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Biomedical subjects

E Frau

Publications and source records attributed to E Frau.

At least 55 records · Page 3Linked to original sources
PubMed1998

[Incidence and evaluation of viral retinitis in patients infected with the HIV virus and treated with HIV protease inhibitors].

BACKGROUND: Since the beginning of the use of HIV-Protease Inhibitors (PI) to treat HIV-infected patients, a decrease of the incidence of extraocular opportunistic infections has been observed. We studied the incidence of CMV-retinitis in patients treated with a highly active antitetroviral therapy (HAART) containing PI over a mean follow-up of 12 months. METHODS: Ninety-three HIV-infected patients treated with HAART containing PI were included. The mean initial CD4+ cell-count was 54/microliter (median: 22/microliter), and the mean plasma HIV-load was 5.46 log 10 RNA-copies/ml. Fundus examination was performed each month in case of a previously treated and controlled CMV-retinitis or if initial CD4 cells were below 50/microliter. In other patients, fundus examination was performed every 3 months. The mean follow-up was 362 days. RESULTS: Among the 7 patients with a previously treated and controlled CMV-retinitis, one experienced a progression during the study (after 163 days of PI). Among the 59 patients with CD4 cells below 50/microliter and without previous CMV-retinitis before the beginning of PI, 5 experienced a CMV-retinitis (mean delay after the onset of HAART: 141 days), including 2 with relapse. When retinitis occurred, CD4 cells were below 32/microliter except in one case (147/microliter). CONCLUSIONS: Compared to previously published reports, this study showed an increase of the time to progression of previously treated and controlled CMV-retinitis in patients treated with PI. Considering deeply immunocompromised patients (less than 50 CD4-cells/microliter), the risk of suffering from CMV-retinitis was 8.5% after 12 months of PI treatment. Longer follow-up remains necessary to confirm these results.

AIDS-Related Opportunistic Infections↗
PubMed1997

Efficacy of proton therapy in circumscribed choroidal hemangiomas associated with serious retinal detachment.

OBJECTIVE: The purpose of the study is to evaluate the efficacy and safety of proton therapy in complicated circumscribed choroidal hemangiomas. DESIGN: The study design was a retrospective review. PARTICIPANTS: Studied were 13 patients (13 eyes) who had circumscribed choroidal hemangioma associated with serous retinal detachment. Of these, four eyes previously underwent laser unsuccessfully. INTERVENTION: Proton therapy including a total dose of 30 Cobalt-Gray-Equivalent was administered to each eye. MAIN OUTCOME MEASURES: Patients were controlled for initial and final best-corrected visual acuity, slit-lamp examination, intraocular pressure, fundus examination, fluorescein angiography, and tumor thickness on B-scan ultrasonography. RESULTS: The mean follow-up period was 26 months (range, 9-48 months). Retinal reattachment was obtained in all cases after a mean period of 52 days. The tumor height decreased in all cases. Visual acuity improved to two lines or more in eight eyes (62%) and reached 20/200 or more in nine eyes (69%). No radiation complication was detected during follow-up. CONCLUSIONS: Proton radiation seems to be effective and safe in the management of choroidal hemangioma associated with serous retinal detachment. It may be useful when photocoagulation can not be performed.

Adult↗
PubMed1997

[Initial results of proton therapy in choroidal melanoma at the d'Orsey Center for Proton Therapy; the first 464 cases].

PURPOSE: Retrospective analysis of the treatment of choroidal melanoma with protontherapy at the Centre de protonthérapie d'Orsay, France. PATIENTS AND METHODS: Between September 1991 and September 1995, 612 patients presenting with choroidal melanoma were treated by protontherapy in Orsay. Following initial management of the first 464 patients, results were analyzed, as were results after a 1-year follow-up for 305 patients, a 2-year follow-up for 169 patients, and a 3-year follow-up for 59 patients. RESULTS: Univariate analysis showed that the actuarial local recurrence rate was 5%, the 3-year survival rate 88%, and the overall metastasic rate 5%. The initial tumor volume was the most significant predictive factor for visual results and metastases. Multivariate analysis revealed that visual results were significantly related to the initial tumor volume, initial retinal detachment, and total dose delivered to the optic nerve and macula. CONCLUSION: Protontherapy of choroidal melanoma allows in most cases conservation of the eye without modification of survival. Visual results mainly depend on the site and size of the tumor.

