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Biomedical subjects

G Renard

Publications and source records attributed to G Renard.

At least 73 records · Page 4Linked to original sources
PubMed2001

Nineteen years of penetrating keratoplasty in the Hotel-Dieu Hospital in Paris.

PURPOSE: To identify changing trends in penetrating keratoplasties (PKs) performed at the Hotel-Dieu Hospital in Paris between January 1980 and December 1999 and to explain the reasons for the changes. METHODS: We retrospectively reviewed 3,736 of the 3,836 PKs performed between January 1, 1980, and December 31, 1999, and classified them into diagnostic categories. RESULTS: The most common indications for PK were keratoconus (28.8%), herpetic infections (10.9%), graft failures (9.9%), aphakic and pseudophakic corneal edema (9.9%), Fuchs' endothelial dystrophy (9.4%), and nonherpetic leucoma (7.7%). Other indications represented 23.4% of the cases. The incidence of aphakic and pseudophakic corneal edema progressively increased between 1980 and 1991, became the most frequent indication in 1991 (21.4%), and then progressively decreased. The annual number of PKs increased between 1980 and 1986, decreased between 1987 and 1997, and increased again after September 1997. The decrease was caused by both a shortage of corneal buttons, and, in 1987, the fear of transmitting diseases through corneal transplantation, particularly human immunodeficiency virus. Beginning in 1992, decreases were also associated with stringent governmental regulations of eye bank tissue. CONCLUSION: Changes in the incidence and management of corneal disorders were the primary factors leading to modifications of grafting until 1987. After 1987, corneal button shortage probably corresponded to the acquired immune deficiency syndrome epidemic. Governmental regulations of eye banking led to a severe corneal button shortage between 1992 and 1997. Despite an increase in the number of PKs performed after 1997, corneal buttons are still preferentially allocated to patients in whom there is a high probability of graft success.

Adolescent↗
PubMed2001

Methylprednisolone concentrations in the vitreous and the serum after pulse therapy.

PURPOSE: Intravenous (i.v.) pulse of corticosteroids has been used to treat severe eye inflammation from different origins. Whether such large doses result in vitreous levels that differ either in magnitude or duration from more conventional corticotherapy remain unsolved issues. The authors therefore determined levels of methylprednisolone hemisuccinate and methylprednisolone in the vitreous and serum of patients at different times after a single i.v. perfusion of methylprednisolone hemisuccinate. METHODS: Fifty patients scheduled for a first vitrectomy received an i.v. injection of 500 mg hemisuccinate methylprednisolone at different times before surgery (from 15-24 hours). Patients were divided into two groups: those with (n = 21) and without (n = 29) retinal detachment (RD). Pure vitreous samples were analyzed by high-pressure liquid chromatography. RESULTS: Both the ester and the nonester methylprednisolone forms were sampled in the vitreous, showing a slower rate of hydrolysis compared to the serum. On average, the highest concentration of total methylprednisolone in the vitreous was found at 2.5 hours and rapidly decreased for the group of patients with RD. In the group of patients without RD, the highest concentration was reached at 6 hours and then slowly decreased. The antiinflammatory potency in the nondetached retina eyes was approximately 500 times more than in the physiologic vitreous, but despite the route of administration (i.v. or oral), only 1/10 of the corticosteroid serum concentration was measured in the vitreous. CONCLUSION: High concentration of methylprednisolone is achieved by i.v. pulse therapy without changing the kinetic of entry in the vitreous of nondetached retina eyes when compared to conventional oral corticotherapy. Hydrolysis occurs in the vitreous resulting in high rate of active form. Pulse therapy could be considered in cases of severe ocular inflammation involving the posterior segment of the eye.

Adolescent↗
PubMed2001

A new poly(ortho ester)-based drug delivery system as an adjunct treatment in filtering surgery.

PURPOSE: Pharmacologic modulation of wound healing after glaucoma filtering surgery remains a major clinical challenge in ophthalmology. Poly(ortho ester) (POE) is a bioerodible and biocompatible viscous polymer potentially useful as a sustained drug delivery system that allows the frequency of intraocular injections to be reduced. The purpose of this study was to determine the efficacy of POE containing a precise amount of 5-fluorouracil (5-FU) in an experimental model of filtering surgery in the rabbit. METHODS: Trabeculectomy was performed in pigmented rabbit eyes. An ointmentlike formulation of POE containing 1% wt/wt 5-FU was injected subconjunctivally at the site of surgery, during the procedure. Intraocular pressure (IOP), bleb persistence, and ocular inflammatory reaction were monitored until postoperative day 30. Quantitative analysis of 5-FU was performed in the anterior chamber. Histologic analysis was used to assess the appearance of the filtering fistula and the polymer's biocompatibility. RESULTS: The decrease in IOP from baseline and the persistence of the filtering bleb were significantly more marked in the 5-FU-treated eyes during postoperative days 9 through 28. Corneal toxicity triggered by 5-FU was significantly lower in the group that received 5-FU in POE compared with a 5-FU tamponade. Histopathologic evaluation showed that POE was well tolerated, and no fibrosis occurred in eyes treated with POE containing 5-FU. CONCLUSIONS: In this rabbit model of trabeculectomy, the formulation based on POE and containing a precise amount of 5-FU reduced IOP and prolonged bleb persistence in a way similar to the conventional method of a 5-FU tamponade, while significantly reducing 5-FU toxicity.

