopexy with diode laser or trans-pupillary retinopexy with argon laser].

Purpose: To compare the rate of severe postoperative PVR in primary rhegmatogenous retinal detachments (RD) associated with preoperative grade B PVR and managed either with transpupillary Argon laser photocoagulation or transscleral Diode laser photocoagulation.

Material And Methods: We evaluated 72 primary rhegmatogenous retinal detachment associated with preoperative grade B PVR (retinal tears with curled posterior edges), referred before any failed attempt to reattach the retina. Eleven RD were due to giant tear.

[Retinal detachment following YAG laser section of vitreous strands. Apropos of 3 cases].

Purpose: Retinal detachment after Nd: YAG laser vitreolysis is rarely reported. The pathogenic role of Nd: YAG laser is analyzed from 3 cases of severe retinal detachment.

Methods: Three men aged (40 to 59 years old) had one or more risk factors for retinal detachment: myopia, complicated cataract surgery, personal or family history of retinal detachment.

[Postoperative choroid detachment following microsurgery for rhegmatogenous retinal detachment].

Purpose: To evaluate the incidence, predisposing and prognosis factors of post-operative choroidal detachment after microsurgery of rhegmatogenous retinal detachment.

Materials And Methods: We conducted a retrospective study on a series of 595 consecutive rhegmatogenous retinal detachments referred before any previous failed surgery. Univariate statistical analysis of the data was conducted with evaluation of the odds ratio.

[Nummular keratopathy in Crohn's disease. Apropos of a case].

We report an unusual case of nummular keratopathy of the left eye in a 58-year-old woman with active Crohn's disease, presenting colo-anal and joint symptoms. Spontaneously decreased bowel activity and local steroid treatment provided symptom relief and incomplete decrease in volume of subepithelial elevations. We discuss the clinical aspects, the epidemiologic factors, the pathogenic mechanisms and the treatment of keratopathy in Crohn's disease.

[Retinal vein occlusion and lipoprotein (a)].

Purpose: Epidemiological studies have shown a significant correlation between increased levels of lipoprotein (a) and coronary and cerebral vascular diseases. Lipoprotein (a) presents a striking homology with plasminogen and may therefore complete with binding of plasminogen at fibrin and at the endothelial cell surface, leading to fibrinolytic system dysfunction. The aim of this work is to study the relationship between increased levels of Lp(a) and retinal vein occlusion.

[Surgery of sub-foveal neovascular membranes].

Background: To present the functional, angiographic and electron microscopic results of 3 patients who underwent surgical removal of a subfoveolar neovascularisation. These patients are representative of the most common indications for subfoveolar surgery.

Material And Method: In one case, the neovascularization originated from an old chorioretinal scar close to the macula; in another case, it was associated with high myopia; in the last case the neovascularization was coupled with an age-related macular degeneration (ARMD).

Indocyanine green angiography of drusen.

Purpose: To analyze the indocyanine green angiographic findings of drusen in the early stages of age-related macular degeneration.

Methods: Sixty-nine eyes of 53 consecutive patients with drusen but without exudative complications of age-related macular degeneration were studied. Drusen were classified into four groups: hard drusen, drusen derived from clusters of hard drusen (hard cluster-derived drusen and soft cluster-derived drusen), membranous drusen, and regressing drusen.

[Vascular diseases of the retina].

Retinal venous occlusion are usually associated with hypertension and arteriosclerosis; visual loss can be mild or severe. Two complications are related with a poor visual outcome: macular oedema and severe retinal ischaemia. Retinal artery occlusion is responsible for a sudden visual loss, usually caused by embolism.

[Hereditary retinal diseases].

Hereditary retinal dystrophies can be subdivised into central (macular) and peripheral degenerations. Stargardt disease, Best disease, cone dystrophy and retinoschisis, affecting children or young adults, are the 4 commonest macular dystrophies. Retinitis pigmentosa, with primary affects photoreceptors, presents a wide clinical, genetic and molecular heterogeneity.

[Age-related macular degeneration].

Age-related macular degeneration is the leading cause of non treatable blindness in industrialized countries. The impairment of visual acuity is preceded by the occurrence of "precursors" some of which are the witness of aging and others are the first symptoms of age-related degeneration of the macular retina. The disease involves both eyes with time resulting in a major handicap.

[Diabetic retinopathy].

Retinal complications of diabetes mellitus are chronic but late functional signs can lead to delayed diagnosis and treatments. Light coagulation (argon laser radiation) is recognized for its efficiency at the stage of "mature" retinopathy, converting the prognosis of a disease which was leading to blindness. Photocoagulation is not used in the early stages (early or strictly posterior pole diabetic retinopathy); partial regression or stabilization can be hoped with intensive medical treatment of diabetes.