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B Mortemousque

Publications and source records attributed to B Mortemousque.

At least 19 recordsLinked to original sources
PubMed2006

[Conjunctival provocation test: recommendations].

The diagnosis of ocular allergy, which has become a real public health problem occurring in 25% of the general population and continues to rise, requires allergic testing. Skin and blood tests combined with interviewing the patient demonstrate sensitivity to one or more antigens. However, while allergic testing and interviews generally reveal the cause of the symptoms, only the conjunctival provocation test (CPT) provides clear evidence of a functional relation between the conjunctival pathology and exposure to the antigen. Since there is still no validated consensus regarding the criteria for positivity of the CPT in routine practice, the working group attempted to establish the major guidelines for conducting the test, to standardize approaches and pinpoint areas of uncertainty. The group established a consensus regarding the conditions for using the test (patient selection, allergens to be tested, usable concentrations, the test protocol, the signs and symptoms to be assessed, interpretation of results, follow-up) and identified two distinct patient groups (outpatients and hospitalized patients) in whom test-taking conditions are different. The outpatient group includes patients suffering from benign forms of conjunctivitis (acute, seasonal, or chronic) and those sensitive to the usual allergens (mainly domestic and airborne). In these cases, the test is given in a medical setting with an allergologist or an ophthalmologist who instills the drops relatively rapidly. The criterion for positivity is the extent of the pruritus. On the other hand, in the hospital population, which is composed of patients suffering from vernal conjunctivitis, the attempt to establish the triggering factor requires a more elaborate protocol carried out in an ophthalmologic setting and based on the association of a range of clinical and biological factors. The deliberations of the working group should lead to the standardization of the CPT procedure for diagnostic purposes.

Allergens↗
PubMed2005

[Tissular and mechanical effects observed with an experimental femtosecond laser microkeratome for corneal refractive surgery].

PURPOSE: Despite progress in mechanical microkeratomes used in refractive surgery, mechanical complications during cutting of the cornea still occur. Cutting by laser could reduce these complications and to date, the femtosecond laser is the only potential candidate for this purpose. Our study reports preliminary results with a femtosecond microkeratome for cutting porcine corneas ex vivo. METHODS: We first examined the fundamental principles of the interaction between the femtosecond laser and the corneal stroma, including the volume of tissue lesions, the laser breakdown threshold of the stroma and the laser ablation selectivity. We then analyzed the quality of cutting corneal flaps with the laser, focusing on collateral tissue effects and the roughness of the interfaces observed both histologically and with scanning electron microscopy. RESULTS: The photoablative and photodisruptive effects were very similar with the femtosecond laser. This characteristic is specific to ultrashort impulsion photodisruptor lasers and allows for a very precise surgical procedure. The laser-induced breakdown threshold of porcine corneal stroma was found to be 0.55 J/cm2. Collateral tissue lesions were on the submicrometer level. The roughness of the stromal bed was optimal for postage stamp cutting, providing very many contiguous points of impact which were as spherical as possible. CONCLUSION: Corneal photodisruption with a femtosecond laser is reproducible and extremely accurate. The optomechanical parameters involved with this technique require great technological skill and should be placed in experienced hands.

Animals↗
PubMed2005

[Advantages and disadvantages of the femtosecond laser microkeratome].

Laser in situ keratomileusis (LASIK) complications are mainly attributable to imperfect cutting with the mechanical microkeratome. The femtosecond laser is an important challenger because it can provide extremely precise cutting beginning at any corneal point. We analyze the potential of this new tool from the results reported in the literature. The optomechanical control of the impact position provides freer and more effective intrastromal cutting than the blade. The best cutting matrix is obtained with the postage stamp method. If the plasma quality is not perfectly under control, side effects such as tissue streaks and secondary ultraviolet radiations can be observed. For LASIK surgery, femtolaser cutting can offer greater safety, reproducibility, predictability and flexibility. The risk of incomplete or irregular cutting and the free cap risk are reduced. Striae, epithelial defects and interface deposits should be minimized. A better flap congruence can limit the risk of secondary displacement and epithelial ingrowth. The results of making thinner flaps should be more predictable. Other than the high cost of the procedure, laser cutting has very few disadvantages. In 1999, Intralase Corporation introduced the first femtolaser microkeratome on the American market. Approximately 120,000 intra-LASIK procedures have been carried out with fewer cutting complications than with the mechanic blade.

Humans↗
PubMed2004

[Diffuse diabetic macular edema and vitreoretinal interface pathology: a study of seven cases (ten eyes)].

