Biomedical subjects
Publications and source records attributed to H Hamard.
We studied the flow pattern of the ophthalmic artery by pulsed doppler. The technique of visualization of the artery using bidimensional echography and the method of flow calculation by pulsed doppler are described in this preliminary report. This direct, non-invasive and readily feasible technique may play a prominent role in the clinical diagnosis of ophthalmic artery diseases.
The authors describe two cases of sphenoïd sinus mucoceles, the first with a chiasmatic syndrome and the second with an oculomotor paralysis, and compare these cases with those described in the litterature. This rare benign tumor is revealed by ophthalmological complications which result from compression of adjacent structures. The main clinical findings are pain, decrease in visual acuity, proptosis, and diplopia. Plain X rays and pluridirectional tomographies are usually sufficient to make the diagnosis but CT scan is the procedure of choice for defining the extent of the lesion and thus assuring an appropriate surgical approach. The CT scan findings have been reviewed. Early and correct diagnosis is important to prevent permanent visual loss by optic nerve atrophy.
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PDS (Polydioxanone suture), a new synthetic absorbable suture, was used in experimental and clinical trials. The experiment was performed on 14 rabbits anesthetized with intravenous sodium pentobarbital. Five months were needed for complete absorption of a piece of PDS left in a tunnelled corneal stroma. As late as the end of the second month no histological absorption was detected. This was twice as long as that persistence of polyglactin sutures studied under the same experimental conditions. In another series of 12 animals, the PDS suture was placed in the central cornea and tied with a buried knot. The PDS suture broke four to six weeks postoperatively in the superficial part of the cornea. The histologic tissue reaction in both these studies was minimal, resembling that obtained with black 10/0 monofilament nylon. In the clinical study, PDS sutures were used (size 0.2 metric and 0.3 metric) in 38 cases of cataract extraction. The material was easy to handle, especially when dyed violet. No side-effects attributable to the suture material were observed. PDS retained its tensible strength longer than other absorbable sutures, but can be used only for closing limbal incisions with conjunctival flaps in order to prevent tear hydrolysis of the suture.
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A case of bilateral congenital oculodermal melanocytosis is reported. Ota's naevus is characterized by benign melanosis of the skin of the face in the area supplied by the first (and second) branch of the trigeminal nerve. This is associated with ipsilateral pigmentation of the episclera++, uveal tract, conjonctiva and fundus. The condition is usually unilateral, occurring mainly in the dark races (black races and orientals). Eighty percent of patients are women. It is very rarely potentially malignant, this occurring most frequently in white races and when only ocular (and not oculodermal) melanocytosis is present.
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Initial signs of a craniopharyngioma in a 58 years old woman were a decrease in visual acuity and suppression of the pupillary light reflex. Perimetric signs were: left: central scotoma with an inferior temporal defect of the peripheral field; right: superior temporal field defect. The CT scan showed an intrasellar tumor, extending into the suprasellar region, isodensity of the tumor being the main finding. The radiological diagnosis was adenoma, but all the perimetric defects disappeared spontaneously, and the post-operative diagnosis was craniopharyngioma. Variations of the visual field defect are one of the most typical signs of craniopharyngioma, and absence of calcification, with isodensity of the tumor on the CT scan may lead to a mistaken.
On a case of Günther congenital porphyria with late ophthalmic complications, the authors study clinical and haematological manifestations of this disease (clinical signs are related to light sensibilisation: sclerodactily, hyperpigmentation, non cicatrisating wounds, long standing scars of reposed areas; they begin in the early childhood by hemolytic anemia and emission of dark port urines too). The various porphyries are then studied and their ophthalmologic signs are related either to the light sensibilisation either to angiopathy and neuropathy (acute porphyria). These are always spontaneously reversible after the acute onset; on the contrary, light sensibilisation involvements go worth and worth and in some cases (Günther disease; late cutaneous porphyria) induce irreversible damages: they begin by eyelids and conjunctival scars then involve scleral and corneal tissues (scleral malacia perforans). In fact, they have a bad prognosis: ophthalmologic surgical repair, after a little success, fails, because of the non cicatrisating tissues. Best treatment is preventive: --in case of light sensibilisation: eviction of sunlight or light sensibilisating drugs; --in case of acute porphyria: eviction of some drugs (barbiturates); surgical action.
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