Animals↗
PubMed2001

[Neovascular glaucoma following proton-beam therapy. Case report].

A 52-year-old-male patient was treated for a posterior choroid melanoma of the right eye. When it was diagnosed, it measured 6mm in thickness and 11.9mm for the largest diameter and had a typical mushroom shape. General investigations found no metastatic disease. It was treated with proton-beam irradiation. Seven years later, the patient experienced increased intraocular pressure associated with cataract and pain. The patient finally accepted enucleation, as the vision of this eye was completely lost and the eye had become painful. Histologic analysis of the eye showed changes affecting both the anterior and the posterior segments of the eye, mostly related to the tumor and the consequences of treatment. Neovascular glaucoma is a major complication that very often leads to enucleation.

Cataract↗
PubMed2001

[Papillomatous and nevus of the caruncle].

A 63-year-old male patient was operated of a single conjunctival papillomatous lesion located on the left caruncle. The curative tumoral excision was followed by its histological analysis. Histologically, the tumor associated an epithelial squamous papilloma with a subepithelial nevus, confirming a combination of two different lesions.

Conjunctiva↗
PubMed2001

[Retinal lesion due to an obstetrical traumatism: a case report].

The authors report a case of unilateral, stable, localized, and well-circumscribed choriocapillaris atrophy associated with retinal pigment epithelium dispersion and atrophy. The anterior segment was normal. Facial examination revealed a homolateral malar hypoplasia. The other eye was normal. The electrophysiologic study did not confirm pigmentary degeneration of the retina. The patient's history included a difficult delivery using obstetrical forceps. The authors review the main ocular lesions secondary to birth trauma. In this case, they favored a traumatic chorioretinal lesion secondary to an obstetrical traumatism. In this context, progressive facial hemiatrophy is the main differential diagnosis.

Atrophy↗
PubMed2001

[Conjunctival in situ carcinoma in a patient with Waldenström's disease].

A 73-year-old male patient was treated for conjunctival in situ carcinoma invading the cornea of his right eye. The patient had been previously operated on for two corneoconjunctival lesions on the same eye (one was a pterygium, the other was simple epithelial hyperplasia) and was regularly followed for a systemic lymphoplasmocytic lymphoma (Waldenström's disease). After a corneoconjunctival excision of the tumor, the histological analysis was performed and established the diagnosis of in situ carcinoma. The tumor recurred a few months later and radiation therapy was then given. No recurrence was observed after this latter treatment.

Aged↗
PubMed2001

[Uveal effusion in its pseudotumoral form. A case report].

Uveal effusion exhibits various clinical presentations, some of which may lead to erroneous diagnosis and mimic a choroidal tumor. A 73-year-old female patient displayed a choroidal lesion with a tumoral appearance spontaneously affecting her right eye. Ultrasonography did not establish the diagnosis, leaving doubt for a tumor. In addition to the tumor - like lesion, a moderate inflammation was found in her right eye. The clinical course was favorable and one month after the initial examination, no fundus abnormalities were observed. The delay imposed by the MRI examination contributed to the lack of any active treatment. Apart from cases occurring postoperatively, the diagnosis of uveal effusion may sometimes be difficult to establish. In order to avoid enucleation and even if ultrasonography is helpful in reaching the correct diagnosis, it seems appropriate to wait and regularly follow up the patients when the diagnosis is not certain. The clinical course might be helpful to establish the diagnosis. Our case suggests that in pseudotumoral forms of uveal effusion, we should repeat clinical examination and ultrasonography in order to manage these patients appropriately.

Aged↗
PubMed2001

[Orbital wooden foreign body].

A 76-year-old-female patient fell in her garden, inducing a right orbital wound in which no foreign body was primarily found. As pain and diplopia followed the orbital trauma, a CT-scan was performed, disclosing a linear external foreign body in the right orbit. An anterior orbitotomy was performed to remove an 18-mm-long wooden foreign body. Histopathology of the tissue surrounding the foreign body showed an inflammatory fibrous tissue with small granulomas around telluric particles. Improvement after the operation was dramatic with complete disappearance of diplopia the day following surgery. Antibiotics were prescribed and tetanus prophylaxis was performed.

Accidental Falls↗
PubMed2001

[Hyperkeratosis papilloma of the eyelid. An anatomic clinical case].

