[Enucleations: epidemiologic investigation in Morocco. presentation of 183 cases]. / Enucléations: enquêté épidémiologique marocaine. A propos de 183 cas.

INTRODUCTION: The authors report the results of an epidemiological study concerning 183 enucleated eyeballs. MATERIAL AND METHODS: [corrected] The study is realized over a 12-year period (1988-2000) in the department of Ophthalmology "B" (University Hospital--Rabat) on 183 enucleated eyes, only 90% having an histological examination. RESULTS: The aetiologies are: trauma (40%), malignant tumours (30%), atrophies and glaucoma (17%), panophthalmitis (9%) and corneal lesions (4%). The authors compare their results with those of the literature. CONCLUSION: The causes of enucleation are the same throughout the world. The frequency has lately decreased due to the development of early diagnosis and to the use of more conservative treatments.

[Epidemiology of orbital processes in children. 54 cases]. / Epidémiologie des processus orbitaires chez l'enfant. A propos de 54 cas.

PURPOSE: The aim of this work was to study epidemiological aspect of orbital processes occurring in childhood. PATIENTS AND METHODS: Fifty-four cases of orbital processes treated between January 1990 and January 1997 were retrospectively reviewed. RESULTS: Mean patient age was 4.2 years (range 1 to 15), 36 were males and 18 were females. Proptosis was the first manifestation in 34 cases, other manifestations were low vision (8 cases), ocular pain (14 cases), inflammatory signs (11 cases), ocular palsy (14 cases). The first cause of these processes was secondary tumors, especially retinoblastoma (13 cases). Other causes were rhabdomyosarcoma (9 cases), orbital hydatic cyst (8 cases), inflammatory pseudotumors (7 cases), capillary hemanigoma (4 cases) chloroma (3 cases), glioma (1 case), lymphangioma (8 cases), and mucocele (1 case). DISCUSSION: We emphasize the particular epidemiological aspect of orbital processes in Moroccan children where retinoblastoma predominates and compare our findings with data in the literature.

[Severe toxic optic neuropathies caused by isoniazid. Apropos of 3 cases]. / Neuropathies optiques toxiques graves induites par l'isoniazide. A propos de trois cas.

Three cases of isoniazid-induced toxic optic neuropathy are reported. These severe forms of the disease lead in all cases to bilateral blindness despite drug withdrawal. The epidemiological, clinical and therapeutic aspects of the disease are discussed. Further emphasis is placed on the importance of systematic screening of patients at risk using regular ophthalmological examinations before and after treatment.

[Value of ultrasonography in persistent hyperplastic primary vitreous body. Apropos of 4 cases]. / Intérêt de l'échographie dans la persistance et l'hyperplasie du vitré primitif. A propos de 4 cas.

The authors report 4 patients with complicated persistent hyperplastic primary vitreous. The complications observed are cataract (2 eyes) and retinal detachment (2 eyes). The affection is bilateral in two cases and unilateral in the two other cases. After a short embryologic vitreous recall, the authors present clinical and paraclinical aspects of the condition. The authors focus on the importance of echographic data.

[Tumor of the lacrimal sac. Dangers of simple excision biopsy]. / Tumeur du sac lacrymal. Dangers de la biopsie exérèse simple.

Lacrimal sac tumors are relatively uncommon tumors which recur readily and have poor prognosis if adequate care is not provided early. We report here a case of lacrimal sac tumor in a 56-year-old patient with bilateral pseudophakia and an atypical chronic dacryocystisis aspect of the left eye. After clinical and paraclinical investigations, the patient underwent surgical excision of the tumor followed by external radiotherapy. During follow-up, the patient developed a local recurrence which required surgical removal and radiotherapy. Despite early and adapted management, the prognosis of this tumor remains poor.

[Tuberculous uveitis]. / Uvéite tuberculeuse.

Ocular tuberculosis is relatively rare; however, the most common ocular lesion during ocular tuberculosis is uveitis. The recrudescence of this disease is probably caused by human immunodeficiency virus or long-term corticotherapy. The authors report a of chronic unilateral tuberculosis-related uveitis complicated by panophthalmia with subconjunctival abcesess and scleral fistula. A histopathological study revealed a granulomatous inflammation with caseous material. An extensive work-up revealed no extraocular lesion. A systemic bactericidal treatement associated with topical steroids decreased the local inflammation with phthisis bulbi, and with no spread of the infection. The authors discuss the etiopathogenic, clinical, and therapeutic aspects of tuberculosis-related uveitis.

[Orbital lymphangioma. A case report]. / Lymphangiome orbitaire. A propos d'un cas.

The diffuse form of orbital lymphangioma is well known for its difficult surgical treatment. A diffuse orbital lymphangioma was diagnosed in a 6-year-old girl, revealed by unilateral recurrent proptosis. The imaging procedure discovered a mass presumed to be vascular in nature. The initial incompleted surgical removal was followed by 3 recurrences motivating 3 reoperations. Finally, the tumor was removed incompletely, with an acceptable reduction of the proptosis. The pathologic analyses indicated lymphangioma. Some vascular orbital tumors such as lymphangioma, may be very difficult to manage because of local spreading and frequent recurrence.

[Medulloepithelioma of the ciliary body. A case report]. / Le médullo-épithéliome du corps ciliaire. A propos d'un cas.

Medulloepithelioma of the ciliary body is an uncommon intraocular tumor occurring during the first year of life. Malignant degeneration may occur. We report the case of a 4-year-old child who presented medulloepithelioma of the left eye disclosed by oesotropia at 2 years of age. Clinically, there was oesotropia, positive light perception and cataract with vascular membrane spreading to the nasal side of the irido-corneal angle. CT scan and ultrasound B revealed a ciliary body tumor involving the sclera and orbital fat. After exenteration, the pathology study reported malignant medulloepithelioma of the ciliary body with scleral extension. No local recurrence or metastasis has been observed at 8 months follow-up. We discuss the clinical, radiological and therapeutic features of this uncommon tumor.

[Epithelial cyst in the superior internal angle: a case report]. / Kyste épithélial de l'angle supéro-interne: à propos d'un cas.

Most orbital cysts in childhood are epidermoids or dermoids. We report one uncommon case of an 8-years old girl with a lacrimal orbital cyst revealed by discrete proptosis and pseudo-ptosis in which the cystic histopathological study revealed a lacrimal structure.

[Ophthalmic manifestations of acute leukemia]. / Manifestations ophtalmologiques des leucémies aiguës.

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.