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Biomedical subjects

H Offret

Publications and source records attributed to H Offret.

At least 37 records · Page 2Linked to original sources
PubMed2000

Neuronal propagation of HSV1 from the oral mucosa to the eye.

PURPOSE: To identify possible neuronal pathways leading to herpetic ocular disease after primary oral infection in mice. METHODS: The SC16 strain of herpes simplex virus (HSV)-1 (10(6) plaque-forming units) was injected into the mucocutaneous border of the left upper lip. Animals were killed 2 to 10 days postinoculation (DPI). Spread of the virus in neural structures was studied by immunochemistry. RESULTS: HSV1 first replicated at the site of inoculation and then at the superior cervical ganglion (at 2 DPI). The trigeminal ganglion and the facial nerve fibers were infected by 4 DPI. Infection of the ciliary body and iris occurred at 6 DPI, together with several brain stem nuclei belonging to the autonomic or sensory pathways. Between 8 and 10 DPI, the neural infection gradually cleared up, except for the ipsilateral sympathetic ganglion, and ipsilateral keratitis appeared in some animals. CONCLUSIONS: The pattern of viral dissemination in this mouse model suggests that infection of iris and ciliary body results from transfer of virus in the superior cervical ganglion from sympathetic neurons innervating the lip to neighboring neurons innervating the anterior uvea. Later, zosteriform spread of virus from the trigeminal system may have contributed to the clinical and histologic findings.

Animals↗
PubMed1999

Cytomegalovirus retinitis in advanced HIV-infected patients treated with protease inhibitors: incidence and outcome over 2 years.

We prospectively studied the incidence of cytomegalovirus (CMV) retinitis in 93 patients treated with highly active antiretroviral therapy (HAART) containing a protease inhibitor (PI), during a median follow-up period of 24 months. The median initial CD4+ count was 22 cells/microl (range, 1-311 cells/microl), and the median plasma HIV viral load was 5.1 log10 copies/ml (range, 2.4-6.4 log10 copies/ml). The fundus was examined monthly in patients with a history of CMV retinitis or an initial CD4+ count <50 cells/microl and every 3 months in the other patients. Of patients with previously controlled CMV retinitis, 1 of 7 relapsed. In addition, 6 of 59 patients with a CD4+ count <50 cells/microl and no history of CMV retinitis before starting PI therapy developed CMV retinitis. Of them, 3 had at least one relapse during follow-up. CD4+ counts were <40 cells/microl at the time of primary or recurrent CMV retinitis, except in two cases (147 cells/microl and 203 cells/microl). In conclusion, the incidence of CMV retinitis was 0.091 per patient-year among study subjects with advanced HIV infection who were receiving HAART (95% confidence interval [CI], 0.037-0.145). The time to progression of CMV retinitis (mean, 215 days; 95% CI, 113-317 days) was longer than reported before widespread use of PIs.

AIDS-Related Opportunistic Infections↗
PubMed1999

[Hemangioma of the choroid with extra-scleral extension].

We report a case of atypical circumscribed choroidal hemangioma with retinal detachment in a 41-year-old man referred with the diagnosis of Harada disease. B. Scan ultrasonography showed an hyperechogenic area extended through the sclera. Careful examination of the fundus showed a small peripapillary orange mass and an inferior retinal detachment. Surgical exploration revealed an extrascleral hemangioma. Proton beam irradiation was followed by retinal reattachment within three months. No recurrence has been observed 18 months after treatment.

Adult↗
PubMed1998

[Incidence and evaluation of viral retinitis in patients infected with the HIV virus and treated with HIV protease inhibitors].

