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T Maalouf

Publications and source records attributed to T Maalouf.

At least 19 recordsLinked to original sources
PubMed2005

[Surgery of lacrimal secretion].

Surgical treatment of lacrimal secretion consists in reducing the product of tears in the lacrimal gland. Denervation of the lacrimal gland was described long ago by Whitwell and remains in current use. Recently, injection of botulinum toxin into the lacrimal gland was successfully carried out. In our department, we have been developing lacrimal duct orifice cauterization for several years. We discuss these three methods and develop the latter in greater detail.

Female↗
PubMed2004

[Palpebral edema secondary to treatment by a specific inhibitor of tyrosine kinase: Glivec. A case report].

Iatrogenic causes for palpebral edema are rarely suspected and must be specifically sought. The authors report a case of palpebral edema in a patient treated with a specific inhibitor of the BCR-ABL tyrosine kinase (Glivec) for chronic myeloid leukemia. Histopathological analysis of specimens of the excised upper eyelid tissue revealed the absence of leukemic infiltration, suggesting the toxic effect of the treatment. This side effect should be noted so that patients are informed and biopsy is proposed to eliminate tumoral infiltration.

Aged↗
PubMed2004

[Abnormal eyelid positions in Brown syndrome].

PURPOSE: To describe the possible abnormal upper eyelid positions in congenital Brown syndrome (BS) and discuss physiopathology. CONTEXT: A typical symptom of BS, the incapacity to raise the eye in adduction, is usually accompanied by a retraction of the upper eyelid. However, as the abnormal position of the eye often refers to a patient looking straight ahead into the distance, abnormal eyelid positions are possible but are on the whole unknown. PATIENTS AND METHODS: The study investigated 82 patients with unilateral congenital BS, who consulted between 1989 and 2001. The primary position of the upper eyelid concerned was carefully measured, each side separately. The patients were then classified into three groups according to the type of difficulty encountered when raising the upper eyelid: group 1--those with a raising deficiency in adduction (42 cases), group 2--those with a raising deficiency in adduction and in primary position (26 cases), group 3--those with a global raising deficiency with predominance in adduction (14 cases). Fifty patients were operated on for strabismus, after which the position of the upper eyelid was remeasured. RESULTS: An abnormal position of the upper eyelid was noted in 23 patients (28%) and the distribution between the different groups was as follows: group 1, 14%; group 2, 30%; group 3, 63%. The following malpositions were found: pseudoptosis with hypotropia, eight cases; ptosis, six cases; pseudoretraction with vertical oculomotor disorder, five cases; real upper eyelid retraction, four cases. Ptosis and pseudoptosis were observed more often when BS involved the nondominant eye; retraction or pseudoretraction was observed more often when BS involved the dominant eye. After surgery for vertical strabismus, the abnormal position of the upper eyelid had remarkably decreased and only three cases required specific surgery for ptosis. CONCLUSION: The abnormal position of the upper eyelid in primary position was found in nearly one-third (28%) of the patients with BS, therefore a quite frequent occurrence. It sometimes involved associated congenital ptosis. However, the most frequent symptom was a deficiency of the eyelid that was caused either by the patient being incapable of preventing the eyelid from falling (ptosis and pseudoptosis) or the patient making a compensatory effort to raise the eyelid (retraction and pseudoretraction).

Adolescent↗
PubMed2002

Risk of dry eye after mullerectomy via the posterior conjunctival approach for thyroid-related upper eyelid retraction.

INTRODUCTION: Mullerectomy by a conjunctival approach is an excellent way to reduce thyroid-related superior lid retraction. Especially the lateral horn of the levator, into the lacrimal gland, has to be reduced. Alterations in lacrimal secretion have been hypothesized, but never studied. MATERIALS AND METHODS: The basal and reflex Schirmer test and functional status were studied in 39 patients with thyroid-related orbitopathy after mullerectomy by a conjunctival approach (12 functional, 27 cosmetic indications). In 24 patients, the results could be compared with those of other measures carried out pre- or postoperatively or, in case of unilateral surgery, the operated and non-operated sides were compared. RESULTS: The Schirmer test was reduced in 7 of 12 functional cases and in 4 of 27 cosmetic cases. Although tear production was reduced, only two patients had to have increased dosages of artificial tears and two other patients required punctum plugs. Among the 12 functional indications, 10 showed an improved corneal surface. CONCLUSION: Lacrimal production may be reduced after mullerectomy by the conjunctival approach. Nevertheless, the clinical risk is low in comparison with the functional and cosmetic results of the procedure. At present, we try to identify and preserve the lacrimal ostia during surgery.

