[Clinical features and management of acute myositis in idiopathic orbital inflammation]. / Présentation clinique et prise en charge des myosites aiguës dans les inflammations orbitaires non spécifiques.

Acute myositis is the second most common component of non-specific orbital inflammation. We will describe its clinical features and natural history. This is a retrospective study of 10 cases. The diagnosis of acute myositis was based on clinical and imaging criteria. Our study includes five men and five women. The average age was 35.8 years (17-59 years). Clinical symptoms were: pain increased on eye movement (10/10), diplopia (4/10), proptosis (6/10), visual loss (3/10), lid edema (6/10), conjunctival hyperemia (7/10), anterior scleritis (2/10), episcleritis (2/10), chemosis (4/10), upper lid retraction (1/10), limitation of eye movement (3/10), fundus abnormalities (2/10). Imaging showed thickening of one or more extraocular muscles (10/10). Recovery was complete with anti-inflammatory therapy in six patients. Three patients experienced recurrence, and one patient had a clinical rebound upon tapering the treatment. Acute myositis can be defined by pain on eye movement, signs of inflammation, and extraocular muscle thickening on imaging. If the clinical presentation is typical, histopathological analysis can be deferred but remains necessary in cases of poor response to treatment, chronic duration or suspicion of tumor infiltration. The diagnosis of acute myositis may be suspected in the presence of consistent, well-defined clinical signs. Contiguous inflammation is often associated. Treatment is based on steroids or non-steroidal treatment anti-inflammatory therapy, administered alone or consecutively. Recurrences are frequent but do not alter the final prognosis.

[A case of primary herpetic eye disease]. / Un cas de primo-infection herpétique oculaire.

Herpetic eye disease is very common. However, primary infections are most frequently asymptomatic. We report herein a case of a 15-year-old male whose diagnosis of primary herpetic infection was delayed and who initially had unsuitable treatment that aggravated the symptoms. This case highlights the importance of early diagnosis of primary herpetic infection, which allows an adapted therapeutic care.

[Ophthalmologic characteristics of spheno-orbital meningiomas: a series of 23 surgical cases]. / Manifestations ophtalmologiques des méningiomes sphéno-orbitaires. A propos de 23 cas chirurgicaux.

PURPOSE: The authors report the ophthalmological characteristics and the postoperative results of patients presenting with spheno-orbital meningioma. DESIGN: A retrospective study of 23 charts of patients, presenting with spheno-orbital meningioma between 1994 and 2007, was performed. The data of preoperative and postoperative ophthalmologic examinations, perimetry and visual evoked potentials were collected. RESULTS: All the 23 patients were female. Diagnostic elements were proptosis (n=18), filling of the temporal pit (n=12) and visual impairment (n=11). Diagnosis was confirmed by orbital imaging. Perimetry and visual evoked potentials enabled to detect asymptomatic impairment of visual function, perimetry being the more sensitive method. Neurosurgery was the gold standard treatment, completed with radiotherapy in some cases of incomplete surgery or recurrence. CONCLUSION: Meningioma without optic nerve compression in the optic canal had better postoperative results with stabilization or improvement of the visual acuity compared with more unpredictable results obtained in cases with preoperative compression in the optical canal. Long term follow up of these patients is necessary because of the risk of relapse (n=3).