PURPOSE: Diffuse diabetic macular edema (DDME) is a serious complication, only partially understood. In this study, we have attempted to find a relation between DDME and a pathologic vitreo-retinal interface (VRI). PATIENTS: We examined ten eyes using biomicroscopy, fluorescein angiography, B mode echography and for five of these eyes, OCT. We found that DDME and pathological VRI are indeed associated. DISCUSSION: We hypothesize that structural and biochemical changes of the vitreoretinal interface are closely related to the progression of DDME. We support this hypothesis with anatomical, epidemiological, physiopathological, clinical and paraclinical arguments. CONCLUSION: Diffuse diabetic macular edema appears to be mediated by vitreomacular traction caused by structural and biochemical changes of the vitreoretinal interface. The pathological inner limiting membrane (ILM) seems to be a risk factor in DDME development. During pars plano vitrectomy, the additional peeling of the ILM could improve the resolution of the macular edema.

Aged↗
PubMed2004

Randomised double masked trial comparing the efficacy and tolerance of 0.05% mequitazine eye drops versus 0.05% levocabastine and placebo in allergic conjunctivitis induced by a conjunctival provocation test with Dermatophagoides pteronyssinus.

AIM: A double masked randomised trial comparing 0.05% mequitazine eye drops with 0.05% levocabastine and placebo was carried out in otherwise healthy volunteers allergic to house dust mites (Dermatophagoides pteronyssinus). METHOD: Double masked, randomised, single centre study, comparing three parallel treatment groups. 60 healthy adults with a confirmed history of allergic conjunctivitis to house dust mites for at least 2 years were included and completed the trial. Conjunctival provocation tests (CPT) were done at screening, at visit 2 (V2) (1 week later), and at visit 3 (V3) (2 weeks after V2). Treatment was instilled in the same eye, 5 minutes after the CPT at V2, and twice daily until V3. CPT were scored 5, 10, 15, and 60 minutes after instillation of the dose of Dermatophagoides pteronyssinus antigen determined at inclusion (V2, curative test) or resulting in positivity (V3, preventive test) RESULTS: In the V2 (curative) test the difference between the active treatments and placebo on the redness+itching scores was not significant. At the V3 (preventive) CPT there was a lower number of reactions at the threshold dose with mequitazine (20%) compared to placebo (60%, p = 0.01) or levocabastine (45%, p = 0.10). CONCLUSION: This trial failed to clearly demonstrate curative superiority of topical antihistamines with placebo, when a single dose of treatment was instilled following CPT. However mequitazine 0.05% eye drops were superior to placebo in preventing a reaction to CPT, after 2 weeks of treatment.

Adolescent↗
PubMed2003

House-dust mite sublingual-swallow immunotherapy in perennial conjunctivitis: a double-blind, placebo-controlled study.

BACKGROUND: The safety and the efficacy of sublingual-swallow immunotherapy (SLIT) in perennial conjunctivitis caused by house dust mite were evaluated in a double-blind, placebo-controlled study including 60 patients for 24 months. METHODS: Patients received either placebo or SLIT with standardized Dermatophagoides pteronyssinus (D.pt.) and D. farinae (D.f.) 50/50 extract. The evaluation of the efficacy of the SLIT was obtained by using standardized D. pteronyssinus (D.pt.) extracts on the antigen-specific conjunctival provocation test (CPT). Specific CPT, skin sensitivity and serum-specific IgE were performed before starting treatment and 6, 12, 18 and 24 months. RESULTS: Of the 60 patients included, only 45 completed the study (26 in the active group and 19 in the placebo group, P < 0.05). Two out of 30 (6.6%) patients dropped out because of insufficient efficacy in the active group compared to eight out of 30 (26.6%) in the placebo group (P < 0.05). There was a significant increase in the antigen threshold required to obtain a positive CPT from 8.2 IR [95% confidence interval (CI) 5.9-11.4] at baseline to 21.7 IR (95% CI 15.4-30.4) at 2 years (M24) in the active group, compared to 8.1 IR (95% CI 5.4-12.1) at baseline to 8.1 IR (95% CI 5.1-12.4) at M24 in the placebo group (P < 0.04 for overall treatment difference, P < 10-7 for the time-treatment interaction; repeated measures ANOVA). Differences between groups at individual time points were significant from 18 months on. Despite increased antigen concentrations, CPT scores were lower overall in the active than in the placebo group (P < 0.001). No serious adverse effects were reported. CONCLUSION: SLIT effectively increased the antigenic threshold required to obtain a positive CPT to house-dust mite antigen. Tolerance to and innocuity of SLIT were comparable to previous studies. This could justify recommending SLIT for the preventive treatment of perennial conjunctivitis caused by house dust mites.