BACKGROUND: Since the beginning of the use of HIV-Protease Inhibitors (PI) to treat HIV-infected patients, a decrease of the incidence of extraocular opportunistic infections has been observed. We studied the incidence of CMV-retinitis in patients treated with a highly active antitetroviral therapy (HAART) containing PI over a mean follow-up of 12 months. METHODS: Ninety-three HIV-infected patients treated with HAART containing PI were included. The mean initial CD4+ cell-count was 54/microliter (median: 22/microliter), and the mean plasma HIV-load was 5.46 log 10 RNA-copies/ml. Fundus examination was performed each month in case of a previously treated and controlled CMV-retinitis or if initial CD4 cells were below 50/microliter. In other patients, fundus examination was performed every 3 months. The mean follow-up was 362 days. RESULTS: Among the 7 patients with a previously treated and controlled CMV-retinitis, one experienced a progression during the study (after 163 days of PI). Among the 59 patients with CD4 cells below 50/microliter and without previous CMV-retinitis before the beginning of PI, 5 experienced a CMV-retinitis (mean delay after the onset of HAART: 141 days), including 2 with relapse. When retinitis occurred, CD4 cells were below 32/microliter except in one case (147/microliter). CONCLUSIONS: Compared to previously published reports, this study showed an increase of the time to progression of previously treated and controlled CMV-retinitis in patients treated with PI. Considering deeply immunocompromised patients (less than 50 CD4-cells/microliter), the risk of suffering from CMV-retinitis was 8.5% after 12 months of PI treatment. Longer follow-up remains necessary to confirm these results.

AIDS-Related Opportunistic Infections↗
PubMed1997

Efficacy of proton therapy in circumscribed choroidal hemangiomas associated with serious retinal detachment.

OBJECTIVE: The purpose of the study is to evaluate the efficacy and safety of proton therapy in complicated circumscribed choroidal hemangiomas. DESIGN: The study design was a retrospective review. PARTICIPANTS: Studied were 13 patients (13 eyes) who had circumscribed choroidal hemangioma associated with serous retinal detachment. Of these, four eyes previously underwent laser unsuccessfully. INTERVENTION: Proton therapy including a total dose of 30 Cobalt-Gray-Equivalent was administered to each eye. MAIN OUTCOME MEASURES: Patients were controlled for initial and final best-corrected visual acuity, slit-lamp examination, intraocular pressure, fundus examination, fluorescein angiography, and tumor thickness on B-scan ultrasonography. RESULTS: The mean follow-up period was 26 months (range, 9-48 months). Retinal reattachment was obtained in all cases after a mean period of 52 days. The tumor height decreased in all cases. Visual acuity improved to two lines or more in eight eyes (62%) and reached 20/200 or more in nine eyes (69%). No radiation complication was detected during follow-up. CONCLUSIONS: Proton radiation seems to be effective and safe in the management of choroidal hemangioma associated with serous retinal detachment. It may be useful when photocoagulation can not be performed.

Adult↗
PubMed1997

[Subconjunctival adipose hernias of the orbit].

Clinical report of three cases of subconjunctival fat prolapse. Differential diagnoses are discussed. Subconjunctival orbital fat prolapse is a benign entity with a fat herniation through defective Tenon's capsule.

Adipose Tissue↗
PubMed1997

[Toxoplasmic chorioretinitis complicated by retinal detachment].

PURPOSE: To describe and analyse relationship between chorioretinal toxoplasmosis and retinal detachment. PATIENTS AND METHODS: Seven immunocompetent patients examined and treated between November 1992 and March 1996, with ocular toxoplasmic retinochoroiditis and retinal detachment. RESULTS: Of the 7 patients examined, 5 had active retinochoroiditis and 2 had typical inactive scars. Of the patients with active focus 3 had giant retinal tears, one had a posterior retinal tear and one had a retinal tear located at the edge of an atrophic scar. Of the patients with inactive lesions, one had tractional retinal detachment and the other presented with a complete retinal detachment, multiples tears and PVR. Five patients were treated by corticosteroid without antitoxoplasmic drug before they were referred. The seven patients underwent endo-ocular surgery with silicon oil or long actic gas tamponade. Three patients developed PVR and redetachment of the retina and two patients underwent further surgery. Good anatomical result was obtained in 6 patients. CONCLUSION: Retinal detachment associated with toxoplasmic retinochoroiditis is rare. However it represents a serious complication. Steroid administrated to salvage vision may then worsen the clinical course, these may be justified to reduce hypersensitivity to toxoplasma antigen, but they should be combined with an antimicrobial agent.

Adult↗
PubMed1995

[Fluorophotometry of changes of hemato-ocular barriers in intermediate uveitis].

