Biomedical subjects

Z Hajji

Publications and source records attributed to Z Hajji.

10 recordsLinked to original sources

PubMed2003

[Diabetic cystoid macular edema and vitrectomy. Preliminary results: about 19 cases].

INTRODUCTION: Vitrectomy can be performed to release the anteroposterior and tangential vitreoretinal tractions that sometimes create diabetic macular edema. The present study evaluates the efficacy of this treatment. MATERIAL AND METHODS: We retrospectively studied 19 operated eyes in 15 patients with diabetes over 17 months. The group's mean age was 61.4 years. There were 11 men and 4 women, with 13 cases of noninsulinodependent and two cases of insulinodependent diabetes. A vitrectomy was done by the same surgeon to detach posterior hyaloidal and inner limiting membranes. Two groups were defined and compared, one including patients whose visual acuity had improved and the other, patients with no improvement. We used Student's t test and Leven's test from SPSS. RESULTS: Improvement in visual acuity was observed in 57.8% of the eyes studied, stabilization was achieved in 26.3%, and regression was noted in 15.7%. Cystoid macular edema resolved in 68.42% of eyes. Furthermore, inner limiting membrane colored by indocyanine green was removed. An angiographic improvement was noted in 68.42% of eyes. There was no significant difference between the two groups allowing a definition of success criteria. CONCLUSION: Vitrectomy for diabetic cystoid macular edema is currently under study and seems effective given its encouraging results.

Age Factors↗

PubMed2003

[Should associated intraoperative and/or postoperative photocoagulation be systematic during or after vitrectomy for proliferative diabetic vitreoretinopathy?].

PURPOSE: To analyze the results of vitrectomy in proliferative diabetic vitreoretinopathy and to check whether systematic intra- and/or postoperative photocoagulation is necessary in most cases. PATIENTS AND METHODS: We retrospectively reviewed 108 patient records (137 eyes) of vitrectomy performed for complications of proliferative diabetic vitreoretinopathy between 1982 and 2000. Fifty-eight percent of the patients were women. The average age was 44 years. Sixty percent of the patients presented with diabetes type 1. Only 39% of the eyes had complete preoperative panretinal photocoagulation. Preoperative visual acuity was lower than 2/200 in 81% of eyes, 27% presenting initially with traction retinal detachment involving the macula. The surgical technique used was segmentation-delamination. Endodiathermy was necessary in 45% of the eyes and intraoperative photocoagulation was not performed. Postoperative complementary photocoagulation was carried out in only 9% of the eyes. RESULTS: Results were analyzed with an average follow-up of 66 months. Anatomical success was obtained in 69% of the eyes, with 55% visual improvement. These results were unchanging at long-term follow-up in 95% of the eyes studied. Iatrogenic retinal breaks were observed in 8% of the eyes. Postoperative complications were dominated by single (8%) or recurrent vitreous hemorrhage (8%). The rate of postoperative neovascular glaucoma was approximately 5%. These results are similar to the rates reported by other authors using intraoperative endophotocoagulation. CONCLUSION: Intra- and/or postoperative photocoagulation should not be systematic but reserved for management of iatrogenic retinal breaks and also for extensive panretinal photocoagulation in recurrent vitreous hemorrhage.

Adult↗

PubMed2003

[Melanoma of the iris and pregnancy].

Iris melanoma is a malignant melanocytic tumor, making up 1.2%-6.6% of uveal malignant melanomas. The growth of choroidal melanoma during pregnancy is described and a hormonal influence is suggested. We present a case of iris melanoma occurring during pregnancy. A 32-year-old woman, in the 28(th) week of her fifth pregnancy, was referred to the ophthalmologist with a 2-month history of blurred vision and pain in her left eye. The visual symptoms became progressively worse with decreasing vision. Her visual acuity was 20/70 in her left eye, with a temporal, pigmented, prominent iris mass extending into the trabecular meshwork and the corneal endothelium. Elsewhere other pigmented localizations were found in the iris and in the trabecular meshwork. There was secondary glaucoma with intraocular pressure of 36mmHg and C/D=0.9. The right eye was normal. A general physical examination found no pigmented lesions. Chest radiography and hepatic ultrasonography revealed no metastasis. The diagnosis of iris malignant melanoma was made from the diffuse involvement extending into the trabecular meshwork and the advanced secondary glaucoma; an enucleation was performed and histopathological examination confirmed the diagnosis of iris melanoma with involvement of the trabecular meshwork. The patient had no further problems (follow-up of 11 months). From this case report, we discuss the differential diagnosis of iris melanoma and the hormonal influence on its growth.

Adult↗

PubMed2003

[Solitary retinal astrocytic hamartoma simulating retinoblastoma].

Retinal astrocytic hamartoma and retinoblastoma may be very similar clinically and their differentiation in atypical cases can be difficult, even with the use of ultrasonography and computed tomography. In such cases, a close follow-up is recommended before enucleation. This paper reviews the case of a 18 month old girl who presented with a solitary retinal astrocytoma of the right eye, without any other physical or ocular disorder. The initial presentation simulated a retinoblastoma; nevertheless atypical patterns as yellow calcifications and the lack of tortuous and dilated feeding blood vessels were present. Ophthalmoscopic and ultrasound regular evaluation did not reveal any change after one year follow-up. Additional investigations performed in order to exclude tuberous sclerosis (neurological and dermatological examination, CT-scans) showed no other organ involvement, which ruled out a phakomatosis. The clinical appearance and course of astrocytic hamartomas, its differential diagnosis from other retinal tumors, especially retinoblastoma, and its association with tuberous sclerosis are discussed.

