Toxoplasma gondii: flat-mounting of retina as a new tool for the observation of ocular infection in mice.

Ocular toxoplasmosis is the principal cause of posterior uveitis and a leading cause of blindness. Animal models are required to improve our understanding of the pathogenesis of this disease. The method currently used for the detection of retinal cysts in animals involves the observation, under a microscope, of all the sections from infected eyes. However, this method is time-consuming and lacks sensitivity. We have developed a rapid, sensitive method for observing retinal cysts in mice infected with Toxoplasma gondii. This method involves combining the flat-mounting of retina - a compromise between macroscopic observation and global analysis of this tissue - and the use of an avirulent recombinant strain of T. gondii expressing the Escherichia coli beta-galactosidase gene, visually detectable at the submacroscopic level. Single cyst unilateral infection was found in six out of 17 mice killed within 28 days of infection, whereas a bilateral infection was found in only one mouse. There was no correlation between brain cysts number and ocular infection.

[Treatment of a case of retinal detachment in morning glory syndrome]. / Traitement d'un cas de décollement de rétine secondaire à un syndrome de morning glory.

The association of Morning glory syndrome and retinal detachment has been described several times. The observation of one clinical case has led us to review all the proposed physiopathogenic hypotheses and to deduce an original therapeutic attitude. The possibility of an abnormal communication between the sub retinal and sub arachnoidal spaces has justified the use of acetazolamide to reduce the secretion of spinal fluid and the prevention of its subretinal diffusion by an ocular compression. The reapplication which has been obtained was followed by a wide spread retinopexy on the detached retina. In addition, an intravitreous injection of C3F8 has been used to treat of a retinal hole in the staphylomatous area.

[Endogenous bacterial endophthalmitis. Report of 3 cases]. / Endophtalmie bactérienne endogène. A propos de trois observations.

Since the antibiotic era, endophthalmitis has been a rare complication of bacterial septicemia. The authors report hereby 3 cases of endogenous bacterial endophthalmitis. Both eyes were involved in one case. Causative bacteria were identified in blood. Cultures were positive respectively for Streptococcus pneumoniae, Staphylococcus aureus and Klebsiella pneumoniae. All patients received intravenous antibiotherapy, once intravitreal antibiotic was injected. Clinical manifestations were three times panophthalmitis with dramatic course. In one case, only the anterior segment was involved. The course became complicated with a cataract, but the patient finally recovered. Although several clinical types with distinct prognoses can be defined, endogenous bacterial endophthalmitis remains a devastating situation. Treatment is controversial because of the uncertainty about the value of intravitreal antibiotics and vitreous surgery.

[Bilateral serous detachment of neuroepithelium of the posterior pole disclosing acute leukemia]. / Décollement séreux bilatéral du neuroépithélium du pôle postérieur révélant une leucémie aiguë.

A 51 year-old woman presented with sudden loss of vision secondary to serous neuroretinal detachments of both maculas. Fluorescein angiography revealed multiple hyperfluorescent pin-point dots in the early phases. The areas of fluorescein hyperfluorescence became more diffuse as dye leaked into the subretinal space. The diagnostic of acute monoblastic leukemia was made. Following treatment, her vision improved. Fundus examination at that time showed resolution of the bilateral serous retinal detachment. She died one month after the onset of visual complaints and autopsy was refused. There have been 14 previous reports of acute leukemia with serous retinal detachment. In most cases, retinal detachment occurred as the presenting sign or during relapse of the systemic disease. It was often bilateral and located in the posterior pole. Histopathologic studies showed leukemic infiltration of the choroid with areas of degeneration and proliferation of the retinal pigment epithelium. Angiographic findings are similar to what is observed in choroidal ischemia. The relationships with macular serous retinal detachment and choriocapillaris occlusion are discussed.

[Retinal detachment in pseudophakia. Results apropos of 74 cases]. / Le décollement de rétine du pseudophake. Résultats à propos de 74 cas.

If the pseudophakic retinal detachment presents certain analogies with aphakic detachment; it as however a certain specificity: higher frequency of macular involvement, of proliferative vitreoretinopathy, of detachments without tears. In addition pseudophakic detachments must be analysed according to the mode of extraction and implantation.

[Postoperative uveitis following extra-capsular extraction and posterior chamber implantation]. / Les uvéites postopératoires après extraction extra capsulaire et implantation en chambre postérieure.

We describe significant non infectious post operative uveitis after extracapsular cataract extraction (ECCE) with insertion of a posterior chamber intra ocular lens. We observe three forms of evolution: the acute and early uveitis, quickly resolving; the late-occuring uveitis; and the chronic, recurring uveitis, which suggests that the inflammatory response may be caused by the hypersensitivity to the lens protein which remained after the ECCE. So a phako-anaphylactic reaction may occur.

Stabilization of severe proliferative diabetic retinopathy by long-term treatment with SMS 201-995.

Growth hormone and growth factors have been implicated in the pathogenesis of diabetic retinopathy. Hypophysectomy has been proposed as a treatment for proliferative diabetic retinopathy unresolved by panretinal photocoagulation (PPC). SMS 201-995, a long acting somatostatin analogue which slows down growth hormone secretion, may provide a non-invasive therapy for these rare cases. To assess this possibility, we studied the feasibility and efficiency of long-term SMS 201-995 treatment in diabetics. SMS 201-995 was injected subcutaneously with a continuous pump system at a dose of 400 micrograms/d into 4 insulin dependent diabetic patients suffering from proliferative diabetic retinopathy progressing despite a pan-photocoagulation. The mean age of these patients was 29 +/- 3 years and mean disease duration 18 +/- 3 years. Treatment periods lasted from 6 to 20 months (mean 15 months). Mean 24-hour growth hormone levels decreased by 57% after only one month of treatment (7.4 +/- 1.9 mU/l to 3.2 +/- 0.9 mU/l). The decline continued up to the third month. After the sixth month, signs of resistance to the drug were noted. The frequency of 24-hour GH peaks over 10 mU/l followed a parallel pattern. No rebound was observed when the treatment was progressively discontinued. In 2 patients neovascularization stopped. In the other 2 the process regressed. In all treatment had beneficial effects on the retina. Overall visual acuity improved (7.8 +/- 0.8/10e vs 5.5 +/- 0.8/10e). These effects were obtained within 3 to 6 months. Glycosylated haemoglobin levels did not change (8.8 +/- 1.3% to 9.0 +/- 0.8%). Insulin doses decreased 41% (46.5 +/- 1.7 U/d to 27.3 +/- 3.0 U/d). No severe hypoglycaemia occurred.(ABSTRACT TRUNCATED AT 250 WORDS)

Tratamento da infeccao urinaria com acido pipemidico - consideracoes sobre 50 casos. / Treatment of urinary infection with pipemidic acid. Considerations on 50 cases

O presente trabalho estudou 50 pacientes, 18 homens e 32 mulheres, portadores de infeccao urinaria, tratados com acido pipemidico em capsulas na dosagem de 400 mg "per os" cada 12 horas por 10 dias conforme normas estabelecidas no protocolo de pesquisa. Como resultado obteve-se um indice de 88% de bons resultados. De acordo com os resultados obtidos, concluiu-se que o acido pipemidico e um dos antibacterianos de largo espectro de primeira escolha no tratamento das infeccoes do trato urinario