[Status of low-vision rehabilitation for age-related macular degeneration by orthoptists in the North of France]. / "Etat des lieux" en rééducation orthoptique Basse Vision dans la région Nord-Pas-de-Calais.

AIM OF THE STUDY: To evaluate the status of low-vision rehabilitation carried out by the orthoptists in the North of France. This study was a preliminary step in setting up a network between different vision professionals for the management of age-related macular degeneration (AMD) the North of France. METHODS: The ASO (Association Septentrionale d'Ophtalmologie) conducted a survey funded by the URCAM (Union Régionale des Caisses d'Assurance Maladie) with the FAQSV (fond d'aide à la qualité des soins de ville). The survey was based on the analysis of two forms sent to orthoptists of the North region of France. RESULTS: The survey analyzed 46 responses (a representative sample with 69% responses) providing a description of the orthoptists of the North of France: 19% males, 81% females whose mean professional experience was 13.3 years. Thirty-four percent of the orthoptists have had training in low-vision rehabilitation. This training was given during the university courses for 21% of responders and during a postgraduate course for 79%. Of the orthoptists surveyed, 64% worked in a private context, 9% in a public context, and 27% in both public and private contexts. Their main activity was in their own private practice for 60%, in an ophthalmologist's office for 20%, in a public institution for 16%, and a private institution for 4%. The mean number of patients treated was 70 per week per orthoptist, with 21% working mostly with children, 36% working mainly with adults between 16 and 60 years of age, and 7% with the elderly, whereas 36% reported no specificity related to patient age. The mean number of patients dealt with for low vision related to AMD was 4.1 per month per orthoptist. The average number of patients dealt with for low vision with no relation to AMD was 1.5 per month. The prescriber of low-vision rehabilitation was an ophthalmologist for 88.9% of the orthoptists and a general practitioner for 11.1%. Questions addressed to AMD patients: at the beginning of the survey, 83.8% of the patients did not have sufficient visual acuity to be able to read a text of current size (Parinaud 4); 40.4% of the patients required help for everyday life, and 59.6% were autonomous. For 7.1% of the patients, low-vision rehabilitation was carried out less than 1 month after the stabilization of retinal lesions, but in 35.3%, rehabilitation was carried out more than 2 years after lesions were stabilized. The main request of the patients involved improvement of near vision (89.9%). CONCLUSION: This survey will be a preliminary step in setting up a regional health network coordinating the ophthalmological and orthoptic management of AMD.

[Retinal pigment anomalies associated with Fabry's disease]. / Anomalies pigmentaires rétiniennes associées à une maladie de Fabry.

INTRODUCTION: Fabry's disease is an X linked disease with ocular, skin and kidney lesions. We report a case which presented all the ophthalmologic signs and particular retinal manifestations. CASE REPORT: Fabry's disease was suspected in a 18 year old young man, with angiokeratomes, attacks of pain located in fingers, toes and also in the abdomen. Typical ocular morphological findings, namely whorl-like corneal opacities, posterior spoke-like cataracts and tortuosity of conjunctival vessels were found. His mother had the same ocular signs. The patient was also examined with fluorescein fundus angiography. DISCUSSION: The diagnostic value of the ocular abnormalities can be significant and are very indicative of the disease in hemizygous and heterozygous patients. Except the retinal vascular tortuosity, we describe peripheric abnormalities of the retinal pigment epithelium suggesting another disease finding.

High hyperopia with papillomacular fold.

We report a case of evolutive high hyperopia in a child aged 10 years. It is associated with organic amblyopia due to a large papillomacular retinal fold. Ultrasonography and CT scan helped to establish the diagnosis. This is probably a hereditary disease affecting the development of the posterior sclera.

[Pyocyanic corneal abscess]. / Abcès cornéens à pyocyanique.

The authors report 3 different cases of pseudomonas abscess of the corneal layers: these occurred; one on a soft lens; the second one apparently without any reason; the last one 2 days after a corneal traumatism. In spite of rapidly administrated antibiotherapy, the abscess spread very rapidly and left a residual corneal macula.

[Value of electroretinography and early echography in severe eye injuries]. / Intérêt de l'électrorétinographie et de l'échographie précoce dans les traumatismes oculaires graves.

We tested Dawson-Trick-Litzlkow (DTL) fiber electrode as the active electrode in electroretinogram associated with an B echography in important ocular trauma. The advantages are its atraumatic characteristic and the good quality of the electroretinogram.

[The use of expansive gas in retinal detachment complicated by vitreoretinal proliferation]. / Utilisation des gaz expansifs dans les décollements de rétine compliqués de prolifération vitréo-rétinienne.

We used quantities of perfluoropropane as a substitute of vitreous in some cases of retinal detachment with vitreoretinal proliferation. It seems to be a good method compared with the injection of silicon oil for in 23 cases treated recently, the evolution of the vitreoretinal proliferation seems to have stopped better than with silicon oil. Postoperative intraocular pressure surveyance is highly advisable.

[Complications of dermolipoma ablation]. / Les incidents de l'ablation du dermolipome.

Complication following surgical cure of two dermolipomas producing a ptosis due to section of the elevator muscle. Analysis of the cause. Partial ablation or exposure of the elevator before posterior dissection are needed to avoid this complication.

[Jaffe's syndrome and anomalies of capillary permeability]. / Syndrome de Jaffé et anomalies de la perméabilité capillaire.

The parallelism between ophthalmoscopy and angiography in the different grade classifications of idiopathic epiretinal membranes is not compulsory: spotty and irregular fluorescein leakage is apparent in many cases, even early. This leakage, who might bring biochemical factors stimulating cellular migration and proliferation could therefore be usually associated with more progression of the membrane.

[Choroidal granuloma in sarcoidosis. Discussion apropos of 2 cases]. / Granulome choroïdien sarcoïdosique. Discussion à propos de deux cas.

Specific granuloma of the choroid is an exceptional localization of sarcoidosis. It is characterized by overlying neurosensory retinal detachment without anterior uveitis. Other more frequent findings can be revealed by fundus examination in sarcoidosis. Choroidal granuloma is often part of a systemic sarcoidosis. Most often, systemic corticosteroid therapy provides a prompt improvement of the lesion. The diagnosis relies on clinical and paraclinical informations which are reviewed in this survey on recent cases.