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Biomedical subjects

G Coscas

Publications and source records attributed to G Coscas.

At least 145 records · Page 8Linked to original sources
PubMed1989

[Retinopathy in pancreatitis].

Three patients with retinopathy associated with acute pancreatitis were observed. Each of them had a long history of alcohol abuse. The first patient was asymptomatic. Second one developed moderate visual loss in one eye (visual acuity 20/40), with a fascicular defect on Goldmann visual field registration. Third patient complained with bilateral and severe visual loss, with a large central scotoma. Cotton-wool patches and hemorrhages were present in the mild types of retinopathy. These cases had a good prognosis. An ischemic edema of posterior pole was associated in severe type of retinopathy. In this case, fluorescein angiography showed occluded macular retinal arterioles. Visual prognosis was poor. Pathogenesis of the lesions is still discussed. The main hypothesis are fat emboli or activated complement-induced granulocyte embolus formation. Efficacity of corticosteroids is not known.

Acute Disease↗
PubMed1989

[Treatment of subretinal neovessels in idiopathic recurrent multifocal choroiditis].

We have conducted a retrospective study about 25 patients who have presented subretinal neovascularization and idiopathic recurrent multifocal choroiditis. Final visual acuity level (mean 20/30) was almost the same as the pre laser treatment visual acuity level (mean 20/25) for a follow up of 12 months. We have also studied the main clinical, angiographic and serologic features of these cases of multifocal choroiditis.

Adult↗
PubMed1989

[Erythrocyte aggregation and retinal vein occlusion. Preliminary data for a randomized study on the efficacy of anti-erythrocyte aggregation (troxerutin) in retinal vein occlusion].

Erythrocyte aggregation (EAg) is one of the principal determinants of blood viscosity at low shearing rates (slow flow). The retinal venous circulation, characterised by a slow circulatory rate and a high resistance to flow, creates a favourable environment for the formation of erythrocyte aggregates. EAg and other laboratory parameters (haematocrit, fibrinogen, plasma proteins, clotting) were measured in 64 patients presenting with retinal vein occlusion (RVO) and 64 controls matched for age, sex, risk factors (HT, diabetes, smoking) and concomitant vascular disease. Statistical analysis of the results demonstrated a significant difference between the RVO group and the control group for fibrinogen (p = 0.03) and erythrocyte aggregation (p = 0.00003 for the aggregation index at 10 sec and p = 0.0002 for the threshold of partial dissociation). The rise in the fibrinogen level alone cannot explain the increased erythrocyte aggregation. These results demonstrate that the increased EAg largely explains the hyperviscosity reported by other authors and suggest that it plays an important role in the pathogenesis of RVO.

Adult↗
PubMed1989

[Rothmund's syndrome].

Rothmund's syndrome was observed in a 9 year old boy. Parental consanguinity was present, but no siblings were affected. He presented with rapidly progressive bilateral cataracts. Visual recuperation was excellent after "in the bag" phakoemulsification and intercapsular implantation. There were no other ocular anomalies. Extensive erythematous skin changes appeared when the boy was 3 months old and, at the time of presentation, he had poïkiloderma predominantly in those areas exposed to light (face and hands). There were no associated anomalies of the nails or hair, no endocrine disorder nor other malformations. A brief review of this syndrome is presented and treatment of these cataracts discussed.

Cataract↗
PubMed1989

[The dye laser: experimental and clinical results in subretinal macular neovascularization].

The tunable dye laser provides now a large assortment of monochromatic wavelengths that allow selective targeting on individual tissues in the retina, according to in vitro studies showing extinction coefficient of ocular pigments (xanthophyllic pigment, rhodopsin, melanin, lipofuschin, hemoglobin) for different laser wavelengths. Confluent heavy and juxtafoveolar laser burns in eyes of cynomolgus monkeys showed, after 38 days, similar lesions in all the wavelength studied (green, red, yellow, orange) at the level of the choriocapillaris, Bruch's membrane, pigment epithelium and photoreceptor's layers. However, the inner retina layers were discretely more damaged with yellow and orange than with green and red. In clinical approach, the effects of these different wavelength haven been compared in human eyes presenting with subfoveol new vessels and disciform age-related macular degeneration. After healing, the scar was similar biomicroscopically, and on fluorescein angiography with all wavelengths studied (green, red, yellow, orange). In conclusion, dye laser seems to be efficient and easily tunable for photocoagulation in macular area.