Blepharoplasty↗
PubMed2002

[Ocular involvement during primary central nervous system lymphoma].

PURPOSE: The aim of our study was to assess and to characterize the ocular involvement in patients with primary central nervous system lymphoma. POPULATION AND METHODS: We conducted a prospective study between August 1995 and December 1998 on a cohort of consecutive patients affected by primary central nervous system lymphoma and who underwent a systematic ophthalmological examination before treatment. RESULTS: The study population comprised 24 patients (mean age, 57 years; 16 women and 8 men). Among these patients, 6 had ocular involvement (2 patients with ocular signs revealing the cerebral process, 2 evidenced at the time of the initial ocular examination, and 1 as the disease evolved). Ocular involvement was vitritis in all cases, anterior uveitis in 1 patient, obliterant vasculitis in 1 patient and yellowish subretinal lesions in 1 patient. In 1 case, a vitrectomy led to adequate diagnosis of the disease. CONCLUSION: Our study shows a 25% incidence of ocular involvement in patients with primary central nervous system lymphoma, with posterior uveitis as the most common manifestation. Because of the relatively high incidence of ocular involvement, a systematic ophthalmological examination of this subset of patients should be mandatory.

Adult↗
PubMed2001

[Dilated cardiomyopathy and panuveitis as presenting symptoms of Lyme disease. General review of one case].

INTRODUCTION: The clinical expression of Lyme disease is highly variable. If a patient presents clinical findings consistent with a systemic Lyme borreliosis, this disease must be considered in an endemic area because of its favorable outcome with adequate treatment. EXEGESIS: The authors report and discuss the case of a patient with an unusual history of dilated cardiomyopathy and supraventricular fibrillation followed by bilateral panuveitis. Enzyme-linked immunosorbent assay and Western blot were positive for Borrelia burgdorferi antigens. The diagnosis of Lyme disease was made after other infectious, inflammatory and autoimmune disorders were excluded by clinical, instrumental and biological investigations. The treatment by ceftriaxone and amoxicillin resolved the ophthalmologic manifestations and improved the cardiac condition. CONCLUSION: This report underlines the possibility of an unusual presentation of Lyme disease. Ophthalmologic and cardiac involvement should be known by clinicians.

Adult↗
PubMed2001

Recurrent orbital myositis and Crohn's disease.

Diagnosis of orbital pseudotumor remains rare in Crohn's disease; to the best of our knowledge, only six cases have been reported. In these cases, the diagnosis of Crohn's disease was made before or pending that of the orbital pseudotumor. In the present paper, we present and discuss a new case with a concomitant evolution between these two diagnoses. In our case, the diagnosis of orbital pseudotumor was made two years before that of Crohn's disease. Orbital biopsy showed a polyclonal monomorphous lymphoid infiltration and supported the hypothesis that orbital inflammation in Crohn's disease is indirect and is probably due to immune-mediated disorders.

Journal Article↗
PubMed2001

[A full thickness macular hole as an uncommon complication of Behçet disease].

The authors report the occurrence of an unusual complication of Behçet's disease: a full thickness macular hole caused by retinal vasculitis resulting in a definite functional impairment. A review of the different ocular complications is provided, stressing the unusual location on the posterior segment and the potential seriousness of these complications.

Adrenal Cortex Hormones↗
PubMed2001

[Clinical course and prognosis of diplopias after orbital bony wall decompression for thyroid related orbitopathy].

INTRODUCTION: The aim of this study was to assess how oculomotor complications progress after orbital bony decompression for dysthyroid orbitopathy and to assess the residual risk of consecutive diplopia. MATERIAL AND METHODS: The medial orbital wall and floor were decompressed by a transpalpebral approach in 77 patients (117 orbits). Indications for decompression were optic neuropathy in 22 patients, exposure of the cornea in 1 patient, and cosmetic rehabilitation in 54 patients. Occurrence of oculomotor disorder after surgery was noted and the clinical course after a one-year follow-up was studied. RESULTS: Diplopia was observed in 34 patients (44%): 18 of these patients were treated by external orbital radiotherapy before surgery. Diplopia decreased spontaneously over a period ranging from 15 days to 2 months or was treated by adequate prism in 22 cases. A higher degree of diplopia (12 to 30 diopters) was noted in 12 cases, requiring surgical care that was successful in all cases. This progress was especially observed in patients with optic neuropathy or in patients who had been previously treated with external orbital radiotherapy. CONCLUSION: Prognosis of diplopia after bony wall decompression for thyroid-related orbitopathy can be favorable with spontaneous reduction, prism, or surgical treatment. Precise information should be given to the patients before surgery.

