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Biomedical subjects

D Ducournau

Publications and source records attributed to D Ducournau.

At least 19 recordsLinked to original sources
PubMed2006

[Triamcinolone-assisted vitrectomy in the treatment of recurrent retinal detachment due to myopic macular hole].

PURPOSE: To report the use of triamcinolone-assisted vitrectomy to assess the cause of vitrectomy failure in the treatment of retinal detachment due to myopic macular hole. OBSERVATIONS: We report the cases of three myopic patients presenting with recurrent retinal detachment due to macular hole after initial vitrectomy treatment with posterior vitreous detachment, a systematic attempt at membrane peeling, and gas injection (SF6). No retinal traction or tear other than the macular hole was observed. The recurrence of retinal detachment was treated with vitrectomy and intraoperative use of triamcinolone, which demonstrated persistent posterior hyaloid and thin and strongly adherent membrane remnants in each case. Anatomic success was obtained after peeling these structures. CONCLUSION: Intraoperative use of triamcinolone reduces the risk of overlooking hyaloid or membrane remnants during vitrectomy for the treatment of myopic retinal detachment. Transparent remnants of posterior hyaloid and membranes were visualized by triamcinolone-assisted vitrectomy. They could lead to traction on the retina and explain the failure of the initial vitrectomy. Anatomic success was obtained after peeling these structures.

Aged↗
PubMed2003

[Efficiency of surgical treatment for chronic macular edema due to branch retinal vein occlusion].

INTRODUCTION: Internal limiting membrane peeling has recently given interesting results in the management of macular edema in diabetic patients, even in the absence of vitreomacular tractions. This study was conducted to evaluate the results of a surgical treatment for macular edema resulting from branch retinal vein occlusion. MATERIAL AND METHODS: A nonrandomized prospective study was conducted between March 2001 and April 2002 on 12 eyes of 12 consecutive patients with a visual acuity of 20/40 or less resulting from branch retinal vein occlusion with macular edema. Internal limiting membrane peeling associated with arteriovenous crossing sheathotomy was performed on six eyes and internal limiting membrane peeling alone was performed on six eyes. Patients were tested with ETDRS visual acuity, fluorescein angiography, automated perimetry, and OCT pre- and postoperatively (at 3 and 6 months). RESULTS: At 6 months, postoperative visual acuity was improved in all patients (mean VA=20/40; range, 20/125-20/20), with an average gain of three lines of vision (or 14 ETDRS points) (p=0.002). Fundus examination and fluorescein angiography results were improved in all patients. At 6 months, on automated field testing, the mean corrected defect improved from 3.4+/-0.9dB to 2.3+/-0.9dB (p=0.008). On OCT, mean foveal thickness decreased from 419+/-57 micro m to 233+/-10 micro m (p=0.02). No difference was noted between simple vitrectomy with internal limiting membrane peeling and arteriovenous crossing sheathotomy in terms of visual acuity (p=0.5), visual field (p=0.2), or foveal thickness (p=0.6) improvement. CONCLUSION: Our findings suggest that internal limiting membrane removal for macular edema may improve the functional prognosis in patients with branch retinal vein occlusion. Adventitial sheathotomy did not yield further functional benefits in these cases.

Adult↗
PubMed2003

[Radial optic neurotomy for severe central retinal vein occlusion: preliminary results].

PURPOSE: To describe the results of radial optic neurotomy for the treatment of severe central retinal vein occlusion. PATIENTS AND METHODS: Prospective noncomparative single-center study. Analysis of ten eyes of ten consecutive patients whose visual acuity was 0.1 or less. They underwent fluorescein angiography, visual field testing by automated perimetry, and macular thickness analysis by optical coherence tomography preoperatively at 3 months and at 6 months postoperatively. RESULTS: Mean visual acuity on an ETDRS chart increased from 30+/-12 points preoperatively to 42+/-15 points at the 3-month visit, (p=0.03), and mean macular thickness decreased from 580+/-150 micro m to 361+/-52 micro m (p=0.04). All patients had clinical improvement as determined by fundus examination and fluorescein angiography. An improvement in the central visual field was observed in all eyes. Mean visual acuity of the five patients followed-up for 6 months was 52.8+/-20 points. No visual loss was observed. None of the patients underwent laser photocoagulation or has presented with neovascularization so far. Optociliary veins developed in three eyes and a retinochoroidal anastomosis within the disk incision was observed in two eyes. CONCLUSION: These preliminary results are encouraging when compared to the reported natural progression of severe central retinal vein occlusion. A bypass of the site of occlusion is a possible mechanism for radial optic neurotomy. A randomized study should be conducted to assess the efficacy of radial optic neurotomy and determine the best candidates for surgery.

Aged↗
PubMed2001

Juxtapapillary subretinal pigment epithelial polypoid pseudocysts associated with unilateral tilted optic disc: case report with clinicopathologic correlation.

OBJECTIVE: To describe the unique preoperative appearance, successful postoperative clinical course, and histopathologic features of a cluster of progressively enlarging pseudocysts that arose at the temporal margin of a unilateral tilted optic disc. STUDY DESIGN: Case report. METHODS: Clinical observation, color fundus photography, fluorescein angiography, and optical coherence tomography, as well as routine histologic and immunohistochemical studies of tissue removed by subretinal surgery. RESULTS: Subretinal surgical excision of the lesions resulted in retinal reattachment with improved postoperative visual acuity. Histologic examination disclosed a cluster of fluid-filled polypoid pseudocysts lined by small vessels of choroidal origin lying beneath the basement membrane of the overlying retinal pigment epithelium (RPE). CONCLUSIONS: We postulate that buds of small vessels of choroidal origin grew through or around the edge of Bruch's membrane at the temporal margin of the tilted optic disc and then passed under the juxtapapillary RPE. Ensuing leakage of proteinaceous fluid from these vessels eventuated in formation of a cluster of polypoid pseudocysts and subsequent localized papillomacular retinal separation with visual loss. The lesions were amenable to subretinal surgical removal with restoration of visual acuity.

Adult↗
PubMed1985

[N-acetyl-aspartylglutamic acid eye drops in allergic-type conjuctivitis. Double-blind comparative clinical study].

Fifty patients with allergic conjunctivitis were included in a double-blind randomized clinical trial designed to compare the efficiency and tolerance of two antiallergic eye-drops: one containing NAAGA (22 patients), the other one containing disodium Cromoglycate (28 patients). Both treatments were used at a dosage of 1 drop 4 times per day. Ocular symptoms, conjunctivo-corneal signs and the subjective ocular condition assessed by the patients themselves with visual analogue scales, were all significantly improved by both eye-drops during the first month of treatment. Statistical analysis showed that patient ocular condition improved more rapidly with NAAGA eye-drops. In 25 patients (12 in the NAAGA group and 13 in the Cromoglycate group), the study was continued for an additional month according to a cross-over protocol. During the 2nd month of treatment, additional improvement of ocular symptoms and signs were observed with both eye-drops but more markedly in those patients who received NAAGA after Cromoglycate. Ocular tolerance was good for both eye-drops.

Adolescent↗
PubMed1980

[Systematisation of the choroïdal vasculature (author's transl)].

The systematization of the choroïdal vasculature has been studied by injection of radio-opaque material. The most important points are:--the absence of specific macular arteries,--the presence of two different clusters of short posterior ciliary arteries: a para-optic cluster and a remote cluster,--the inconstant presence of anterior recurrent ciliary arteries,--the absence of anastomoses between the S.P.C.A. arteries,--the segmental distribution of the capillaries,--the lobules are autonomous, but non independent,--the greatest variability of that systematization.

Animals↗