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Les atteintes ophtalmologiques au cours de la SPA sont présentes dans 35 % à 50 % des cas. Ceci correspond essentiellement à une uvéite antérieure. Par ailleurs l´atteinte du segment postérieur est une atteinte rare reportée dans certaines publications. Nous rapportons le cas d´un patient âgé de 26 ans ayant comme antécédents une des lombalgies inflammatoires, qui se présente pour une uvéite totale avec vascularite occlusive bilatérale compliquée d´hémorragie intra vitréenne; un bilan étiologique a été réalisé ayant éliminé une cause infectieuse ou autre de sa vascularite, une IRM sacro-iliaque a mis en évidence un hypersignal sacro-iliaque; le diagnostic de vascularite rétinienne secondaire à la spondylarthrite ankylosante a été retenu. Nous avons rapporté un cas rare d´uvéite postérieure avec une vascularite au cours de la spondylarthrite ankylosante, ceci devrait nous inciter à chercher les atteintes du segment postérieur au cours de la SPA et éventuellement ne pas réfuter le diagnostic en cas de telles manifestations.

Patient de 48ans de teint clair, ayant la notion de 5 décès dans la famille par des cancers de localisations variables, qui présente depuis une année une tuméfaction de la conjonctive palpébrale inférieur augmentant progressivement de volume, de forme nodulaire ulcéro-bourgennante, mesurant 2cm de grand axe, occupant la moitié interne de la conjonctive tarsale inférieure présentant un contact intime avec le point lacrymal inférieur (A). La biopsie de la tumeur est en faveur d'un carcinome épidermoïde de la conjonctive bien différencié. Le traitement a consisté en une exérèse tumorale (B) avec marges de sécurité larges revenant saines après étude anatomopathologique.

Patient de 79 ans, opéré de cataracte par phaco-émulsification en 2000, avec une pseudo-exfoliation capsulaire ODG préopératoire. Présente un glaucome pseudo-exfoliatif avec une récidive sur l'implant.

Le lupus érythémateux systémique (LES) est une maladie auto-immune multi systémique d'étiologie inconnue. Nous rapportons une manifestation très rare du LES représentée par une choroidopathie bilatérale sans hypertension artérielle associée. Il s'agit d'une patiente âgée de 45 ans, suivie pour un LES depuis 5 ans, qui présente une baisse de l'acuité visuelle bilatérale et progressive depuis 3 mois. L'examen du fond d'oeil, complété l'angiographie à la fluorescéine et la tomographie en cohérence optique, retrouve un décollement séreux rétinien (DSR) multifocal et bilatéral. L'évolution après corticothérapie systémique est marquée par une amélioration de l'acuité visuelle et une régression du DSR. L'atteinte oculaire au cours du LED est dominée par la kérato-conjonctivite sèche (1/4 à 1/3 des cas). La choroïdopathie est plus rare: seulement une trentaine de cas sont rapportés dans littérature. Elle se manifeste par un décollement séreux rétinien et est habituellement observée chez les patients présentant une néphropathie ou une hypertension artérielle, ce qui n'est pas le cas de notre observation. L'apparition d'une atteinte oculaire au cours du LES peut annoncer une poussée d'atteinte systémique et doit susciter une enquête appropriée.