Aging↗
PubMed1989

[Retinal pigment epithelial tears after photocoagulation in age-related macular degeneration].

Retinal pigment epithelial tears after photocoagulation for subretinal new-vessels complicating age related macular degeneration were observed in 20 patients between 1980 and 1988. The patients, 4 males and 16 females, aged from 60 to 86 years (mean: 72.5) were followed up between 12 and 53 months (mean: 21 months). Laser photocoagulation was performed for directly visible lacy subretinal new-vessels (6 cases) or vascularized pigment epithelial detachment (10 cases) or both lesions associated (4 cases). Krypton laser (17 cases), blue-green argon laser and/or orange dye laser (625 nm) (3 cases) were applied in one (9 cases) to four sessions. Retreatment (11 cases) was performed for persistent subretinal new-vessels (3 cases) or recurrences (4 cases) or appearance of a pigment epithelial detachment after photocoagulation for isolated SRNV (4 cases). The tear was observed on fluorescein angiography 10 to 180 days after the last session. It was preceded by occurrence of subretinal hemorrhages, increase in size of the PED or newly formed PED. It appeared on the border of the PED (16 cases) usually temporally, or on the immediate border of the laser scar (4 cases). Further evolution was rapidly defavorable with dramatic impairment of vision and constitution of fibrovascular scar in the macular area. Only 4 eyes progressed to flat atrophic scars after retreatment and retained useful central vision (0.1 to 0.2). Factors which could explain this complication following laser treatment of age related macular degeneration are discussed.

Aged↗
PubMed1989

[Parry-Romberg progressive facial hemiatrophy and localized scleroderma. Nosologic and pathogenic problems].

A case of a 65-year-old caucasian woman with progressive hemifacial atrophy (Parry-Romberg syndrome) is reported. The atrophy had begun ten years before. At time of presentation, she was suffering from facial pain and diplopia. She presented with severe enophthalmos associated with eyelid atrophy, loss of cilia and mild blepharoptosis. There was a patch of alopecia and atropic areas of skin, recognised as scleroderma "en coup de sabre". Ophthalmic examination showed miosis. Horner's syndrome and ocular motility disturbance. Biomicroscopic examination of anterior and posterior segments was normal; there was no heterochromia and no disc atrophy. Aesthetic surgical treatment was proposed. The etiology of hemifacial atrophy remains controversial, and its relations with scleroderma and autonomic nervous system disorders are discussed.

Aged↗
PubMed1989

[Macular holes].

Explore the source record for details and available documents.

Aging↗
PubMed1989

[Multifocal choroiditis: diagnostic aspects and results of photocoagulation. Apropos of 25 cases].

A retrospective study was conducted on 25 patients who presented with both recurrent multifocal choroiditis and subretinal neovascularisation. As in other series, striking features were the young age of the patients (mean age 33 years), frequent recurrences of the macular lesions during a limited follow-up period, inflammation of the vitreous or the optic disk, and macular fibrosis. However, unlike previously reported data, refraction was more often in the emetropic range, there was no female predominance, and inflammatory signs were mild or limited to papillitis. Moreover serologic tests did not indicate an acute infection due to Epstein-Barr virus in any of the patients. This study also emphasized the results of Krypton laser treatment of the subretinal neovascularisation. Final visual acuity improved or remain the same in 26 eyes (72%) and worsened in 11 eyes (28%) during a mean follow-up period of 13 months (range 2-48 months). The best results were obtained in 15 eyes with neovascular membranes located more than 200 mu from the foveal avascular zone (mean final visual acuity: 20/40). However the mean final visual acuity of the nine eyes with neovascular membranes closer than 200 mu from the FAZ, was over 20/60. Recurrences of subretinal neovascularisation occurred in 7 out of 24 treated eyes and 3 were under the center of the FAZ. These results should be confirmed by a randomized prospective clinical trial in order to assess the benefits of laser treatment in recurrent multifocal choroiditis.

