Diffuse unilateral subacute neuroretinitis in Africa.

PURPOSE: Diffuse unilateral subacute neuroretinitis (DUSN) is well known in endemic areas of the southeastern United States, South America, and the northern Midwestern United States. Two different categories of nematodes, according to their length, are related to endemic areas. We report the first case of DUSN caused by a small nematode in Africa. METHODS: We describe the case of a 12-year-old Senegalese girl who presented a long-standing diffuse unilateral subacute neuroretinitis and in whom the worm could be localized. RESULTS: The length of the unidentified worm measured using the software of the fundus camera was approximately 600 microm. This measurement corresponds to the smaller nematode usually found in patients from the southeastern United States and South America. CONCLUSION: Diffuse unilateral subacute neuroretinitis can also be observed in patients living in Africa.

Multicenter study of the Artisan phakic intraocular lens.

PURPOSE: To assess the Artisan intraocular lens to correct myopia in phakic eyes. SETTING: European multicenter study sponsored by Ophtec BV, Groningen, The Netherlands. METHODS: In this prospective multicenter clinical study, the Artisan lens was implanted in 518 eyes between September 1991 and October 1999. The power of the lenses ranged from -5.0 to -20.0 diopters (D). Follow-up examinations were performed at 6 months and 1, 2, and 3 years. Follow-up ranged from 6 months (n = 454) to 3 years (n = 249). The preoperative uncorrected visual acuity (UCVA) was not recorded but was estimated to be worse than 0.1. The preoperative mean best spectacle-corrected visual acuity (BSCVA) was 0.67 +/- 0.26 (SD). Endothelial cell counts were done at 6 months and 1, 2, and 3 years in a subgroup of 129 eyes. RESULTS: A UCVA of 20/40 or better was observed in 76.8% of eyes regardless of the postoperative goal. A BSCVA of 20/40 or better was observed in 93.9% of eyes and remained stable throughout the follow-up. Of the eyes with extremely high myopia (>-15.0 D), 63.3% gained 2 or more lines of BSCVA; of those with moderate myopia (-5.0 to -10.0 D), 23.5% gained 2 or more lines. The mean endothelial cell density change was 4.8% at 6 months, 2.4% at 1 year, 1.7% at 2 years, and 0.7% at 3 years. The incidence of persistent adverse events at 3 years was relatively low. Secondary surgical interventions included repositioning of the lens because of poor initial placement and lens exchange because of preoperative power calculation errors. Glare and halo effects during night driving were noted and were related to large pupils in young patients. CONCLUSION: The Artisan lens is a safe, stable, efficacious, and predictable method to correct -5.0 to -20.0 D of myopia. This study suggests that the corneal endothelial cell loss is stabilized to the physiologically normal level after 3 years.

[Pneumatic retinopexy. Analysis of the first 20 cases]. / Rétinopexie pneumatique. Analyse des 20 premiers cas.

The author analyses the results of 20 eyes with retinal detachment (RD) treated by the Pneumatic Retinopexy procedure (intra-vitreal gas injection and coagulation of the retinal breaks). The selected RD's were caused by peripheral retinal breaks located in the superior 270 degrees of the retina and of less than 45 degrees width. Proliferative vitreoretinopathy (PVR) was grade C1 or less. In 15% of the cases, the RD was a recurrence after previous surgery and 10% of the eyes were aphakic. The anatomic success rate was 95% both initially and after 6 months follow up. Three (15%) recurrences of RD were noted within the first postoperative month. One of these was caused by massive PVR. A secondary buckling was proposed when important vitreoretinal traction was noted after pneumatic reattachment. No case of subretinal gas, macular pucker or infection was seen. Postoperative visual acuity greater than or equal to 4/10 was obtained in 80% of the 10 macular off cases. In this limited series, the anatomic success rate of the Pneumatic Retinopexy procedure was similar to that of classical RD surgery, but functional results proved better. If these results are confirmed by larger series, Pneumatic Retinopexy could become the choice procedure in primary repair of uncomplicated rhegmatogenous RD's.