Purpose: To compare the outcomes of pars plana vitrectomy (PPV) and combined PPV with phacoemulsification (PPVCE) surgeries for proliferative diabetic retinopathy (PDR) and cataract treatment., Methods: Retrospective analysis of 120 diabetic patients who underwent PPV or PPVCE., Results: The key outcome indicators were best-corrected visual acuity (BCVA) and post-operative complications. The PPVCE group had an average age of 53 years, with 50% females and 50% males. The initial visual acuity (VA) was 1.84 log MAR. In this group, BCVA remained stable or increased in 61 eyes (74%). Regarding the PPV group, the average age was 43 years; 65% were men while 34% were women. The initial VA was 1.83 log MAR; in this group, the VA increased or remained stable in 28 eyes (73%). The evolution of the VA was rather symmetric in the two groups without a significant difference (P = 0.9). Similarly, the occurrence of postoperative complications was comparable for the main complications studied, namely the inflammatory reaction (P = 0.809), ocular hypertension (P = 0.344), corneal edema (P = 0.07), and neovascular glaucoma (P = 0.413). However, there was a decrease in BCVA (three lines) in the PPV group after 6 months of follow-up (P = 0.05) in patients with a clear lens preoperatively and who developed a clinically evident cataract., Conclusion: According to this study, for diabetic patients with severe cataracts and vitreoretinal disease requiring vitrectomy, combining vitrectomy with phacoemulsification as a single surgical intervention may be a suitable therapeutic choice. This approach does not significantly increase the risk of visual impairment or retinopathy development., (Copyright © 2024 Copyright: © 2024 Indian Journal of Ophthalmology.)

Purpose: To assess functional and anatomical consequences of the delay in intravitreal injections for diabetic macular edema (DME) patients during the corona virus pandemic lockdown in Morocco as well as to evaluate factors associated with disease progression., Patients and Methods: This cross-sectional study included DME patients who did not complete their scheduled intravitreal bevacizumab injections during the Lockdown period (March 20, 2020 to May 20, 2020). Data recorded included age, duration of diabetes, number of previous intravitreal injections, best-corrected visual acuity, and central macular thickness before and after the lockdown., Results: One hundred and fifty four eyes of 104 patients were analyzed. 57.8% were male. The mean age was 59.4±9.04 years. The mean duration of delay of intravitreal injections was 57.3±6.7 days. The mean number of intravitreal bevacizumab injections received before the lockdown was 2.29±2.1. Worsening of visual acuity was noted in 44.8% of patients and was associated with a lower number of intravitreal injections performed prior to the lockdown (P=0.001) and with glycemic imbalance (P=0.04). An increase in central macular thickness was noted in 26.6% of patients and was associated with a lower number of intravitreal injections (P=0.038)., Conclusion: The delay in intravitreal injections during the lockdown had negative effects on visual acuity and central macular thickness in eyes with DME. Prolonged delay in intravitreal anti-VEGF injections in diabetic patients should be avoided., (Copyright © 2021. Published by Elsevier Masson SAS.)

Purpose: To investigate the epidemiological, clinical, therapeutic and prognostic factors in cases of inferior rhegmatogenous retinal detachments (RD) treated by scleral buckling surgery., Patients and Methods: A retrospective chart review was performed on 45 patients (45 eyes) with inferior RD with only inferior tears (4:00-8:00), who had been treated by scleral buckling surgery over a 6-year period from 2006 to 2011. The parameters studied included patient demographics, refractive status, time until consultation, clinical exam data, treatment modalities and functional and anatomic results., Results: Forty-five cases were included in this study (45 eyes), with an average patient age of 44.5 years (14 to 75 years) and a slight male predominance (56%). Myopia was observed in 60%. Mean time until consultation was 3.5 months. Visual acuity on admission was less than 1/10 in 53.33%. Macular detachment was found in 80%. Causative lesions were holes in 26 eyes. Proliferative vitreoretinopathy was essentially stage B in 48.9%. Scleral buckling surgery was performed in all patients, with drainage of subretinal fluid in 37.8%. Retinal reattachment was obtained in 36 eyes (80%) with a final visual acuity greater than or equal to 1/10 in 71.11%. The mean follow-up in our study was 6.62 months., Conclusion: Inferior retinal detachment has a predilection for young myopes. The time until consultation is often long, and extraocular surgery, although difficult, exhibits documented efficacy., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)

Ocular involvement in the xeroderma pigmentosum (XP) can be located on the eyelids, conjunctiva or cornea. Malignant melanoma of the conjunctiva is a rare tumor, and even more so in children. Only five cases associated with XP have been published since 1960. We report a sixth case occurring in a girl aged 14. Surgical treatment consisted of an orbital exenteration extended to the eyelids and the evolution is marked by a good healing of the orbital cavity without local recurrence after four months.