A clinicopathologic case of an 80-year-old male patient with a single cutaneous tumor on the upper part of the left eyelid is reported. It was a grayish and pigmented mass covered with a thick keratin layer, well circumscribed, and exophytic. After surgical removal, histopathology showed that the tumor had a papillomatous pattern and was growing under a thick layer of hyperkeratosis. It was a typical squamous cell papilloma. This tumor belongs to the benign eyelid tumor group and can be found on the eyelids of elderly people.

Aged↗
PubMed2001

[Iridocorneal endothelial syndrome. Series of 7 cases].

The ICE syndrome includes 3 variants of the same disease, previously believed to be independent entities. All 3 share clinical and histopathological features such as endothelial abnormalities, iris damage, and progressive closure of the iridocorneal angle. Seven cases of ICE syndrome are reported, affecting 6 women and 1 man, with a mean age of 40 years. Corectopia was found in 5 eyes, a uveal ectropion in 2 cases, and other iris changes in 3 cases. The endothelial changes of the cornea were confirmed by a speculum microscopy in 5 cases. There were 5 cases of Chandler syndrome, 1 of Cogan-Reese syndrome, and 1 case of iris essential atrophy in our series. Ocular hypertony was observed in 3 cases, 2 of which needed to be operated. In one patient, a corneal edema was observed.

Adult↗
PubMed2001

[Corneal crystalline deposits in monoclonal gammapathy: a report of two cases].

Corneal immunoglobulin deposits are an unusual complication of lymphoproliferative affections such as monoclonal gammapathy of indeterminate significance, essential cryoglobulinemia, or multiple myeloma. Although uncommon, this crystalline keratopathy may be the first clinical sign of these malignant disorders. We report two cases of paraproteinic crystalline keratopathy: the first case is associated with a multiple myeloma, combined with cryoglobulinemia, and the second case with monoclonal gammapathy of indeterminate significance. In both cases, corneal crystalline deposits appeared before general clinical symptoms. In the first case, the systemic therapy made no change in the biomicroscopic aspect of the corneal deposit, despite immunoglobulin level normalization in the serum. Conversely, in the second case, we noticed a substantial regression of the corneal crystalline deposits as the systemic normalization. A review of the literature clarified the variety of clinical dorms of paraproteinic crystalline keratopathy, the physiopathogenics hypotheses that are currently being discussed, and the possible therapeutic modalities.

Aged↗
PubMed2001

[Limbal dermoid and Goldenhar syndrome. Report of an anatomoclinical study].

Dysembryoplastic neoplasm, the limbal dermoid is a benign congenital tumor involving the outer coat of the eye. This congenital tumor affected the right eye of a 6-year-old girl. The lesion was typically hemispheric, covered with pink skin, located in the inferior and temporal part of the cornea, and devoid of any major consequences except the cosmetic appearance of the eye. There were no other major abnormalities in the clinical examination but a single skin tag could be observed at the homolateral preauricular area without any visible cutaneous fistula next to it. This additional change allowed us to establish the diagnosis of a minor form of Goldenhar syndrome. This malformative syndrome typically includes several changes: dermoid and/or dermolipoma, preauricular tags and/or cutaneous fistulas in the same area, vertebral abnormalities etc. These findings may be limited to dermoid and cutaneous tags, as in our report. Such changes must be looked for in all limbal dermoids.

Child↗
PubMed2001

[Meibomian adenocarcinoma of the free palpebral edge. Report of a case].

A case of meibomian carcinoma of the left eyelid is reported in a 72-year-old female patient. The tumor had been present on the left eyelid for months. Clinically, the tumor appeared as a reddish mass implanted on the external part of the free margin of the left superior eyelid. An excisional biopsy disclosed meibomian carcinoma. A total resection of the left superior eyelid was followed by plastic surgery. Results after a one-month follow-up were very satisfactory. This case is emphasizes the importance of an early diagnosis which enabled us to perform a rather conservative treatment limited to the removal of the affected eyelid. The diagnosis of meibomian carcinoma is infrequent but it must be kept in mind in cases of tumor without the typical clinical characteristics of a basal cell or squamous cell carcinoma. Complete removal surgery may bring a curative effect and histopathology has a key role in the diagnosis of meibomian carcinoma.

Adenocarcinoma↗
PubMed2001

[Large basal cell carcinoma of the external palpebral angle].

A clinicopathologic case of an 89-year-old female patient with a single cutaneous tumor at the outer part of the outer left eyelids is reported. It was a pink nodular mass, well circumscribed, exophytic and with thin vessels. After surgical removal, histopathology showed that the tumor was a typical basal cell carcinoma, with many cystic-like cavities. Basal cell carcinomas can be commonly observed on the eyelids and surgical excision of these small size lesions is an easy way to perform a curative treatment. As often in other tumors, early diagnosis is probably the easiest way to improve the prognosis.

Aged↗