Adolescent↗
PubMed2002

S/e-PTFE episcleral buckling implants: an experimental and histopathologic study.

To investigate tissue changes induced by the implantation of a silicone band coated with expanded polytetrafluoroethylene (S/e-PTFE) used as scleral buckling, an experimental and histopathological study was performed in rabbits. The right eyes of eight rabbits were implanted for 28-85 days with S/e-PTFE. No complications were encountered in any of the eyes, so histopathological examinations could be performed. Encapsulations combined with numerous giant cells were found to be surrounding the implants in seven eyes, and deposits from the mineral salts of calcium were found in three eyes, forming granulomas possibly caused by irregularities of the implant surface. The porous structure allowed a peripheral colonization by fibrovascular tissue. Taking into account the histological results, the use of this material does not appear suitable. However, this inflammation was limited and did not merge on surrounding tissues.

Animals↗
PubMed2001

Leucodystrophy and oculocutaneous albinism in a child with an 11q14 deletion.

We report a patient with an undetermined leucodystrophy associated with type 1A oculocutaneous albinism (OCA). Type 1 OCA results from recessive mutations in the tyrosinase gene (TYR) located in 11q14.3. The patient was found by FISH to carry a deletion of at least the first exon of the TYR gene on one chromosome and a (TG) deletion at codon 244/245 on the second chromosome. The existence of the microdeletion suggested that a gene responsible for leucodystrophy was located in the vicinity of the TYR gene. A combination of a test of hemizygosity and contig mapping studies allowed us to map the gene within a 0.6 cM region flanked by microsatellite markers D11S1780 and D11S931.

Adolescent↗
PubMed2001

[Histologic evaluation in rabbits of the biocompatibility of episcleral implant material: S-PTFEe (silicone core covered with expanded polytetrafluoroethylene)].

PURPOSE: To study the tolerance of a silicone band wrapped with expanded polytetrafluoroethylene (e-PTFE) in "fauve de Bourgogne" rabbits. METHODS: A 5.7mmx3.2mm band of S-PTFE (silicone-polytetrafluoroethylene, France Chirurgie Instruments) was used. A tight seal was produced between the two materials by silicone gluing. Eight eyes were implanted episclerally and fixed with Mersilene 5-0. One silicone band was used on a control eye. RESULTS: Three eyes were removed at 4 weeks, one at 8 weeks and four at 12 weeks. No extrusion was observed except for the silicone band rejected 2 weeks after implantation. On histopathologic examination, PTFE colonisation was present in all eyes with fibroblast, inflammatory cells, and neovascularization. CONCLUSION: The S-PTFE implant was colonized and well tolerated in rabbit eyes. Advantages of silicone band (quality, stability of indentation) are combined to the tolerance of PTFE.

Animals↗
PubMed2001

[Conjunctival provocation test with Dermatophagoides pteronyssinus in the diagnosis of allergic conjunctivitis from house mites].

INTRODUCTION: Perennial conjunctivitis due to house dust mites is the most frequent form of allergic conjunctivitis in urban environments. However, its diagnosis remains difficult for ophthalmologists. In this study, we evaluated a conjunctival provocation test (CPT) using standardized extracts of Dermatophagoides pteronyssinus (Dpt) and compared it to the diagnostic methods commonly performed in allergology: prick tests with dust and house dust mites and specific and IgE assay. MATERIALS AND METHODS: We performed a CPT on 60 volunteer patients, between the ages of 8 and 64 years, corresponding to 30 patients sensitized to house dust mites with the presence of specific IgE and chronic conjunctivitis, 21 patients not sensitized to house dust mites but presenting features of chronic conjunctivitis, and 9 asymptomatic patients. A house dust mite desensitizing treatment was not an exclusion criterion for a number of allergic patients. CPTs were prepared from Dpt allergenic extracts (Laboratoires Stallergènes, Antony, France) with 5 progressive concentrations by dilution in a nonphenolic physiological solution: 1.2 RI, 3.7 RI, 11 RI, 33 RI, and 100 RI. CPTs were performed in only one eye and asymmetry of the ocular response was evaluated by the cumulative clinical score of Abelson Chambers and Smith. The correlation between the 2 diagnostic tests was established by calculating the Cohen correlation coefficient or kappa. We also evaluated the sensitivity and diagnostic specificity for each test. RESULTS: The statistical correlation between specific IgE and the other allergological tests in for allergic conjunctivitis to house dust mites was 0.93 for the CPT, 0.46 for the prick test to Dpt, and 0.33 for the prick test to dust. The diagnostic sensitivities and specificities for each test were 90% and 100% for the CPT, 60% and 70% for the prick test to dust, 70% and 76% for prick test to Dpt, respectively. Beyond an antigenic cut-off value of 11 RI, we also observed greater hypersensitivity reactions for patients with lacrimal IgE or elevated specific IgE levels. CONCLUSION: The results obtained with the CPT confirm its high antigenic quality. It is a particularly useful, rapid, and perfectly safe clinical test. It is the only test able to establish a relationship between ocular manifestations and specific I(8)E.

