[Ocular manifestations of diabetes: 285 cases]. / Atteintes oculaires dans le diabète: à propos de 285 cas.

BACKGROUND: Diabetes is one of the principal cause of blindness in adults. The aim of the study is to evaluate the frequency of ocular complications and risk factors of diabetes. It's a multicentric prospective study on a representative sample of 285 diabetics. METHODS: We performed a general and an ophthalmologic exam for all patients with retinal angiography and appropriate laboratory tests. Chi 2, Fisher, Mann and Whitney tests were used as statistical methods. RESULTS: Diabetic retinopathy was observed in 45,2% of patients, cataract in 22%, glaucoma in 5%. Diabetic retinopathy frequency rises especially with duration of diabetes and bad glycaemic control. Blindness related to diabetic retinopathy was observed in 6,25% and visual deficiency in 12,5%. The authors compared their results with literature data. They emphasize on the great value of regular better glycaemic control and other associated metabolic disorders. CONCLUSION: We concluded that a regular ophthalmologic follow up is necessary for early diabetic retinopathy detection and treatment.

[Epidemiology of work-related eye injuries]. / Epidémiologie des accidents oculaires du travail.

BACKGROUND: Occupational injury represents 7,7 at 69,9% of the total ocular traumatisms. They can be a major source of visuel loss and blindness. The aim is to study the epidemiology of work-related ocular injuries: objects frequencies,works most exposed. METHODS: We performed a prospective study that interest 78 patients having a work-related ocular traumatism during a 4 months period. They were admitted at ocular emergeney All patients underwent an ophtalmologic examination completed with orbital radiography and echography. A medical and/or chirurgical appropriate treatment was institued. RESULTS: Occupationnal injury frequency was 9% of the whole ocular traumatisms in the same period. The mean age was 31 years. 55% of cases were under 30 years. 91% were male. Most exposed works were industrial and mecanical sectors In 70,5% of cases work-related eye injuries were caused by projectile objects. Most common lesion was corneal superficial foreign body (58%). Open globe injury was noted in 8%. 95% of patients had no eye protection at the time of the accident. 13% were blind or unilateral partially sighted (according to the OMS classification). CONCLUSION: The authors discussed the importance and different prevention strategies to prevent the risk of blindness and socio-economical cost of occupationnal accidents. There is a need for systematic periodic sensibilization to reduce these accidents and blindness.

Does lowering hyperhomocysteinemia by folic acid beneficial for oculo-Behcet's disease? A pilot study.

OBJECTIVE: To determine the effect of folic acid supplementation in Behçet's disease (BD) patients with ocular involvement associated with hyperhomocysteinemia (Hhcys). PATIENTS AND METHODS: 19 BD patients, all with uveitis and/or retinal vasculitis associated with Hhcys (plasma hcy > 15 micromol/l) were prospectively included. Patients were divided into 2 groups. Group 1 consisted of 11 patients that received folic acide (15 mg/d) in addition to their previous standard treatment. Group 2 included 8 patients treated only with their previous standard treatment. Visual acuity and uveitis attacks were assessed initially and monthly at each visit in all groups. Mean Visual acuity and frequency of uveitis attacks were evaluated quarterly. RESULTS: In group 1, the mean plasma hcys level was significantly lower after than before the treatment period (27.7 vs 13.1 micromol/l; p= 0.04) while it did not vary significantly in the same period in Group 2 patients. Frequency of uveitis attacks was significantly lower after than before treatment at each quarter in groupl and mean visual acuity in this group increased from 4.33 to 5.44 decimals. During the treatment period, the mean number of uveitis attacks, converted to frequency per 12 months were significantly lower in group 1 than in group 2. During this period, the VA slightly increased in group 1 and decreased in group 2 but the difference was not significant. CONCLUSION: Our results indicate that folates supplementation is useful for BD patients with Hhcys.

[Aspects of outcome and therapy of edematous branch retinal vein occlusion]. / Aspects evolutifs et thérapeutiques des occlusions de branches veineuses rétiniennes oedémateuses.

The main cause of oedematous branch retinal vein occlusion (BRVO) vision loss is macular oedema persistence. We studied 18 patients having oedematous branch retinal vein occlusion. An ophthalmologic exam completed with angiography and etiologic assessment were performed. Argon Laser macular grid photocoagulation was performed in 11 eyes where macular oedema had persisted for over 3 months with visual acuity under 5/10. In 45% of cases, occlusion interests superotemporal vein. Atherosclerosis risk factors are found in 88% of cases. The course was spontaneously favourable in 39% of cases. Improvement of visual acuity was obtained in 36% of cases treated with laser photocoagulation. Oedematous branch retinal vein occlusion outcome is variable; it can be favourable if veino-veinous anastomosis develops rapidly, or unfavourable with macular edema persistence and decreased visual acuity. In the later case, grid macular phototcoagulation should be performed leading to macular edema regression. So, macular edema secondary to branch retinal vein occlusion can disappear spontaneously and needs laser treatment only if it persists.

[Indications and results of vitrectomy in Terson syndrome]. / Indications et resultats de la vitrectomie dans le syndrome de Terson.

Terson syndrome or vitreal hemorrhage associated with subdural hemorrhage is a rare condition. The goal of our work through a retrospective series of 3 cases (4 eyes) is to study clinical characteristics as well as adequate moment of surgery. All our patients had unilateral or bilateral visual impairement secondary to cerebral lesion. Ophtalmologic exam showed an intravitreal hemorrhage. Two of our patients were operated by vitrectomy, the third case had a spontaneous resorption of intravitreal hemorrhage and no surgery was performed. Functional prognosis depends on neuro-ophtalmologic sequellas. Ophtalmic exam is essential in cerebral hemorrhage. For intravitreal hemorrhage spontaneous resorption is frequent and vitrectomy must be delayed.