Adult↗
PubMed2001

[Gyrate atrophy and craniopharyngioma: a case report].

We report the case of a 13-year-old girl who developed a craniopharyngioma and a gyrate atrophy. No genetic link between these two diseases has ever been reported. This case recalls the characteristic features of gyrate atrophy.

Adolescent↗
PubMed2000

[Endogenous aspergillus endophthalmitis: a case repport].

We report a case of endogenous aspergillus endophthalmitis. This infection occurred in a young immunocompromised boy of 6 years old. The localisation of the chorioretinitis was unusual because out of the posterior area. The evolution was favorable with recovering of the visual acuity under general treatment and intravitreous injections.

Amphotericin B↗
PubMed1999

Place of radiotherapy in the treatment of Graves' orbitopathy.

PURPOSE: The aim of this study is to evaluate the response of Graves' orbitopathy to irradiation, and to specify the prognostic factors allowing one to better define the indications of orbital radiotherapy. METHODS AND MATERIALS: From 1977 to 1996, 199 patients received bilateral orbital irradiation delivering 20 Gy in 10 fractions and 2 weeks for a progressive Graves' orbitopathy. 195 patients were seen between 1 and 6 months after radiotherapy. The different symptoms were studied and their response to radiation was analyzed. Factors such as age, sex, evolution of thyroid disease, history of symptoms, and previous or combined treatments were analyzed. RESULTS: The results revealed that 50 patients (26%) had a good or excellent response, 98 (50%) had a partial response, 37 (19%) were stable, 10 (5%) had a progression of disease. The signs that best responded to radiotherapy were the infiltration of soft tissues and the corneal involvement. Responses of proptosis or oculomotor disorders were more complete when these signs were not advanced at the time of treatment. Irradiation seemed to have the same efficacy when applied as first-line treatment or after failure of corticosteroids. Neither modality of treatment of hyperthyroidism nor thyroid status at the time of orbital irradiation modified the results. The best results were recorded for early or moderately advanced presentation (p = 0.05). Patients treated within a delay of 7 months after the beginning of the ophthalmopathy had better responses than patients treated later (p = 0.10). CONCLUSION: Radiation therapy was successful in Graves' orbitopathy by stopping the progression of disease in almost all cases, by improving the comfort of patients, by obtaining objective responses, and by avoiding surgical treatments particularly when signs were moderate.

Adult↗
PubMed1999

What has become of our idiopathic inflammatory pseudo-tumors of the orbit?

OBJECTIVE. We looked for the development of specific systemic disease or malignant lymphoma in patients whose initial diagnosis was idiopathic inflammatory pseudo-tumor of the orbit (IOPT). PATIENTS AND METHODS. IOPT was diagnosed in 24 patients on the basis of imaging findings and surgical biopsies (70%). Nineteen of these 24 patients (10 men and 9 women, age range 19- 83 years) were reassessed 1-12 years after the initial diagnosis. RESULTS. The initial diagnosis described diffuse inflammation (33%), dacryoadenitis (20%) or myositis (47%). At reassessment, 4 patients had developed a specific disease: generalized lymphoma, Wegener's disease, necrotizing vasculitis, and Crohn's disease. All four were recognized within one year of the IOPT diagnosis. A biopsy was obtained in these four patients and was not contributive. One case of non-specific granulomatous proliferation was found 6 years after the initial diagnosis. One case of orbital meningioma occurred 10 years after radiotherapy of the orbit and could not be attributed to a definite cause. The other patients had a common non-specific clinical course; recurrent inflammation required corticosteroid therapy in 55% and complementary external radiotherapy of the orbit in 22%. DISCUSSION AND CONCLUSION. Specific diseases that developed after an initial diagnosis of inflammatory pseudo-tumor of the orbit occurred early and appeared more often in diffuse forms, suggesting the need for more extensive histopathological diagnostic procedures. The clinical course tended to be more quiescent in patients who passed the critical period of the first year.

Journal Article↗