The prevalence of retinopathy is similar in diabetes mellitus secondary to chronic pancreatitis with or without pancreatectomy and in idiopathic diabetes mellitus.

In a retrospective study, we compared the prevalence of retinopathy in two groups of 88 diabetic patients (84 men, 4 women) with either diabetes mellitus secondary to chronic pancreatitis (CP-DM group) or idiopathic diabetes mellitus (I-DM group). The patients of these two groups were pair-matched according to age (48.7 +/- 1.1 versus 48.8 +/- 1.0 yr in CP-DM and I-DM groups, respectively; mean +/- SEM), sex, duration of diabetes (7.96 +/- 0.56 versus 8.08 +/- 0.8 yr) and therapy (80 on insulin and 8 on oral hypoglycemic agents in each group). Retinopathy was assessed by bilateral ophthalmoscopic examination of the fundus after pupillary dilation in all 176 patients and by fluorescein angiography in 47 patients with CP-DM and 35 patients with I-DM. Forty-one percent of patients in the CP-DM group and 45.5% of patients in the I-DM group had diabetic retinopathy (P greater than 0.5). In each group, patients with retinopathy were older than patients without retinopathy (51.6 +/- 1.3 versus 46.7 +/- 1.8 yr in the CP-DM group, P less than 0.01, and 52.1 +/- 1.5 versus 46.0 +/- 1.2 yr in the ID-M group, P less than 0.01). They had diabetes of longer duration (10.9 +/- 1.0 versus 5.9 +/- 0.6 yr in the CP-DM group, P less than 0.001, and 10.5 +/- 1.0 versus 6.0 +/- 0.6 yr in the ID-M group, P less than 0.001). The prevalence of retinopathy increased parallel to the duration of diabetes in a similar way in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Visual evoked potentials in diabetic patients.

Visual evoked potentials (VEPs) were assessed in 50 adult type I (insulin-dependent) and 19 type II (noninsulin-dependent) diabetes mellitus patients and in 54 controls. P100 wave latency was significantly longer in diabetic patients (P less than .001). Twenty-eight percent of diabetic patients had P100 wave latencies above the normal range. There was no correlation between P100 latency and type or duration of diabetes mellitus, quality of metabolic control, or presence of degenerative complications. The significance of VEP abnormalities in diabetes mellitus remains speculative.

[Submacular neovascular membrane and drusen of the optic disk]. / Membrane néovasculaire sous-maculaire et drusen de la papille.

A case of unilateral serous hemorrhagic maculopathy with a very acute course is reported in an eight year old girl fluorescein angiography revealed the presence of a subretinal neovascular membrane extending from the inferotemporal part of the disc to the macula; CT scan identified calcified drusen of the optic disc. Ophthalmoscopy and angiography one year later showed a glial macular scar, absence of hemorrhage and serous detachment. Visual acuity was reduced to counting fingers. This unusual type of maculopathy combining optic disc drusen and a neovascular membrane contradicts the classically benign prognosis of optic disc drusen.

[A new etiology of episcleritis: nephropathies with IgA and/or isolated C3 deposits]. / Une nouvelle étiologie des épisclérites: les néphropathies à IgA et/ou C3 isolé.

Scleritis is a condition of the eye often associated with systemic diseases, allergy and infections. Nomoto et al. have reported the frequency of episcleritis in patients with IgA nephropathy (Berger's disease), a primary glomerulonephritis initially described by Berger in 1968. It is characterized by mesangial deposits of IgA, and is considered one of the most frequent nephritides in France. We report our study of the association of scleritis with glomerulonephritis (GN). Fifty-three GN patients were examined for the presence of scleritis. The exact type of nephropathy in each patient was determined by a renal biopsy and immunofluorescence studies. Episcleritis was found in 10 GN patients: in 5 out of 27 Berger's disease, 3 out of 4 patients with isolated mesangial C3 deposits, 1 out of 2 patients with membraneous GN, and 1 out of 5 patients with membranoproliferative GN. The finding of episcleritis in 18% of patients with IgA nephropathy is very similar to the results reported by Nomoto et al. (15%). As no other cause of episcleritis was found in these positive patients, the ocular lesion may be considered to be related to their GN. Episcleritis patient had no abnormal levels of serum IgA, but circulating immune complexes activating the alternate pathway of the complement system were present in most of them. In one female patient with Berger's disease and frequent episodes of episcleritis, an episcleral biopsy was obtained for immunohistological studies. Large numbers of dimeric IgA secreting plasma cells were observed in this tissue. These results suggest the involvement of ocular surface immunity in some cases of IgA nephropathy. It might therefore be useful to investigate the renal function of patients presenting recurrent episodes of episcleritis.

[Serous macular detachment of the neuro-epithelium and flumequine]. / Décollements séreux maculaires du neuro-épithélium et fluméquine.

Flumequine (1 200 mg/day) was prescribed as treatment for infection of the urinary tract to three patients with chronic renal failure, who reported positive scotoma three days later. Ophthalmologic examination evinced bilateral symmetrical macular bullae. A characteristic yellow papule was present at foveal level. In all three cases, visual acuity was impaired (down to 4/10), without any angiographic alteration. Foveolas showed a moderate persistent hyperfluorescence. All patients recovered a normal visual acuity, within two days after treatment cessation, and bullae disappeared without sequelae within 5 days. The chronology and kinetics of clinical manifestations were clearly and reproducibly correlated with flumequine therapy in all patients, and suggest that this drug may be considered responsible for the ocular symptom reported. Chronic renal failure (creatinine clearance lower than 25 ml/mn) most certainly favoured the appearance of visual troubles, but other factors may possibly play a similar role: hepatic failure, individual hypersensitivity... Quinolones used as urinary antiseptics (nalidixic acid, oxolinic acid, pipemidic acid...), and other flumequine analogues may possibly be involved in such side-effects. This was reported by Bouissou et al. in an experimental model with nalidixic acid, where transient bullae appeared on young animals' articular cartilage. Such lesions are related to focal alterations of the C2 intermediary layer of cartilage, with marked edema of the interstitial material. The volume of synovial fluid increases concomitantly. These alterations suggest a direct cytotoxic effect at the intercellular level of target organs, a mechanism possibly also occurring in the retina.

[Pituitary adenoma revealed by Traquair's syndrome]. / Adénome hypophysaire révélé par un syndrome de Traquair.

Junction scotoma is a classic field defect initially described by Traquair in 1917. Sparse cases have been reported until today. The authors report a silent pituitary adenoma in a 58 year-old female revealed by a junction scotoma. The field defects secondary to insult of chiasma from pituitary tumors besides usual bitemporal hemianopsia are reviewed by the authors. The possibility of minor ophthalmologic symptoms despite voluminous tumor has to be emphasized.

[Surgical treatment of sequelae of Basedow's orbitopathy]. / Le traitement chirurgical des séquelles de l'orbitopathie basedowienne.

Sequellae of Graves' orbitopathy often need a functional or cosmetic correction. The different procedures are reviewed with special commentary (orbital decompression, surgery of oculomotor disturbances, lid retractions and orbital fat protrusion). A modified procedure for levator lengthening is described.