Adolescent↗
PubMed2000

Corneal myxoma associated with keratoconus and Down's syndrome.

PURPOSE: Primary myxoma of the cornea is extremely rare. Until now, only four primary corneal myxomas were reported in the literature, whereas secondary involvement of the cornea by conjunctival and limbal tumors is much more common. METHODS: We report an additional case in a 26-year-old woman with keratoconus and Down's syndrome. Excision of the corneal mass was performed by penetrating keratoplasty. Histochemical, immunohistochemistry, and ultrastructural studies were used to obtain a definitive diagnosis. RESULTS: The tumor exhibited the characteristic histologic features of myxoma. The tumor cells showed immunoreactivity for vimentin but not for S-100 protein, epithelial membrane antigen, CAM 5.2, HHF-35, or muscle-specific actin. Ultrastructural features were fibroblast-like or stellate cells with cytoplasm containing abundant, rough reticulum and dilated cisternae. No recurrence was observed 36 months after penetrating keratoplasty. CONCLUSION: This is only the fifth report of such an occurrence. Although the coexistence of myxoma in Down's syndrome with keratoconus is described here for the first time, the differential diagnosis of apparently evident acute hydrops on clinical inspection should not rule out the possibility of a corneal myxoma. Histologic analysis should therefore be performed.

Adult↗
PubMed2000

[Myelinated retinal nerve fibers. Review of the literature].

We describe the clinical findings and diagnostic particularities of myelinated retinal nerve fibers observed in a personal case and review the literature. An 8-year-old child was referred for bilateral papillary abnormalities. The diagnosis was myelinated retinal nerve fibers as white striated patches with feathery edges. Myelinated retinal nerve fibers are a developmental anomaly which may be continuous or discontinuous with the optic nerve head. They are reported to occur in 0.57% to 0.98% of ophthalmic patients. The pathogenesis has not been established. Myelinated retinal nerve fibers are clinically conspicuous. Although they are generally believed to be benign lesions, they occasionally are associated with ocular complications such as myopia.

Child↗
PubMed1999

Nedocromil sodium eye drops are more effective than sodium cromoglycate eye drops for the long-term management of vernal keratoconjunctivitis.

BACKGROUND: Vernal keratoconjunctivitis (VKC) is a severe though transient form of ocular allergy, predominant in young males, which requires careful management. Corticosteroids are effective but also cause serious topical side-effects in the eye, such as glaucoma and cataracts. The safer, mast cell stabilizing anti-inflammatories (commonly sodium cromoglycate) therefore have an important role. This parallel group study compared efficacy, tolerability and safety of sodium cromoglycate 2% with nedocromil sodium 2%, administered as one drop per eye four times daily for a period of 5 months. METHODS: Children aged 4-17 years, with a diagnosis of mostly limbal VKC in the last 12 months, entered a 2-week baseline during which they used only artificial tears, and were then randomized to treatment, in groups of 18, on an investigator single-masked basis. Daily symptom diary cards were kept by patients/guardians, and VKC was assessed by the clinician at approximately monthly intervals. Dexamethasone was provided for rescue control of severe symptoms, if needed. RESULTS: A total of 34 patients completed the study. Both trial treatments produced rapid improvements and many ocular signs and symptoms, including Trantas' dots, chemosis, itching, soreness and sticky discharge, were fully controlled by the end of the study. However, nedocromil sodium took effect more quickly, with a significant reduction compared to sodium cromoglycate for itching, grittiness, hyperaemia and keratitis within 6 weeks. In addition, nedocromil sodium was the more efficacious overall (significant vs sodium cromoglycate for hyperaemia, keratitis, papillae and pannus at 22 weeks). Both treatments were well tolerated and without serious adverse effects. Final opinions favoured nedocromil sodium, with full control of VKC recorded for 94% (patient opinion) and 100% (clinician opinion) of this treatment group, compared with 29% and 0%, respectively, in the sodium cromoglycate group. CONCLUSIONS: Nedocromil sodium 2% eye drops is significantly more effective than sodium cromoglycate for treatment of VKC.

