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Biomedical subjects

B Piguet

Publications and source records attributed to B Piguet.

At least 55 records · Page 3Linked to original sources
PubMed1994

[Macular drusen. Changes in the retinal pigment epithelium and angiographic characteristics as prognostic markers].

Drusen in the macular area may precede other manifestations of age-related macular disease associated with severe visual loss. To identify fundus changes that might be predictive of advanced age-related maculopathy, we examined 79 patients with drusen for up to 3 years. Fundus photographs and fluorescein angiograms were independently analysed by two readers in a masked fashion using a standardized grading scheme. Fourteen patients (17.7%) developed a new exudative or nonexudative lesion involving the fovea. Delayed choroidal perfusion on the fluorescein angiogram, interpreted as an indicator for diffuse thickening of Bruch's membrane and relative atrophy of the choriocapillaris, was observed in 12 patients, 5 of whom developed geographic atrophy of the retinal pigment epithelium during follow-up (P < 0.009). Additional predictive characteristics included focal hyperpigmentations (P < 0.005) and focal extrafoveal areas of atrophy of the retinal pigment epithelium within 1600 microns of the center of the fovea (P < 0.031). These ocular features allow identification of patients with macular drusen at high risk for the development of complicating macular lesions.

Aged↗
PubMed1993

Age-related Bruch's membrane change: a clinical study of the relative role of heredity and environment.

For many years there has been controversy concerning the role of genetic influences in the pathogenesis of age-related macular disease. It is widely believed that the lesions causing visual loss occur in response to age-related changes in Bruch's membrane which are recognised clinically as drusen. In this study the density, size, and confluence of drusen as shown on colour photographs were compared in eyes of 50 spouses and 53 sibling pairs ascertained during a prospective study of age-related macular disease. Concordance between pairs of drusen--number, size, and density-were determined by kappa statistic and chi 2 test for trend. Drusen were absent in one sibling and 26 spouses of patients. There was a trend towards concordance of drusen characteristics between siblings but not between spouses, although the difference achieved 5% significance only for the number and density of drusen in the central macula. The difference of concordance between the probands and spouses and the probands and siblings was significant for all characteristics. These findings support the belief that genetic factors influence age-related changes in Bruch's membrane. They also imply that environmental factors are less important or alternatively that the environmental variation between households included in our study was not great enough to be evident.

Aged↗
PubMed1992

Evolution of age-related macular degeneration with choroidal perfusion abnormality.

Prolonged choroidal filling on fluorescein angiography in age-related macular degeneration is thought to indicate diffuse thickening of Bruch's membrane. To test the importance of this clinical sign, we reviewed the evolution of disease in eyes of patients with good visual acuity and a readable transit phase of fluorescein angiography at the time of recruitment into a longitudinal study of age-related macular degeneration. Ninety-six eyes satisfied these criteria. Of the 32 eyes with prolonged choroidal filling, 12 (38%) lost two or more lines, of visual acuity by two years, whereas only nine of 64 (14%) eyes with normal choroidal filling did so. The difference was caused by the higher incidence of geographic atrophy in the first group. The proportion of eyes that developed subretinal neovascularization was the same in the two groups, and no pigment epithelial detachments occurred. These findings indicate that this clinical sign has implications concerning visual prognosis in age-related macular degeneration.

Aged↗
PubMed1991

[Prevention of ocular complications of herpes zoster ophthalmicus by adequate treatment with acyclovir].

We compared the frequency of severe ocular complications secondary to Herpes Zoster Ophthalmicus (HZO) in 232 patients. They were divided into three groups: 1) patients without treatment (n = 164); 2) patients treated adequately (n = 48) with acyclovir (ACV; 5 x 800 mg/d orally and ophthalmic ointment 5 x /d for a minimum of 7 days, given within three days after skin eruption); and, 3) patients treated inadequately (n = 20) with ACV (only topical treatment, insufficient doses, interrupted treatment, delayed treatment). Patients with no treatment or with inadequate treatments showed the same frequency of severe ocular complications (21% (34/164) and 25% (5/20), respectively). In contrast, when adequate treatment of ACV was given complications occurred in only 4% (2/48) of cases. This study emphasizes the need for prompt (within three days after skin eruption) and adequate (5 x 800 mg/d for at least 7 days) treatment of ACV to prevent the severe complications of HZO.

Acyclovir↗
PubMed1991

High-dose oral acyclovir in acute herpes zoster ophthalmicus: the end of the corticosteroid era.

Systemic acyclovir (ACV), a new potent anti-herpes drug, was shown to reduce effectively the morbidity in the acute phase of herpes zoster ophthalmicus (AHZO). Using high dose oral ACV (5 X 800 mg/day) our aim in this study was: (1) to compare disease profiles in the ACV-treated group and in a group of zoster patients having had no ACV, analysed retrospectively; (2) to establish if high-dose ACV was able to prevent severe long term complications of AHZO; and (3) to determine the present role of corticosteroids in AHZO. From 1984 to 1988, 48 patients with AHZO of less than 3 days' duration were included. All patients received at least 7 days of oral ACV (5 X 800 mg/d) associated with topical ACV. Steroids were not given unless severe uveitis occurred. Follow-up was 2 years in 43 patients and 1 year in all 48 patients. Main conclusions from our study are: 1. Ocular involvement occurred in 67% of ACV-treated cases, a rate comparable to our retrospective group (59%) and to the literature (71%). However the rate of severe long term complications was minimal (4%) when compared to our non-treated retrospective group (21%). 2. Steroid treatment was not necessary in any of the ACV-treated patients. 3. ACV was well tolerated and did not have to be discontinued in any of the patients. High dose ACV and avoidance of steroids seems to eliminate the severe complications of AHZO.

Acute Disease↗
PubMed1990

[Surgical treatment of epiretinal macular fibrosis: the Lausanne experience].

Between 1981 and 1988, vitreous surgery was performed on 28 nondiabetic patients with epiretinal macular fibroplasia. The fibroplasia was idiopathic in 9 eyes, occurred after successful surgery for retinal detachment in 10, and was associated with other ocular disorders in 9. The patients were followed up for between 5 and 72 months. While visual acuity improved in 26 cases, metamorphopsia increased in all. The results were poorer in cases where symptoms had already existed for more than 6 months or where not only the retina, but also the macula was detached. Complications were confined to 3 cases in which peripheral tears occurred intraoperatively; there were 2 postoperative retinal detachments. While increased lens opacification was observed in 7 patients, a recurrence was seen only in one.

Adult↗
PubMed1975

[Various clinical aspects of cutaneous leishmaniasis, a disease too often unrecognized in the Paris area. Diagnostic and therapeutic problems].

Muco-cutaneous leishmaniasis is now more frequently observed in France owing to population movements. One should learn to recognise the disease, the various aspects of which are presented here (7 cases). They recall the necessity of associating direct search for leishmania in the serous exsudate from the lesions or on histological sections, routine culture of swabs on agar jelly en riched with blood and on heart-brain blood medium. The immunoglobulin estimation sometimes revealed significant increase in their levels, but the sero-immunologic reactions by the indirect immuno-fluorescent method, were all negative. The best treatment is N-methylglucamine antimoniate by intradermal injection under the lesions or, in some cases, the parenteral route. On the other hand, metronidazole does not seem to be efficacious in skin leishmaniasis in this part of the world.

Adult↗