A 15-year-old child followed for Best vitelliform macular dystrophy presented to the clinic with an abrupt visual impairment of his left eye. Fundus examination showed bilateral vitelliform lesions, with serous retinal detachment and adjacent retinal hemorrhage in the left eye. Fluorescein angiography and optical coherence tomography confirmed the diagnosis of type-2 choroidal neovascularization complicating the Best disease. The juxtafoveal location of the choroidal neovascularization prompted us to realize monthly intra-vitreous injections of bevacizumab. After the fourth injection, we observed visual and anatomical improvement that remained stable after a 12-month follow-up. It’s important to look for complications in front of a sudden decrease in visual acuity in Best disease.

Acute retinal necrosis syndrome (ARN syndrome) is a rare condition, caused by DNA viruses. The diagnosis of this condition is mainly based on the suggestive clinical appearance. Prompt diagnosis and treatment is crucial to prevent visual loss. We report the case of 56-year-old women, diabetic, who presented to the emergency room for rapid decrease of visual function of her left eye, which revealed granulomatous uveitis with retinal necrosis.

The purpose of this study is to compare two alternative methods of collecting and transporting media for the diagnosis of corneal ulcers, as not all clinical settings have conventional culture materials and transport media available.In this open-label, prospective, comparative, and randomized study, patients with clinical suspicion of infectious keratitis with high risk of loss of vision had corneal specimens collected using two methods and transport media: Eswab scraping with Amies transport medium and 23-gauge needle scraping in BACTEC Peds broth. The order of each collection method was randomized. The samples were processed by standard methods, comparing the positivity frequencies for both by parametric and nonparametric tests, according to normality criteria.Corneal infiltrates from 40 eyes of 40 patients were analyzed. Culture positivity rate was 50% for Eswab and 35% for 23-gauge needle (P = 0.258). The overall growth rate of the two methods combined was not higher than with the swab alone. The results obtained with a swab were not influenced by the collection sequence (P = 0.112); however, the positivity rate was significantly higher when the sample taken with the needle was performed first (P = 0.046).The single sample Eswab method of collection and transportation for the diagnosis of high risk corneal ulcers is a valid alternative and can be used in cases in which, for various reasons, there is no access to the full set of traditional culture materials.L’objectif de cette étude est de comparer deux méthodes alternatives de collecte et de milieux de transport de cornées pour le diagnostic des ulcères cornéen dans la mesure où tous les établissements de soin ne disposent pas de matériel de culture et de milieux de transport conventionnels.Dans cette étude ouverte, prospective, comparative et randomisée, des échantillons de cornée ont été recueillis chez des patients présentant une suspicion clinique de kératite infectieuse avec un risque élevé de perte de vision, en utilisant deux méthodes et deux milieux de transport : utilisation d’un écouvillon E avec un milieu de transport Amies et grattage avec des aiguilles de calibre 23 avec le bouillon BACTEC Peds. L’ordre de chaque méthode de collecte a été randomisé. Les échantillons ont été traités selon des méthodes standard, en comparant les fréquences de positivité par des tests paramétriques et non paramétriques, en fonction de critères de normalité.Les infiltrats cornéens de 40 yeux de 40 patients ont été analysés. Le taux de positivité de la culture était de 50 % pour le coton-tige E et de 35 % pour les aiguilles 23 gauge (p = 0,258). Le taux de croissance global des deux méthodes combinées n’était pas supérieur à celui obtenu avec l’écouvillon seul. Les résultats obtenus avec un écouvillon n’ont pas été influencés par la séquence de collecte (p = 0,122) ; cependant, le taux de positivité était significativement plus élevé lorsque l’échantillon d’aiguille avait été prélevé en premier (p = 0,046).La méthode de collecte et de transport d’un seul échantillon E-swab dans le diagnostic des ulcères de la cornée à haut risque est une alternative valable et peut être utilisée dans les cas où, pour différentes raisons, il n’est pas possible d’accéder à l’ensemble complet du matériel de culture traditionnel.

We report the case of a hypertensive patient who has macular edema, secondary to retinal vein occlusions, revealing pigmentary glaucoma. 54-year-old man had a visual impairment in the left eye. In connection with an retinal vein occlusion; the interview reported hypertension and diabetes, The diagnosis of occlusion of the old retinal vein branch associated with pigmentary glaucoma in a strong myopic is made. Before hypertension, the search for glaucomatous ocular hypertonia must be systematic because it is a particular cause of retinal vein occlusions Related to papillary excavation.

We report the case of a hypertensive patient who has macular edema, secondary to retinal vein occlusions, revealing pigmentary glaucoma. 54-year-old man had a visual impairment in the left eye. In connection with an retinal vein occlusion; the interview reported hypertension and diabetes, The diagnosis of occlusion of the old retinal vein branch associated with pigmentary glaucoma in a strong myopic is made. Before hypertension, the search for glaucomatous ocular hypertonia must be systematic because it is a particular cause of retinal vein occlusions Related to papillary excavation.