PURPOSE: Intermediate uveitis presents a characteristic clinical picture with inflammation in the vitreous and peripheral retina. From a physiological point of view, the disease is characterised by a rupture of blood-ocular barriers. To determine the sites involved, a vitreous fluorophotometry was performed in patients with intermediate uveitis and in a group of healthy patients. METHODS: Seventy-one patients with an intermediate uveitis were studied by vitreous fluorophotometry. Anterior chamber and posterior segment fluorophotometric findings were measured 5 and 60 minutes after injection of fluorescein. Results were compared to a group of healthy patients. RESULTS: Vitreous fluorophotometry demonstrated abnormal leakage of fluorescein in all vitreous sectors of the patients suffering from uveitis compared with the control group (p < 0.001). In the anterior chamber, leakage of fluorescein was not significantly different between the two groups (p > 0.05). CONCLUSION: Results obtained suggest that intermediate uveitis involves a generalized permeability disturbance of the posterior segment secondary to a diffuse vasculitis. However, in the anterior segment this disturbance is not found.

Adolescent↗
PubMed1995

[Uveitis with hypopyon in patients with acquired immunodeficiency syndrome, treated with Rifabutin].

BACKGROUND: Iridocyclitis has been identified as a dosage-dependent side effect in patients with the acquired immunodeficiency syndrome who are treated for Mycobacterium avium complex infections with systemic Rifabutin. We reviewed cases of acute hypopyon uveitis occurring in patients with AIDS to establish whether there was an association or not. METHODS: All patients were referred by an infection disease specialty service for complete ophthamological evaluation and ancillary laboratory. Six patients with AIDS, aged from 29 to 65 years, presented with acute unilateral hypopion. RESULTS: At the time of presentation, all six patients were receiving treatment for MAC infection with Rifabutin (dosage range, 300-600 mg/d) and four received Fluconazol. Results of microbiological investigations were negative. Hypopyon developed in the second eye of two patients. Hypopion resolved rapidly with intensive antibiotherapy without corticosteroids. CONCLUSION: Concomitant use of Rifabutin and Fluconazol may precipitate hypopyon uveitis. The cause of the uveitis is less certain, but the possible role of a microbiological agent cannot be ruled out.

AIDS-Related Opportunistic Infections↗
PubMed1995

[Uncommon ophthalmological involvement in chronic atrophic polychondritis].

OBJECTIVE: Report of two uncommon ocular manifestations of relapsing polychondritis (PR). METHODS: A 53 year-old woman presented with a uveal effusion. Diagnosis of PR was made 17 years later. A case of PR in a 41 year-old man is reported. The ocular manifestation was a pseudotumor of the lacrimal gland. CONCLUSION: The relapsing polychondritis must be known by the ophthalmologists. The ocular manifestations of this uncommon disease are significative and inflammatory.

Adult↗
PubMed1995

[Solitary oligodendroglioma of the optic nerve. Apropos of a case].

Proptosis, decreased vision and oculo-motor palsies developed in the left eye of a 14-year-old girl, without neurofibromatosis signs. Computed tomographic (CT) Scans of the head and orbit showed a large fusiform expansion of the left optic nerve without intracranial involvement. Magnetic resonance imaging improved contrast resolution over CT Scanning. A neurosurgical approach was performed and the optic nerve was resected from the back of the globe to the intracranial portion. Microscopic sections demonstrated oligodendroglioma, an unusual form of optic nerve glioma.

Adolescent↗
PubMed1995

[Orbital Erdheim-Chester disease].

Erdheim-Chester disease is related to a tissue infiltration of foamy histiocytes. Results of immunoperoxydase stains for S-100 and T6 protein, the Langerhans cells antigen, is negative. It is a multisystemic disease, and it particularly involves bones and orbit. The visual prognosis is threatened, and the disease may lead to a fatal issue. Treatments have poor effects on the disease. Patients sometimes have good symptomatic response to corticotherapy. This case was revealed by headaches and diabetes insipidus. The orbital infiltration was asymptomatic.

Adult↗
PubMed1995

[Palpebral mycosis].

A 47-year-old man presented with a necrotic and haemorrhagic ulceration of the lower eyelid. He had a-one-year history of secondary hepatocarcinoma. The patient underwent excision biopsy of the lesion. Histological examination showed fungal spores, which could be candida albicans.

Candidiasis, Cutaneous↗