[Posterior acute ischemic optic neuropathy (author's transl)]. / Ischémie aiguë postérieure du nerf optique.

Posterior acute ischemic neuropathy is a new and distinct clinical entity. This syndrome associate unilateral visual disturbance with arcuate or altitudinal defect. Ocular ophthalmoscopic examination and fluorescein fundus angiography are normal at the onset of the disease. Later develop varied degrees of optic atrophy. Association with anterior optic acute ischemic neuropathy on the other eye is possible. Systemic lupus erythematosus, periarteritis nodosa, temporal arteritis, and arteriosclerosis are often involved. Study of three personal cases. Discussion on pathogenesis.

[Syndrome of acute choriocapillaris ischemia in leukemia. Thoughts apropos of a case]. / Syndrome d'ischémie aiguë choriocapillaire au cours d'une leucose. Réflexion à propos d'une observation.

Choriocapillaris occlusion is rare in leukemia. After Zimmerman in 1964 our case is the tenth published. A 20-year-old maghrebin male with documented acute lymphoblastic leukemia in relapse from two years was evaluated for sudden loss of vision Examination of the both fundus revealed a serous central retinal detachment. Our material consists in four fluorescein angiographies realized at 72 hours, 8th, 25th and 65th days. Initial aspect was numerous hyperfluorescent spots at the level of the pigment epithelium and following a bleb of serous detachment fullfiled of dye. The deep leakages were blown out after a week, when patient received anti-neoplasic drugs and corticoids. On the 25th Elschnig's spots appeared but a recurrence happened after two months. Unfortunately the eyes were not documented. Choroid is the most frequent ocular structure infiltrated in leukemia. On the other hand parallel may be done with Stern and Ernest experimentation (microspheres occlusion). Thus we considered that occurs infraction of choriocapillaris units by lymphoblasts or coagulopathy. Succed focal acute changes in Bruch's membrane and pigment epithelium.

[Spontaneous hematoma of the intra-orbital optic nerve]. / Hématome spontané du nerf optique intra-orbitaire.

A young male was observed with papilledema and optic nerve enlargement on CT scanning. Visual acuity and field were not affected. A microsurgical procedure, through a para-latero-nasal approach, revealed a blue domed cyst around the neural structure. Incision of the cyst released old hemorrhagic fluid and biopsies of the cyst wall were collected. Microscopy showed granuloma and hemosiderin pigments. The post-operative course was uneventful, and the papilledema resolved in six weeks. The clinical presentation and surgical findings, the histopathology and the post-operative course lead us to conclude that this is a case of spontaneous hematoma of the optic nerve. Although intracranial and chiasmal optic nerve hematomas have been described since 1966, this is the first report to our knowledge of a hematoma involving the intraorbital portion of the optic nerve. The para-latero-nasal approach seems to be a easy way of acquiring good visualization without any osteotomy, when an operating microscope is available. This report may alert ophthalmologists to consider a cyst as a rare cause of papilledema.