Le traitement du glaucome primitif à angle ouvert (GPAO) est préférentiellement médical. Cependant en cas d’échec ou d’insuffisance de celui ci, des traitements alternatifs ou complémentaires peuvent être envisagés. La trabéculoplastie sélective dans cette approche est un traitement physique en plein essor et les avantages qui lui sont reconnus ont été très peu étudiés chez le sujet mélanoderme africain. L’objectif de cette étude était d’évaluer l’efficacité de la trabéculoplastie sélective sur la baisse de la pression intraoculaire (PIO) chez le sujet mélanoderme africain atteint de GPAO.Nous avons réalisé une étude rétrospective chez des patients mélanodermes traités par laser sélectif entre mars 2010 et mars 2011. Tous les patients présentaient un GPAO avec trabéculum accessible sur 360°. Le protocole thérapeutique a consisté en un traitement sur 360° en 2 séances (180°/séance) à 15 jours d’intervalle. Le succès était défini par une baisse de la PIO initiale ≥ 3 mm Hg sans traitement supplémentaire.Nous avons retenu 44 patients correspondant à 82 yeux. L’âge moyen des patients était de 55,94 ± 11,66 ans avec des extrêmes de 19 ans et 76 ans. La pression intraoculaire moyenne avant le traitement au laser (PIO initiale) était de 18,43 ± 4,18 mm Hg. Après traitement au laser, la réduction pressionnelle moyenne était de (i) 3,81 mm Hg (20,67 %) à 15 jours ; (ii) 4,08 mm Hg (22,14 %) à 1 mois ; (iii) 4,45 mm Hg (24,14 %) à 3 mois ; (iv) 4,95 mm Hg (26,86 %) à 6 mois. Le taux de succès après traitement au laser était de 67,60 % à 15 jours, 83,78 % à 1 mois, 72,09 % à 3 mois et 80,43 % à 6 mois.La trabéculoplastie sélective est efficace chez le mélanoderme africain. Son efficacité est comparable à celle d’un inhibiteur de l’anhydrase carbonique voire une prostaglandine. Elle pourrait être une alternative complémentaire ou substitutive du traitement du GPAO chez le mélanoderme africain.The treatment of primary open angle glaucoma (POAG) is preferably medical. However, when medical therapy fails, alternative or complementary treatments may be considered. In this regard, selective laser trabeculoplasty is a widely popular procedural treatment whose accepted benefits have been very little studied in African blacks. The objective of this study was to assess the efficacy of selective laser trabeculoplasty on the reduction of intraocular pressure (IOP) in African blacks with POAG.We conducted a retrospective study of black patients treated with selective laser trabeculoplasty between March 2010 and March 2011. All patients had POAG with trabecular meshwork accessible over 360°. The treatment protocol consisted of a 360°treatment in two sessions (180°/session) 15 days apart. Success was defined as decrease from the initial IOP ≥ 3 mm Hg without additional medications.We included 44 patients, corresponding to 82 eyes. The mean age of the patients was 55.94 ± 11.66 years with extremes of 19 years and 76 years. The mean intraocular pressure before laser treatment (initial IOP) was 18.43 ± 4.81 mm Hg. After laser treatment, the mean pressure reduction was (i) 3.81 mm Hg (20.67%) at 15 days ; (ii) 4.08 mm Hg (22.14%) at 1 month; (iii) 4.45 mm Hg (24.14%) at 3 months; and (iv) 4.95 mm Hg (26.86%) at 6 months. The success rate after laser treatment was 67.60% at 15 days, 83.78% at 1 month, 72.09% at 3 months and 80.43% at 6 months.Selective laser trabeculoplasty is effective in African blacks. Its efficacy is comparable to that of a carbonic anhydrase inhibitor or even a prostaglandin. It could be a complementary or substitutive alternative to POAG medications in African blacks.

Dissecting intramural hematoma of the esophagus (DIHE) is a rare condition in which intramural hemorrhage can lead to submucosal dissection of the esophageal wall. DIHE is generally considered a benign disease, and the only mortality associated with DIHE has been due to operative intervention or to the presence of another underlying, life-threatening condition. We report, however, a case of sudden death due to the spontaneous rupture of a DIHE that occurred in a 32-year-old woman, affected by neurofibromatosis type1. She was admitted to the local emergency room, presenting a 24-hour history of sudden onset, severe central chest and interscapular pain associated with dysphagia, odynophagia and vomiting. Her condition worsened and proved fatal within a 6-hour period. A complete autopsy was then conducted, showing a complete dissecting intramural hematoma with laceration of the third superior of the esophagus. We can hypothesize that abnormal variations of gastro-esophageal pressure during ingurgitation and during bolus movement could be predisposing factors in the pathogenesis of the dissection. On the other hand angular kyphoscoliosis deformity may have had play a role as precipitating factor while vomiting in the subject's medical history can then be interpreted as the likely activation phenomenon.

