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Biomedical subjects

J F Risse

Publications and source records attributed to J F Risse.

At least 19 recordsLinked to original sources

[Toxocara canis infection. 2 cases of peripheral granuloma in adults].

PURPOSE: We report two cases of toxocariasis peripheral granuloma in adults. METHODS: Diagnostic difficulties linked to parasite serologies, particular to these two cases, are presented. Serology is often poorly contributive, but PCA and/or vitreous study with the ELISA reaction to Toxocara canis homologous antigens in the endocular fluids are the most reliable means of reaching a diagnosis, as evidence in our two observations. In the same way, the presence of eosinophils and of IgE in the aqueous humor and or vitreous is of great importance for orienting the diagnosis. RESULTS: The treatment consisted in systemic steroids and granuloma cryotherapy associated with vitrectomy and for one case indentation due to a traction. Later, retinal membrane peel was performed for the same patient. No treatment with antihelminthic drugs was proposed. The functional and anatomic results were good in both cases (8/10-P2 and 6/10-P2). CONCLUSION: Toxocara canis infection is based on clinical aspects. The ELISA technique is useful for biological diagnosis.

Adult↗

[Spatial contrast sensitivity in patients with severe myopia].

PURPOSE: The purpose of this study was to assess the effects of amount of myopia, axial elongation staphyloma and type of optical correction on contrast sensitivity of high myopic subjects. METHODS: Fifty-one patients (91 eyes) were selected on the following qualifications: myopia > or = 8 dpt and/or axial length > or = 26 mm, and visual acuity > or = 0.1 recorded through spectacle lenses. Contrast sensitivity was measured using a "Moniteur Ophtalmologique" for all subjects when corrected with spectacle lenses, and thereafter on a lot of patients (50 eyes) wearing a contact lens. RESULTS: Contrast sensitivity obtained with spectacle lenses was significantly decreased over the whole spatial frequency range. The higher the spatial frequency was, the lower contrast sensitivity was. The impairment increased with the amount of myopia and axial length, but without positive correlation. Contrast sensitivity was significantly lower for only the three highest spatial frequencies measured (6.4; 12.8 and 25.6 c/deg), when a staphyloma (n = 52) was present by comparison with results obtained for eyes without staphyloma (n = 39). Differences between the two situations (spectacle lens vs. contact lens) were not significant for eyes wearing daily spectacle lenses; conversely, for myopic subjects generally fitted with contact lenses, contrast sensitivity with contact lenses was significantly better than that measured with spectacles for the three highest spatial frequencies tested. CONCLUSION: This suggests that the decrease in contrast sensitivity measured in high myopia is related to defects in the optical and neuro-retinal systems.

Adult↗

[True or supposed bacterial endophthalmitis. Study of anatomo-functional outcome apropos of 32 cases].

PURPOSE: Vision prognostic study depending on the germs and the therapic performed in bacterial endophthalmitis. METHODS: In a retrospective study over a period of 3 years (1991-1993), 32 cases of post surgery bacterian endophthalmitis were detected: 30 cases after cataract surgery (29 cases after extra capsular surgery and one case after intra capsular), one case after trabeculectomy and one case after keratoplasty. RESULTS: A risk factor was evidenced in 15.6% of the cases. Endocular samples were done in 68.75% of the cases. The positive rate was 36.4% showing a Staphylococcus in 5 cases out of 8 (62,5%). In 37.5% of the cases an intraocular antibiotic injection was associated to the anterior chamber punction. 40% of the cases contaminated with Staphylococcus regained a visual acuity of more than 3/10. For the two cases where a Streptococcus was isolated an evisceration was necessary. Our results show that a higher visual acuity was obtained when a posterior vitrectomy was performed. When the posterior vitrectomy was associated with a corticoid therapy, the visual prognostic was better. Thus, 71% of these cases regained a visual acuity of more than 3/10. CONCLUSION: Our results show that performing a posterior vitrectomy associated to a general corticotherapy within 48 hours from the bacterian endophthalmitis diagnosis would allow best vision improvement.

Adrenal Cortex Hormones↗

[Dacryocystorhinostomy using Nd YAG laser by the intracanicular approach].

Endocanalicular dacryocystorhinostomy is a recent surgical procedure for stenosis of the naso-lacrymal duct, thanks to a laser filter fitted into the heart of 800 mu diameter metallic pin constituting a rigid armed laser probe. We create a lacrymo-nasal orifice from inside the lacrymal bag towards the nose, using the laser fiber. The Nd YAG used is the solid state mobilisable Ophtalas sp 32 giving out infrareds at 1064 nm or green at 532 nm. The indications are the stenosis of the naso-lacrymal duct, the failed classical dacryocystorhinostomy, the conjunctivodacryocystorhinostomy and the stenosis of the common canaliculus. This surgical procedure compared to the classical surgical technics appears to the very promising due to its simplicity, innocuousness, time saving. Our results, still inferior to the classical technique for all indications (success rate: 70%) are very good for the idiopathic stenosis of the naso-lacrymal duct (success rate: 87.5%).

Adolescent↗

[Search for bacterial contamination of the aqueous humor during cataract surgery with and without local antibiotic prophylaxis].

