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Biomedical subjects

G Chaine

Publications and source records attributed to G Chaine.

At least 55 records · Page 3Linked to original sources

[Photocoagulation with the argon laser in cystoid macular edema in retinal venous occlusions. Apropos of 68 cases].

Sixty-eight consecutive eyes with cystoid macular edema due to venous occlusion were treated by grid laser photocoagulation. The diagnosis of cystoid macular edema was based on both the biomicroscopic and angiographic findings. The treatment was applied with blue-green or green argon laser. The criteria for treatment were the presence of cystoid macular edema, visual acuity of 0.5 or less and duration of the venous occlusion for more than 6 months. The technique of treatment included direct photocoagulation of certain microaneurysms and of collateral dilatations exhibiting fluorescein leakage in the macular area, followed by grid photocoagulation applied to the area of cystoid edema. No laser burn was placed within 300 microns of the center of the macula. The patients were followed for periods of 6 to 24 months with a mean follow-up of 15 months. Forty-five eyes presented with a branch vein occlusion. Photocoagulation resulted in the decrease or disappearance of macular edema in 42 of these eyes (93%) and the improvement of visual acuity by 0.2 or more in 12 (27%). Twenty-three eyes presented central vein occlusion. In these cases, photocoagulation resulted in the decrease or disappearance of macular edema in 20 eyes (87%), and visual acuity improved by 0.2 or more in 4 (17%). These results indicate that grid laser photocoagulation is an effective method, reducing persistent cystoid macular edema due to venous occlusion. However, visual results were better in the branch vein occlusions than in the central vein occlusions.

Aged↗

[Winer's cutaneous calcinosis. Apropos of a case with eyelid localization].

A case of Winer's solitary cutaneous calcinosis is used as a basis for a literature review of this rare, benign dermatosis. Despite concordant clinical features diagnosis of this lesion is histologic. Normal blood biological values, a debated etiopathogenicity and the need to eliminate a collagen disease are important factors to bear in mind before making this diagnosis of such a cutaneous lesion, for which exeresis ensures a cure.

Adult↗

[Hypertensive retinopathy and papilledema. Apropos of a case of glycyrrhizin poisoning].

We present a case report of a patient suffering of severe hypertension and grade IV hypertensive retinopathy according to the Keith-Wagener classification. Simultaneously hypertensive encephalopathy was present confirming the poor prognosis of discoedema occurring in the course of hypertension when left untreated. Hypertension was related to chronic poisoning with glycyrrhiza, and its hyperaldosteronism like effect. Pathogenesis of discoedema in malignant hypertension is discussed.

Adult↗

Ocular fluorophotometric and angiographic findings in toxemia of pregnancy.

Ocular fluorophotometry was performed in 24 patients with hypertension due to toxemia of pregnancy and in ten normal subjects. Patients showing features of accelerated hypertension in the fundus (eg, hemorrhage, cotton-wool spots, and disc edema) were excluded from the study. Fluorescein concentrations in the aqueous and posterior vitreous increased significantly in toxemic patients compared with those in normal subjects; the blood-aqueous barrier was disrupted earlier than the blood-retinal barrier. Nevertheless, these barriers were only disrupted when the arterial diameter was altered. Ocular fluorometric abnormalities disappeared after delivery in all but two cases.

Eye↗

Hereditary vitelliform macular dystrophy.

Two families with vitelliform macular dystrophy were investigated ophthalmologically and genetically. The pedigree examination verified the usual expressivity. Macular pigmentary abnormalities or extramacular vitellin deposits were disclosed in some asymptomatic patients.

Adolescent↗

Best's vitelliform macular dystrophy.

We examined and evaluated the ophthalmological findings of 47 patients with Best's Vitelliform Macular Dystrophy (BVMD) and 5 cases suffering from related conditions to this macular disorder. Our sample re-confirm that BVMD is a progressive disease which may have several appearances in the course of its evolution. The heredity of this disorder is autosomal dominant with reduced penetrance and variable expressivity. Some contradictions exist regarding the nature of the primary defect in this entity. Electrooculographic and angiographic investigations lend support to the belief that the basic pathological changes are located in the retinal pigment epithelium. However, recent histopathological findings and flicker electroretinographic results indicate the possibility that the photoreceptor cells are equally involved, even before the pigment epithelium. In view of the existing disagreements about the pathogenesis of this disorder, certain considerations were advanced which suggest that the basic pathologic process in this entity produces a disorganisation in the structural and functional interdependance of both the photoreceptor cells and pigment epithelium.

Adolescent↗

Paramacular telangiectasis.

Forty six patients with paramacular retinal telangiectasis were reviewed; unilateral telangiectasis was present in 26 and bilateral disease was present in 20. Patients with unilateral macular telangiectasis had the more extensive vascular involvement associated with exudation and were more likely to have peripheral telangiectasis. Bilateral macular telangiectasis was associated with pigment epithelial changes and sub-retinal scars. Visual acuity was mildly reduced in the majority of patients; severe loss of vision was most frequent in patients with bilateral macular disease. The evolution of vascular changes was very slow and only 5 patients lost vision of two lines or more during an average period of 40 months. The high incidence of peripheral changes in unilaterally involved patients implies the possibility of a primary defect of the retinal vessels in these patients. There is evidence to suggest that there may be a primary defect of the retinal pigment epithelium in some patients with bilateral involvement.

Adult↗

[Treatment of diabetic cystoid macular edema by argon laser photocoagulation].

Diabetic maculopathy remains the main cause of poor visual acuity in diabetic retinopathy either proliferative or non proliferative. Although photocoagulation in the macular area is known to be effective in treatment of exudates, results in treatment of cystoid macular edema (CME) are still questionable. 36 eyes with diabetic CME and non ischaemic capillary bed were treated with argon laser photocoagulation in the macular area. Two groups of patients were studied. Group I consisted of 16 eyes with CME and with circinate exudates in the paramacular area. Mild argon burns (50-200) were applied on the microvascular abnormalities and on the pigment epithelium in the center of the circinate exudates. The macula (1500 of diameter) was not treated in this group. As expected, results on the exudates rings were good. CME disappeared in 43% of the cases, and regressed in 23% of the cases. Nevertheless 3 years after treatment the mean visual acuity was found to be slightly worse than before the treatment. Group II consisted of 20 eyes with CME, exudates were absent or scattered. Mild argon burns were applied on the area of macular cysts avoiding only the foveal avascular zone (500 of diameter). Exudates when present disappeared in all cases. CME disappeared in 80% of the cases and regressed in 15% of the cases. Three years after treatment mean visual acuity remained identical. Extensive review of the literature concerning the treatment of diabetic maculopathy shows a wide range of techniques and evaluation procedures. We propose the following method of treatment: when exudate rings are present with CME, treatment should be aimed first towards focal microvascular abnormalities avoiding the macular area. When exudates are absent or in cases of unchanged CME after extramacular photocoagulation, treatment should be aimed towards the microcystic area avoiding the foveal avascular zone, if visual acuity is less than 0,5.

Aged↗