Le dysfonctionnement des glandes de meibomius représente la première cause de sécheresse oculaire de type évaporatif. Notre objectif était de déterminer les caractéristiques épidémiologiques et cliniques du dysfonctionnement des glandes de Meibomius, ainsi que son impact sur la surface oculaire du sujet âgé mélanoderme en milieu camerounais.Nous avons mené une étude transversale et analytique du 2 janvier au 31 mai 2017 dans le service d’ophtalmologie de l’hôpital Laquintinie de Douala, chez des mélanodermes âgés de 50 ans et plus. Un examen clinique axé sur les glandes de Meibomius a été réalisé ; le Break Up Time et le test de Schirmer I pour l’évaluation qualitative et quantitative des larmes ont été effectués. Le test de régression linéaire a été effectué pour établir la relation entre le DGM et les variables quantitative et qualitative.Nous avons enrôlé 340 mélanodermes âgés. La moyenne d’âge était de 62 ± 9 ans. La prévalence du dysfonctionnement des glandes de Meibomius était de 71,8 % et cette prévalence n’augmentait pas avec l’âge. La forme clinique hypoproductive était la plus fréquente (47,9 %). La prévalence du dysfonctionnement meibomien asymptomatique était de 19,7 %. La sécheresse oculaire de forme évaporative était la plus fréquente (34,7 %). En dehors de l’âge avancé, la survenue du dysfonctionnement meibomien était associée à l’hypertension artérielle (p = 0,020), à la chirurgie de la cataracte (p = 0,034), à la prise d’antiglaucomateux au long cours (p = 0,041) et à la consommation d’alcool (p = 0,043).Le dysfonctionnement des glandes de Meibomius est très fréquent chez les sujets âgés mélanodermes en milieu camerounais.Meibomian gland dysfunction is the leading cause of evaporative-type dry eye syndrome. Our goal was to determine the epidemiological and clinical features of meibomian gland dysfunction as well as its impact on the ocular surface in elderly black patients in Cameroon.We performed a cross-sectional analysis from January 2 through May 31, 2017 in the ophthalmology department of Laquintinie Hospital in Douala, including blacks aged 50 years and older. The examination focused on the Meibomian glands, Tear film Break Up Time and Schirmer I test for qualitative and quantitative assessment of tears. The relationship between the quantitative and qualitative variables and meibomian gland dysfunction was determined by linear regression tests.We enrolled 340 elderly black patients. The mean age was 62 ± 9 years. The prevalence of meibomian gland dysfunction was 71.8 % and did not increase with age. The hypoproductive clinical form was the most frequent (47.9 %). The prevalence of asymptomatic Meibomian gland dysfunction was 19.7 %. Evaporative dry eye disease was the most frequent (34.7 %). Aside from advanced age, Meibomian gland dysfunction was associated with high blood pressure (P = 0.020), cataract surgery (P = 0.034), long-term glaucoma medication (P = 0.041) and alcohol consumption (P = 0.043).Meibomian gland dysfunction is very common in elderly black patients in Cameroon.

The Ota nevus or nevus fuscocaerulus ophtalmomaxillaris, recently named oculodermic melanocytosis, was described by the Japanese Ota in 1939. It consists of cutaneous hyperpigmentation in the territory of the first and second trigeminal branches, associated with ocular melanocytosis. This abnormal pigmentation is due to the aberrant migration of the cells of the neural crest, these cells being the embryological precursors of melanocytes. The sectoral form of the Ota nevi is rare.

Introduction: The Non hodgkinien lymphma (NHL) orbital location is a rare tumor, difficult to diagnose. The mantle cell lymphoma represents 6% of cases of LNH B. We report a patient of 60 years with bilateral exophthalmia revealing a mantle cell lymphoma. Clinical Observation: A man of 60 years ran for ophthalmological emergencies in an array of orbital cellulitis of the right eye. This swelling was that day, painful, inflammatory, axile, irreducible, and non-pulsatile, with limited horizontal movement of the eyeball. In general terms, the patient has axillary lymph nodes and supraclavicular without splenomegaly. A biopsy of the orbital mass produced by trans-conjunctival, concluded in a non-Hodgkin lymphoma B type mantle (CD20 +, CD5 +, cyclin D1 +). The assessment of extension realized in the Hematology Clinic department shows that this is a mantle cell lymphoma NHL B stage (nodes above and below the diaphragm, bilateral eyelid damage, spinal cord and location). After 3 treatments Rituximab-CHOP and DHAP-Rituximab treatments 3, obtaining a complete remission. Discussion: The mantle cell lymphoma represents about 6% of NHL. Its incidence is estimated between 0.07 and three cases per 100 000 population per year. The geographical area and ethnicity shows a higher frequency in Caucasians than in African Americans. Ocular involvement in the NHL is a rare event, as evidenced by the limited number of cases reported in the literature. It may be opening that is the case of our patient, or alter the course of lymphoma known. Conclusion: The eye location of mantle cell lymphoma is a rare entity. The clinical picture of this location can be misleading, particularly that of orbital cellulitis. The tumor biopsy confirms the diagnosis. Despite the treatment regimens, the prognosis of this type of lymphoma is reserved.