Visual field defects due to optic nerve drusen in Afro-Caribbean patients: A case series of 16 eyes.

INTRODUCTION: Optic Nerve Head Drusen (ONHD) are very rare among black patients but may cause more severe visual defects in these patients. The goal of our study was to describe the frequency of visual field defects secondary to OND in Afro-Caribbean patients and study the characteristics of their physical examination, color vision and contrast sensitivity. METHODS: We carried out a prospective study at the Martinique university medical center on patients of African descent with ONHD diagnosed on fundus examination and B-scan ultrasonography. All patients received a complete neuro-ophthalmological examination. The primary study endpoint was the frequency of visual field defects. Secondary study endpoints were the results of ETDRS visual acuity, Pelli-Robson contrast sensitivity chart, and 15 hue color vision test. RESULTS: Sixteen eyes of 10 patients from 11 to 68 years of age were included. Forteen eyes (87%) had exposed ONHD. Eleven eyes (69%) showed a visual field defect: 9 eyes (69%) had an enlarged blind spot, and 9 eyes (69%) had an arcuate scotoma. 3 eyes (19%) had loss of ETDRS visual acuity, and 12 eyes (75%) showed loss of Pelli-Robson contrast sensitivity. Five eyes (31%) had an abnormal color vision test. CONCLUSION: This is one of the largest case series of ONHD in Black patients. The frequency of visual field defects was high but comparable to that of studies in other ethnic groups. Larger comparative studies are necessary to confirm these results.

Macular hole following Bartonella henselae neuroretinitis.

PURPOSE: To report a case of macular hole secondary to Bartonella henselae neuroretinitis. METHODS: Observational case report. An 11 year-old boy presented urgently with a decrease of visual acuity in the left eye. Posterior segment examination revealed neuroretinitis attributed to Bartonella henselae. Treatment was initiated, resulting in the disappearance of symptoms. RESULTS: Follow-up consultations 7 months later showed a further decline in visual acuity secondary to a macular hole. CONCLUSIONS: Cat scratch disease is a rare pathology and is most often considered benign. Serious complications can nonetheless occur, such as neuroretinitis, choroidal nodules, and disciform keratitis. The authors report a case of sequellar macular hole. They found only one previous report of macular hole caused by B henselae, which, contrary to their case, appeared rapidly 12 days after presentation.

[Ocular manifestations of emerging arboviruses: Dengue fever, Chikungunya, Zika virus, West Nile virus, and yellow fever (French translation of the article)]. / Manifestations oculaires des arboviroses émergentes : dengue, chikungunya, infection à virus Zika, fièvre du Nil occidental et fièvre jaune.

Arboviruses are viral diseases transmitted by mosquitoes and tics bites. They are a major cause of morbidity and sometimes mortality. Their expansion is constant and due in part to climate change and globalization. Mostly found in tropical regions, arboviruses are sometimes the source of epidemics in Europe. Recently, the Chikungunya virus and the Zika virus were responsible for very large epidemics impacting populations that had never been in contact with those viruses. There are currently no effective antiviral treatments or vaccines. Ocular manifestations due to those infections are thus more frequent and increasingly better described. They are sometimes, as with Zika, complicated by a congenital ocular syndrome. The goal of this review is to describe the ophthalmological manifestations of Dengue fever, Chikungunya virus, Zika virus, West Nile virus, and yellow fever.

Ocular manifestations of emerging arboviruses: Dengue fever, Chikungunya, Zika virus, West Nile virus, and yellow fever.

Arboviruses are viral diseases transmitted by mosquitoes and tick bites. They are a major cause of morbidity and sometimes mortality. Their expansion is constant and due in part to climate change and globalization. Mostly found in tropical regions, arboviruses are sometimes the source of epidemics in Europe. Recently, the Chikungunya virus and the Zika virus were responsible for very large epidemics impacting populations that had never been in contact with those viruses. There are currently no effective antiviral treatments or vaccines. Ocular manifestations due to those infections are thus more frequent and increasingly better described. They are sometimes, as with Zika, complicated by a congenital ocular syndrome. The goal of this review is to describe the ophthalmological manifestations of Dengue fever, Chikungunya virus, Zika virus, West Nile virus, and yellow fever.