Adult↗
PubMed1988

[Macular degeneration related to age and cystoid macular edema. Apropos of 95 cases (100 eyes)].

The leakage from the new vessels, responsible for the exudative form of age-related macular degeneration (ARMD), produces retinal detachment, haemorrhages, exudates and intraretinal cystoid macular edema (CME). In a retrospective study of 100 eyes, we assessed the prognostic value of cystoid macular degeneration of the inner retina. It was nos specifically linked to: 1 - the duration of the neovascular involvement; 2 - the extent of the neovascular membrane; 3 - the location of the new vessels; 4 - the type of the new vessels; definite (48 eyes) or occult (19 eyes), or advanced and fibrous lesions (21 eyes). However, cystoid macular edema was initially associated to legal blindness in 46% of eyes. Active SNV associated with CME were retrofoveal in 83% of the eyes. But biomicroscopical evidence of CME requires fluorescein angiography to identify the new vessels still amenable to laser photocoagulation. After a follow-up period ranging from 30 days to 6 years (mean 15 months), 69% of eyes were legally blind although 41 eyes were treated with laser photocoagulation (focal or perifoveolar). Thus, functional prognosis in ARMD is not uniquely and directly correlated with the presence of cystoid macular edema in ARMD.

Aged↗
PubMed1988

[Papilledema caused by minocycline: apropos of a case].

Benign intracranial hypertension with papilloedema developed in a 18-year-old woman following Minocycline administration. Tetracycline therapy was prescribed for acne vulgaris. One month after the beginning of the treatment, she presented with headache, nausea and vomiting; there were no visual symptoms. Visual acuity and visual field were normal, fundus examination showed bilateral papilloedema. After Minocycline was discontinued and steroid therapy was administrated, symptoms rapidly resolved and papilloedema disappeared. Minocycline is known to penetrate into the central nervous system more effectively and to have a greater lipoid solubility than the other antibiotics of the same group. However the pathogenesis of benign intracranial hypertension after Minocycline therapy remains unknown.

Acne Vulgaris↗
PubMed1988

Oculocutaneous syndromes.

Research in genetics and the collaboration of various medical disciplines are responsible for the discovery of many new syndromes. The association of ocular and skin malformations is not astonishing when one remembers that the embryonic development of the eye and the skin are of ectodermal origin; both the eye and skin may reflect a variety of systemic disturbances occurring during their formation, or represent genetic disorders. An ocular and a dermatological feature may be the first indication of a possible disturbance on other organs. The reality that juveniles may frequently present simultaneous associations of eye and skin malformations is a phenomenon not widely known among physicians and reports in the recognition of syndromes with those manifestations are dispersed among various medical journals. The authors described the various syndromes with ocular and dermatologic findings that are of interest to the ophthalmologist.

Adolescent↗
PubMed1988

[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↗
PubMed1988

[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↗
PubMed1987

Retinal detachment after choroidal ischemia.

Injection of a 15-micron microsphere suspension through one or two vortex veins of nine monkey eyes caused various degrees of sectorial choroidal ischemia, which were documented by fluorescein angiography and electron microscopy. The severity of the lesions to the fundus depended on the volume of microspheres injected (0.4 to 1.6 ml of a suspension of 600,000 microspheres/ml). Three hours after embolization white patches appeared in the retinal pigment epithelium as well as a posterior pole serous retinal detachment in five eyes. Delayed choroidal filling was noted in the quadrant involved, but a few choriocapillaris units slowly perfused, leading to fluorescein leakage in the serous retinal detachments. Histologic examination showed various types of damage to the retinal pigment epithelium, including vacuolization and cell membrane rupture.

Animals↗