Calcinosis↗

PubMed2002

[Ophthalmic manifestations of acute leukemia].

Orbital and ocular lesions are the third most frequent extramedullar locations of acute leukemia after the meninges and testicles. These lesions are treated as a central nervous system lesion; therefore diagnosis is essential to therapeutic adjustment. We present a retrospective study on charts of children treated for acute leukemia between 1996 and 1998. Ophthalmic examination was carried out when there were ocular symptoms. One hundred ninety-six children were treated for acute leukemia. Twelve children (6.1%) had an ocular and orbital lesion: 7 boys and 5 girls, with an average age of 6 years. Six had acute lymphoblastic leukemia, 6 had acute myeloid leukemia. Visual acuity was 1/10 in 9 children. Four children had an initial orbital lesion with a rapidly progressing exophthalmos. The hemogram and myelogram showed a granulocytic sarcoma. Two children who had been previously treated for acute leukemia presented a bilateral anterior uveitis with hypopyon; anterior chamber paracentesis showed blast cells and confirmed the ocular relapse. A corneal lesion was found in 2 children and in 2 cases, the optic nerve had edema; a decrease in visual acuity was the sign of the optic nerve lesion. Two patients had retinal infiltration with hemorrhages in the posterior pole. Prophylaxis consists of intrathecal injection of methotrexate and reinforcement of chemotherapy. Central nervous system irradiation is seldom used in children. Orbital and ocular lesions carry a poor prognosis according to the majority of authors. Two years after diagnosis of the ocular lesions, only 1 of the children studied remains alive.

Acute Disease↗

PubMed2002

[Choroidal nevi associated with serous macular detachment].

PURPOSE: To describe the aspect and progression of choroidal nevi associated with macular serous detachment and to analyze different treatments. MATERIAL: and methods: Twelve posterior choroidal nevi were associated with subretinal fluid. The fovea was detached in 11 cases. Tumor thickness was 2 mm or less. RESULTS: No treatment was given in 6 cases and spontaneous subretinal fluid regression was observed in 3 of these 6 cases. Success was also observed in 2 of 3 cases treated with corticotherapy, but subretinal fluid recurred. Gas injection was performed in 1 case and transpupillary thermotherapy in 2 others, all 3 with successful definitive drying of the nevus. Visual acuity decreased in 6 cases (in 3 untreated cases and in 3 cases treated with corticotherapy), remained stable in 3 cases, and increased in 3 cases (in 1 untreated case, in 1 gas injection case, and in 1 case after thermotherapy). Tumor growth was observed in 3 cases, on the average 2 years after diagnosis (25%). CONCLUSION: Subretinal fluid is rarely observed with choroidal nevi and its progression is variable. Various treatments in addition to observation such as corticotherapy, gas injection, transpupillary thermotherapy seem effective in stabilizing or improving visual function. Supervision is nevertheless needed to detect tumor growth that can be frequent in these nevi associated with subretinal fluid.

Adrenal Cortex Hormones↗

PubMed1998

[Wolfram syndrome. Three case reports].

Wolfram syndrome is a rare disorder defined by the occurrence of diabete mellitus, diabete insipidus, optic atrophy and deafness; DIDMOAD is a commonly accepted acronym. We report 3 further cases: two girls and one boy. Their age ranged from 12 to 17 years. The diagnosis was based on the presence of juvenile diabete mellitus, bilateral optic atrophy, urologic signs, with urinary tract dilation; and deafness in two cases. The ophthalmic signs of Wolfram syndrome are progressive decrease in visual acuity, constriction of the peripheral visual field with or without central scotoma, color vision disturbances and bilateral optic disc atrophy. Diabetic retinopathy is a rare complication. The other clinical features are discussed so as to differentiate between Wolfram syndrome and other optic atrophies associated with diabete mellitus. We discuss of the pathogenic hypothesis including the mitochondrial dysfunction.

Adolescent↗

PubMed1996

[Retinal vasculitis].

PURPOSE: The purpose of this study is to determine aetiologies of vasculitis of retina in Morocco. MATERIAL AND METHODS: This is a retrospective study on 108 cases of vasculitis of retina admitted in the ophthalmology department, for a 5-year period (1987-1993). Our patients had a complete ophthalmological examination : fluorescine angiography, colour vision, general examination and biological study. RESULTS: Many aetiologies have been found, predominantly Behcet's disease. The neovascularization of retina which complicates the vasculitis was detected in 30 % of our patients. A laser photocoagulation was performed on these cases, sometimes a vitrectomy was necessary when a haemorrhage of vitreous body occurred, complicating the neo-vessels of retina. The therapeutics received by our patients was based on the corticotherapy. An immunosuppression treatment was prescribed in most cases of Behcet's disease and in severe vasculitis. Outcome after treatment has been satisfactory, but many patients relapse very frequently, mainly those with Behcet's disease. CONCLUSION: Causes of vascular retinitis are variable, most of them are due to Behcet's disease.

Adult↗

PubMed1995

[Outcome of Behçet disease in ophthalmologic practice in Morocco].

We treated 123 patients with Behçet's disease during a period of 10 years (1984-1993). The ocular lesions include uveal lesions especially the posterior lesions and vascular retinal. Uveitis was total in 72% of cases. Periphlebitis occurred in 51% of cases, vein occlusion in 10% of cases, macular oedema in 16% and papillary oedema in 10%. Clinical course and prognosis were studied. The functional prognosis is poor as such lesions may lead to blindness, particularly due to papillary oedema maculopathy. The treatment used is based on immunosuppressive and corticoid steroid drugs.

Adult↗

PubMed1995

[Outcome of Behçet disease in ophthalmological milieu in Morocco].

Adult↗