Choroid Neoplasms↗
PubMed1997

[A case of atypical exsudative retinal detachment and its treatment].

A 32 year-old woman with bilateral retinal detachment was observed for 18 months after the onset of symptoms. Because of probable systemic lupus erythematosus and a partial response to corticosteroid treatment she received, monthly, cyclophosphamide intravenously. The mechanism of this choroidopathy and its surgical management is discussed in light of data found in the literature.

Adult↗
PubMed1997

[Subconjunctival adipose hernias of the orbit].

Clinical report of three cases of subconjunctival fat prolapse. Differential diagnoses are discussed. Subconjunctival orbital fat prolapse is a benign entity with a fat herniation through defective Tenon's capsule.

Adipose Tissue↗
PubMed1997

[Toxoplasmic chorioretinitis complicated by retinal detachment].

PURPOSE: To describe and analyse relationship between chorioretinal toxoplasmosis and retinal detachment. PATIENTS AND METHODS: Seven immunocompetent patients examined and treated between November 1992 and March 1996, with ocular toxoplasmic retinochoroiditis and retinal detachment. RESULTS: Of the 7 patients examined, 5 had active retinochoroiditis and 2 had typical inactive scars. Of the patients with active focus 3 had giant retinal tears, one had a posterior retinal tear and one had a retinal tear located at the edge of an atrophic scar. Of the patients with inactive lesions, one had tractional retinal detachment and the other presented with a complete retinal detachment, multiples tears and PVR. Five patients were treated by corticosteroid without antitoxoplasmic drug before they were referred. The seven patients underwent endo-ocular surgery with silicon oil or long actic gas tamponade. Three patients developed PVR and redetachment of the retina and two patients underwent further surgery. Good anatomical result was obtained in 6 patients. CONCLUSION: Retinal detachment associated with toxoplasmic retinochoroiditis is rare. However it represents a serious complication. Steroid administrated to salvage vision may then worsen the clinical course, these may be justified to reduce hypersensitivity to toxoplasma antigen, but they should be combined with an antimicrobial agent.

Adult↗
PubMed1995

[Uveitis with hypopyon in patients with acquired immunodeficiency syndrome, treated with Rifabutin].

BACKGROUND: Iridocyclitis has been identified as a dosage-dependent side effect in patients with the acquired immunodeficiency syndrome who are treated for Mycobacterium avium complex infections with systemic Rifabutin. We reviewed cases of acute hypopyon uveitis occurring in patients with AIDS to establish whether there was an association or not. METHODS: All patients were referred by an infection disease specialty service for complete ophthamological evaluation and ancillary laboratory. Six patients with AIDS, aged from 29 to 65 years, presented with acute unilateral hypopion. RESULTS: At the time of presentation, all six patients were receiving treatment for MAC infection with Rifabutin (dosage range, 300-600 mg/d) and four received Fluconazol. Results of microbiological investigations were negative. Hypopyon developed in the second eye of two patients. Hypopion resolved rapidly with intensive antibiotherapy without corticosteroids. CONCLUSION: Concomitant use of Rifabutin and Fluconazol may precipitate hypopyon uveitis. The cause of the uveitis is less certain, but the possible role of a microbiological agent cannot be ruled out.

AIDS-Related Opportunistic Infections↗
PubMed1995

[Uncommon ophthalmological involvement in chronic atrophic polychondritis].

OBJECTIVE: Report of two uncommon ocular manifestations of relapsing polychondritis (PR). METHODS: A 53 year-old woman presented with a uveal effusion. Diagnosis of PR was made 17 years later. A case of PR in a 41 year-old man is reported. The ocular manifestation was a pseudotumor of the lacrimal gland. CONCLUSION: The relapsing polychondritis must be known by the ophthalmologists. The ocular manifestations of this uncommon disease are significative and inflammatory.