PURPOSE: Bacterial contamination of anterior chamber at the end of cataract surgery, was compared between two techniques: extracapsular extraction and phacoemulsification. The effectiveness of preoperative antibiotic eyedrops using Norfloxacine 0.3% (Chibroxine) was also evaluated. METHOD: The study focused on 101 patients grouped according to surgical technique and presence of preoperative antibiotic eyedrops. Conjunctival sampling was made the day prior the surgery, as well as in the operating room, after skin and conjunctival desinfection with povidone iodine in all the patients included in the study. Aqueous humour was collected at the end of surgery. RESULTS: Eight samples out of 101 were positive which represents 7.9% of the cases. In 75% of the cases, the anterior chamber aspirate showed a different germ or non-recurrent germ in the second conjunctival sample. None of the included patients developed endophthalmitis. The two most frequent pathogens were Propionibacterium acnes in 62.5% of the cases, and Staphylococcus epidermidis in 50%. Another pathogen was found in a culture environment: Micrococcus roseus. In two samples, two different bacteria grew: Propionibacterium acnes and Staphylococcus epidermidis. Whatever the surgical technique, no statistically significant bacterial contamination was found. There was no significant statistical difference between patients who had local antibiotic eyedrops and those who did not. CONCLUSION: This study confirms the poor reliability of local antibiotic eyedrops to prevent surgical contamination. Furthermore performing an anterior chamber aspirate at the end of the surgery for risk patients would help the physician identify the pathogens involved in endophthalmitis in order to begin antibiotic treatment as soon as possible.

Administration, Topical↗

[Measuring visual field loss by automated perimetry in chronic glaucoma stabilized by trabeculectomy].

The progression of field loss was determined by Humphrey Automated threshold perimetry in the short and intermediate term after surgical trabeculectomy for chronic glaucoma: mean indices (MD, PSD et FOV) were studied before and after normalisation of the intraocular pressure. Risk factors such as secondary glaucoma, previous visual field defects and cardiovascular risk factors were significantly correlated to poor or bad progression of field loss: the mean variation of MD = +1.23 dB +/- 2.84 (p < 1.5%), the mean variation of PSD = 0.50 dB +/- 1.37 (p < 6%), but the mean variation of FOV was not significant; so 36% of field defects were improved, 42% were stabilized and 22% were aggravated. When the risk factors were absent, 86% of field losses were stabilised but when cardiovascular factors were present, only 64% were stabilised. These risk factors can also be used to ascertain the prognosis of post-surgical progression of visual field, as already shown in previous reports. Automated threshold perimetry was useful to study the visual field progression with standardized and reliable numerical parameters, allowing statistical computerised management of the patients with glaucoma.

Adolescent↗

[Trachoma in North Cameroon].

A study was carried out in the North of Cameroon concerning the frequency of trachomatous blindness among 3,326 cases of blindness. A 4.63% frequency was found. The results show a 2 women for one man sex ratio and differences between the studied ethnic groups. The role of hygiene is stressed in order to explain these numbers.

Cameroon↗

[Calculation of the implant: is it a useless luxury?].

Analysis of the means by which accuracy of intraocular lens power calculation could be improved with theoretical and linear regression formulas. The postoperative refractive errors with the lenses selected by the surgeon were compared with those observed with the emmetropic calculated power lenses and with a standard 20 diopters lens. A consecutive series of 100 eyes with less than 4.50 diopters of pre-operative myopia or hypermyopia, is evaluated. Postoperative refractive errors are out of the range -4; +4 diopters in 6% for standard lens, 4% for actually implanted lens, and 1% for emmetropic power calculated lens.

Algorithms↗

[Effects of laser chorioretinal photocoagulation].

Laser-chorioretinal interactions depend on: non controllable parameters: spectral transmission, absorption of tissue, scattering of laser, distribution of ocular chromophores, thermal conductivity of tissue. They are important determinant of laser tissue effects. parameters that can be monitored by the physician: size of the spot, pulse duration, laser energy and laser wavelengths. Theoretical predictions of laser-tissue interaction with the choroid and the retinal agree with histological and clinical data. The choice of physical parameters of laser must be done in order to prevent adverse effects as to obtain researched therapeutic goal.

Choroid↗

[Prognosis of treated temporal arteritis. Retrospective study of 87 cases].

Eighty-seven patients (mean age 73 years) with histologically proven Horton's disease were followed up in 5 different specialized hospital units from 1970 to 1984. Except for one patient treated exclusively with antimalarials, all were under corticosteroids. The mean initial dose of prednisone or equivalent was 0.7 mg/kg/day and the mean maintenance dose, 10 mg/day. Steroids could be discontinued in 21 cases after 36 months on average; the other patients could not be weaned, even though 4 of them had been on steroids for more than 10 years. Side-effects were noted in 43 cases. Twenty-four patients died, mostly of cardiovascular diseases. Survival rates were 89 +/- 6.35% at 1 year, 60.2 +/- 8.7% at 5 years and 48 +/- 11.3% at 10 years. In the long run, mortality in our series proved to be exactly the same as in the general population. Nineteen patients had ocular manifestations of giant cell arteritis always from the onset, except for a fall in visual acuity; 26 relapses were observed in 18 patients, either during reduction of steroid dosage (21 cases) or after withdrawal (5 cases). In 2 cases histology showed typical lesions of giant cell arteritis after 41 and 50 months respectively under corticosteroid therapy.

Aged↗