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.

Primary Lacrimal Canaliculitis with clinically detected concretions: One-snip punctoplasty with lateral canaliculotomy vs. punctum sparing canalicular curettage.

PURPOSE: To compare two distinct surgical techniques in the management of chronic Primary Lacrimal Canaliculitis (PLC) with clinically detectable concretions. MATERIALS AND METHODS: Inclusion criteria: Patients presenting with symptoms consistent with the diagnosis of primary lacrimal canaliculitis (PLC) with ocular involvement were gathered. Gomori-Grocott Methenamine Silver test was used for concretion staining. Two groups were identified based on the surgical technique. Group A consisted of patients who underwent a punctum sparing canalicular curettage using a chalazion curette, while the patients in Group B underwent one-snip punctoplasty with lateral canaliculotomy. Failure was defined as recurrence of the initial symptoms at any time (ocular and canalicular inflammation with purulent discharge and pouting punctum). The results were analyzed by comparisons using a Fisher's exact test. RESULTS: Ninety-six consecutive patients (96) with a confirmed diagnosis of PLC underwent surgical treatment between 1987 and 2017. Data were collected and divided based on the surgical technique discussed above (Group A and B). Group A: 51 cases with a mean follow-up time of 22 months [1-224] presented with a mean age of 51.5 [25-83] and a surgical failure rate of 19.6%. Group B: 45 patients with a mean follow-up time of 27 months [1-176], a mean age of 68 [17-87] years and a surgical failure rate of 4.4%. Statistical significance was demonstrated, with a p-value of 0.033, odds ratio (OR) of 0.1936 and Standard Deviation (SD) at a 95% confidence interval of [0.0195-0.9885]. CONCLUSIONS: One-snip punctoplasty with lateral canaliculotomy is a simple, fast and effective procedure that allows better anatomical visualization intraoperatively and is thus shown to be statistically superior to punctum sparing canalicular curettage using a chalazion curette.

Bilateral nevus comedonicus of the eyelids: An unusual cause of ptosis and ectropion.

PURPOSE: Nevus comedonicus is a rare developmental abnormality of the infundibulum of the hair follicle. OBSERVATION: We report here an unusual case of bilateral extensive nevus comedonicus of the eyelids complicated by bilateral ptosis and ectropion of the lower eyelids. Blepharoplasty was performed on both upper eyelids. Histopathological findings on skin biopsy typically show large, grouped, dilated follicular ostia filled with keratin. CONCLUSIONS AND IMPORTANCE: This case is unusual as regards the late-onset (lesions first appeared at age 35) and location of the nevus comedonicus on both eyelids.

[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.