Adult↗
PubMed1995

[Solitary oligodendroglioma of the optic nerve. Apropos of a case].

Proptosis, decreased vision and oculo-motor palsies developed in the left eye of a 14-year-old girl, without neurofibromatosis signs. Computed tomographic (CT) Scans of the head and orbit showed a large fusiform expansion of the left optic nerve without intracranial involvement. Magnetic resonance imaging improved contrast resolution over CT Scanning. A neurosurgical approach was performed and the optic nerve was resected from the back of the globe to the intracranial portion. Microscopic sections demonstrated oligodendroglioma, an unusual form of optic nerve glioma.

Adolescent↗
PubMed1995

[Orbital Erdheim-Chester disease].

Erdheim-Chester disease is related to a tissue infiltration of foamy histiocytes. Results of immunoperoxydase stains for S-100 and T6 protein, the Langerhans cells antigen, is negative. It is a multisystemic disease, and it particularly involves bones and orbit. The visual prognosis is threatened, and the disease may lead to a fatal issue. Treatments have poor effects on the disease. Patients sometimes have good symptomatic response to corticotherapy. This case was revealed by headaches and diabetes insipidus. The orbital infiltration was asymptomatic.

Adult↗
PubMed1994

[Severe keratomycosis. Diagnosis and treatment].

We reported three consecutive cases of severe fungal keratitis initially undiagnosed by corneal scrapping. Corneal biopsy showed fungal elements of Paecilomyces lilacinus, Fusarium solani, Scedosporium apiospermum. Most cases of fungal keratitis could be treated successfully if adequate antifungal therapy were started early. Early and accurate diagnosis is of major importance. The results of our cases confirm the superiority of corneal biopsy over corneal scrapping. Corneal biopsy is a procedure of choice in suspected cases of keratomycosis in which corneal scrapings fail.

Abscess↗
PubMed1993

[An update on uveitis].

Uveitis occurs in 0.4% of the population. Anterior uveitis is the most common anatomical type of uveitis (50%). HLA-B27-associated acute anterior uveitis represent 50% of anterior uveitis. Sarcoidosis and Behçet disease are the systemic diseases most frequently associated with anterior uveitis. Toxoplasmosis is the most frequent cause of posterior uveitis. Although the emphasis regarding endogenous uveitis has now shifted towards immunological, if not autoimmune mechanisms, infection is still believed to play a role in the development of disease. The initiating events probably determine the site and type of pathological process within the eye since the perpetuation mechanisms seem to be similar, at least they are mediated by CD4 T lymphocytes. These findings form the basic for control of the inflammatory process by immunosuppressive agents or immunomodulators like ciclosporin A.

Humans↗
PubMed1993

[Ocular lesions caused by pellet guns. Epidemiological study on 160 patients].

We present a retrospective study of ocular trauma related to pellet guns. Over a period of 5 years, 160 such patients were seen in our emergency unit. Eighty per cent of cases were men, with a mean age of 28 years. Ocular trauma was due to a fight in 85%. Ocular trauma was unilateral in 109 patients, and bilateral in 51 patients. We observed a complete disorganisation of the eye in 8 eyes, intraocular foreign bodies in 71 eyes, intraorbital foreign bodies without ocular lacerations in 23 eyes, and blunt trauma in 108 eyes. Final vision was poor or absent in 31 eyes.

Adolescent↗
PubMed1993

[Ocular lesions related to pellet pistols. Epidemiologic study of 160 patients].

We present a retrospective study of ocular trauma related to pellet guns. During 5 years, 160 such patients were seen in our emergency unit. 80% of cases were men, and range age was 28 years. Ocular trauma circumstances was a fight in 85%. Ocular trauma was unilateral in 109 patients, and bilateral in 51 patients. We observed a complete disorganisation of the eye in 8 eyes, intraocular foreign bodies in 71 eyes, intraorbital foreign bodies without ocular lacerations in 23 eyes, and blunt trauma in 108 eyes. Final vision is poor or absent in 31 eyes.

Adolescent↗