Biomedical subjects
Publications and source records attributed to G Soubrane.
Decrease of visual acuity in birdshot retinochoroidopathy is due either to optic atrophy or to 3 types of macular involvement: cystoid macular oedema, geographic atrophy, or macular serous detachment. We describe 3 cases of juxtapapillary subretinal neovascularisation occurring in long-standing birdshot retinochoroidopathy. The mechanism of the formation of the new vessels is discussed.
This study describes a method for quantifying microaneurysms (MA) from fluorescein angiograms. The method was validated by the reproducibility of the number of MA in 30 angiograms read twice each by two independent observers; and by the absolute difference in MA counts between two readings by the same observer, and difference in numbers counted by two different observers. The precise location of each MA on two readings was also studied and the reproducibility of location varied from 60 to 71%, depending on the quality of the angiograms. Clinicians and technicians working in the same or in different centers obtained similar results. The coefficient of correlation between observers and between readings was satisfactory, r greater than 0.9. The method is easy to learn and the reproducibility allows for its use in clinical trials.
In a group of 182 patients of under 50 years of age with subretinal neovascularization, the syndrome of hemorrhagic macular choroidopathy of the young adult was identified in 30 cases. This syndrome is characterized by the occurrence of a juxtafoveolar idiopathic neovascular membrane in an eye normal in all other respects. The natural course of this lesion is the production of a fibroglial scar leading to a mean final visual acuity of 0.15. The syndrome remains unilateral in 75 p. cent of cases, as shown by a mean follow-up of 23.9 months. Photocoagulation of these new vessels is possible, and in a group of 19 eyes it allowed conservation of a mean acuity of 0.6. This syndrome differs from ocular histoplasmosis where widespread uni- or bilateral involvement of the pigment epithelium and choriocapillaris is found. Hemorrhagic macular choroidopathy can also be distinguished from choroiditis associated with hemorrhages. The existence or the sequellae of uveitis, even when associated with subretinal new vessels arising from an atrophic chorioretinal scar, establishes the correct diagnosis. The etiology of hemorrhagic macular choroidopathy is unknown. It is possible that multiple etiologic agents might be responsible for different clinical syndromes in relation to endemic factors.
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In five young adults, mild vitreous hemorrhage occurred from the area of retinal loops near or on the optic nerve. In all cases, the hemorrhage cleared without further complications. This vascular congenital malformation may be associated with secondary complications more frequently than has previously been reported.
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Sub-retinal new vessels arising from the choroid are the most dangerous components in disciform maculopathies. The greatest advance made in their treatment has been due to the use of photocoagulation over the last few years, but their destruction by this method is still a very controversial subject. The aim of the present study was to define which lesions should be treated and which should not. Results demonstrated that the use of photocoagulation to destroy new vascular membrane which is very close to the foveola, is possible, and can restore vision or preserve useful visual acuity. The laser can be used very close to the centre of the foveola, even in a part of the central avascular area. A randomized study is now being conducted and should supply statistical evidence as to whether this treatment should or should not be recommanded.
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The apparition of diabetic retinopathy depends on the duration of the evolution of the diabetes and its control, and its type. The indications for photocoagulation are in progressive retinopathy the existence of macular edema or retinal or prepapillar neovascularisation. The pan-rtinal argon laser photocoagulation is the best technic for treatment. It leads to a global improvement whose results are presented, after 2 years follow-up.