Adolescent↗
PubMed1999

[Fluctuations in uncorrected visual acuity after refractive surgery using intra-stromal corneal rings].

PURPOSE: Refractive surgery is meant to provide early stable and good uncorrected visual acuity. Our main concern in this study was to take special interest in fluctuation in uncorrected acuity within the first three months after implantation of Schanzlin intracorneal ring segments (ICRS) produced by Keravision. PATIENTS AND METHODS: Ten eyes in 6 patients underwent implantation of 2 intrastromal corneal segments for myopias ranging from -1.00 to -3.50 Dipoters. Visual acuity was measured with cytoplegy on day one, on day 8, two weeks, 1 month, and 2 months after surgery. The fluctuations of visual acuity were noted between observations. RESULTS: Uncorrected visual acuity varied up to 4 lines without an obvious pattern of progression over time. Fifty percent of the eyes had a variation of 2 lines. The best spectacle corrected visual acuity was preserved in all patients. DISCUSSION: Corneal topography with measurement of keratometry, intraocular pressure, and examination of the anterior chamber must be studied to identify the parameter that could condition these fluctuations of visual acuity. No parameter was found to predict these variations that may result from individual corneal healing factors peculiar to each patient. The fluctuations of uncorrected visual acuity were relatively important during the 3 first postoperative months. In all patients, final uncorrected visual acuity was always at least 10/10.

Adult↗
PubMed1999

[Vitreous hemorrhage and pre-retinal hemorrhage "without obvious point of origin" in diabetic patients. Apropos of 5 cases].

Five diabetic patients with nonproliferative retinopathy or controlled retinopathy after photocoagulation developed intravitreous or preretinal hemorrhages of unknown origin. Intravitreous hemorrhage of unknown origin is characterized by the absence of angiographic hyperfluorescence suggestive of neovascularization. Examination of the retinal periphery with a three mirror lens reveals the absence of tears and an normally appearing arteriovenous network with no sign of bleeding. The clinical cases reported here demonstrated: 1) the significance of posterior vitreous detachment in the genesis of hemorrhage, 2) the difficulty encountered in assessing the seriousness of the hemorrhage and providing optimal treatment, 3) the importance of initiating treatment early.

Adult↗
PubMed1999

[Hereditary retinal macrovessel. Report of 2 cases].

PURPOSE: We report two cases of hereditary retinal macrovessel an uncommon condition where an anomalous retinal vessel crosses the macula. CASE REPORT: A 45-year-old woman complained of fluctuating visual acuity in the right eye for 10 years. A 24-year-old man was seen at a routine ophthalmic examination. In both patients, dilated fundus examination and fluorescein angiogram confirmed the diagnosis. DISCUSSION: Hereditary retinal macrovessel is a rare condition. The anomalous vessel is remarkably stable and complications only occur exceptionally as described in the literature.

Adult↗
PubMed1998

[A new photocoagulation technic for severe non-proliferative diabetic retinopathy. A prospective study apropos of 54 cases].

PURPOSE: This work deals with the photocoagulation treatment of severe NPDR, suggesting a new therapeutic practice. It is proposed to adopt treatment intensity to each clinical form, to preserve healthy territories through biomicroscopy and to evaluate the risk of complications inherent in this technique, and to be at least as efficient as comparative studies. MATERIAL AND METHOD: We treated 52 eyes and kept under observation 2 eyes which revealed severe NPDR. The patients were followed between 1991 and 1996. The approach was essentially biomicroscopic. Photocoagulation treatment utilized green, yellow or orange wavelengths through panoramic contact lenses. RESULTS: After an average follow-up of 30 months, there was a decrease of visual acuity of 0.72 to 0.64 (Monoyer scale); a severe visual loss in 1.8% of the cases; and an early decrease in visual acuity at 6 weeks in 7.4% of the cases. A "High Risk" PDR occurred in 3.7% of the cases and we had to perform a vitrectomy (1.85% of the cases). We treated with less than 1600 I in 68.5% of the cases and with more than 1600 I in 31.5% of the cases. Patients had 5.5 photocoagulation sessions and were examined every 3.5 months on average. CONCLUSION: We believe our therapeutic approach is interesting, by comparison with other studies, but that it can be improved. All patients show a primary condition in the nasal field which, if treated too massively, becomes unable to see and disturbs daily life. We also note the severe potential for progression in insulin-dependent patients.

Adult↗