[Retinal detachment in preeclampsia: a series of three cases]. / Décollement de rétine et pré-éclampsie : à propos de trois cas.

Three Afro-Caribbean women presented with a decreased visual acuity associated with preeclampsia during the third trimester of pregnancy. Fundus examination exhibited a serous retinal detachment (SRD). Postpartum fluorescein and indocyanine green angiography indicated subretinal leakage induced by choroidal ischemia. The three patients had an improvement of their visual acuity to 20/20 within 2 to 3 months of the onset of symptoms. Fundus exam and fluorescein angiography showed no further abnormality. SRD in preeclampsia may have an impressive acute presentation but seems to resolve favorably spontaneously without intervention, upon delivery. Nevertheless, SRD must be considered to be a sign of imminent worsening of preeclampsia.

[Clinical and paraclinical course of melanocytoma of the optic disk. Contribution of spectral- and time-domain OCT in the study of 10 patients]. / Aspects cliniques et paracliniques évolutifs des mélanocytomes papillaires. Apport de la tomographe à cohérence optique de type spectral dans l'étude de dix cas.

INTRODUCTION: Melanocytoma of the optic disk is a rare, benign, slow-growing tumor. We analyzed the clinical and paraclinical features of melanocytomas followed at the Fort-de-France University Hospital to expose and compare characteristics from new clinical imaging. PATIENTS AND METHOD: This was a prospective study of 10 patients with a melanocytoma of the optic disk. The principal features studied were the ophthalmoscopic findings, the visual field defects, fluorescein angiography features, and the comparison between standard time-domain optical coherence tomography (OCT) characteristics and the latest spectral-domain OCT findings. RESULTS: The mean age of the patients at diagnosis was 49.2 years. All the patients were from the French West Indies. The lesion was discovered incidentally in 90% of the cases. Visual acuity was normal in 70% of the cases. Visual field defects were present at the first visit in 80% of the cases. Tumor growth was monitored in 50% of the cases during a mean follow up of 4.8 years. The in-depth extension into chorioretina and laterally into the retina were better visualized in spectral-domain OCT than in time-domain OCT as hyperreflective granular dots. CONCLUSION: Optic disk melanocytoma appears to be a singular benign tumor that is seen more frequently in dark-skinned patients. Most melanocytomas do not cause significant visual impairment but can show substantial growth in size for many years of follow-up. A malignant transformation is always to fear in case of atypical development. Spectral domain OCT seems to be an important tool in the assessment of extension and follow-up.

[Polypoidal choroidal vasculopathy: clinical and angiographic features]. / Vasculopathie polypoïdale choroïdienne idiopathique: aspects cliniques et angiographiques.

OBJECTIVES: To clarify the clinical and angiographic characteristics of idiopathic polypoidal choroidal vasculopathy (IPCV) and its natural course. METHODS: Descriptive, prospective, consecutive case series of patients with presumed IPCV seen at Fort-de-France Hospital Center (French West Indies) between January and June 2006. All participants underwent complete eye examination and fluorescein and indocyanine green (ICG) angiography. The nature and location of the lesions were assessed in all eyes. Inclusion criteria were demonstration of characteristic lesions of IPCV on ICG angiography. RESULTS: Diagnosis of IPCV was made in 26 eyes of 14 patients, ten women and four men, all of Afro-Caribbean origin. The mean age was 77.4 years (range 60-92 years). Drusen were present in 13 eyes (50%), age-related macular degeneration (AMD) in one eye, and branch retinal vein occlusion in one eye. Twelve patients (85.7%) had bilateral involvement. Twelve eyes (46.2%) had visual acuity (VA) (Snellen) worse than 20/200, six eyes (23.1%) had VA between 20/200 and 20/100, and eight eyes (30.8%) had VA better than 20/100. On ICG angiography, lesions were predominantly located in the peripapillary area but also in the midperiphery, the macular and interpapillomacular areas, and the far periphery. CONCLUSION: Peripheral locations of IPCV and associations with drusen or AMD are not rare. The prognosis of the disease is poor in its natural course. Its etiology is unknown but genetic factors are probably involved. It is the main differential diagnosis for exudative AMD in black patients.