Introduction: The purpose of our study is to determine the incidence of orbital complications that occurred after insertion of orbital porous polyethylene implant in children under the age of 15 years., Material and Methods: We report a series of 21 eyes of 21 patients younger than 15 years and in which a porous polyethylene implant is used for reconstruction of the orbital cavity after enucleation between January 2003 and December 2008.All patients were operated on by the same surgeon using the same technique., Results: These 11 boys and 10 girls, whose average age is 5.7 years. Histopathologic diagnoses after enucleation are dominated by the retinoblastoma (10 eyes) and phthisis bulbi (6 eyes). After a mean follow up of 23 months it was observed two cases of implant extrusion in children enucleated for retinoblastoma. No cases of orbital cellulitis or enucleated syndrome have been reported., Discussion: The most common complication of porous polyethylene implants in children is exposure. Risk factors may be related to surgical technique, infection, the implant, use of wrapping material and the association with adjuvant chemotherapy. Using a porous polyethylene implant uncovered remains an appropriate technique in children under 15 years for the reconstruction of the anophthalmic cavity, provided a rigorous surgical technique.

Purpose: To evaluate the prevalence of pseudoexfoliation syndrome (PES) in Moroccan patients with age-related cataract scheduled for surgery., Patients and Methods: In a retrospective study, 837 consecutive eyes with age-related cataract scheduled for surgery were evaluated for the prevalence of PES, type of cataract, intraocular pressure (IOP) and operative complications., Results: Exfoliation material was detected in 82 patients (9.8 %). The mean age was 69.3 years with no sex predilection. The condition was unilateral in 44 cases (53.7%) and bilateral in 38 cases (46.3%). The prevalence of PES increased with age (p=0.02). Patients with hypermature cataract had significantly more PES (p <0.001). Mean IOP was significantly higher in eyes with PES (17.7 +/- 6.4 mmHg) than those without PES (14.3 +/- 2.9 mmHg) (p<0.001). Operative complications occurred more frequently in patients with PES: 14 (17 %) than in those without PES: 58 (6.9 %)., Discussion: PES is a generalized degenerative fibrillopathy bound to age. The ethiopathogeny remains even unknown. The epidemiological data concerning the prevalence of the SPE in the African populations are scarce, and have not been published in Morocco, what motivated this study. Our study shows that this syndrome is common in Moroccan patients scheduled for cataract surgery with a prevalence of 9.8%. Its presence constitutes an important risk factor of primary open-angle glaucoma, and exposes more to peroperative complications at the time of surgery of cataract, independently of the technique used., Conclusion: There is great variation in the prevalence of PES among people of different regions and ethnic groups, although many factors interfere in the comparative analysis of results, hence the interest to achieve other complementary epidemiological studies.

Introduction: Osteoma is the most frequent benign tumor of paranasal sinuses. It is generally asymptomatic and usually discovered by chance during radiological imaging. Three cases with orbital extension are reported and discussed., Observations: 1st observation: Mrs. M.N. is an 18 years-old caucasian female who presented a stony orbital deformity associated with chronical dacryocystitis. Tomography of the orbit revealed a probable ethmoidal osteoma compressing the lacrimal canals. The management consisted in a surgical excision of the whole tumor by external approach, associated with a dacryocystorhinostomy. The patient's follow-up for the last 12 months was normal. 2nd observation: Miss K.A. is a 16 years-old caucasian female who came to consultation for a swelling of the medial angle of the left eye. Computed tomography images showed a fronto-ethmoidal process displaying a bone density consistent with an osteoma. The tumor was removed through an external ethmoidectomy. The patient was free of symptoms at 6 months follow-up. 3rd observation: Mrs. F. Z. is a 45 years-old patient who presented a 5 years history of right painful exophthalmos. The computed tomography was consistent with a fronto-ethmoidal osteoma with intraorbital extension near the optic nerve. The surgical excision was limited to the intraorbital portion. Postoperative complications included ptosis and diplopia., Discussion: Osteomas most commonly affect the fronto-ethmoid sinuses. They rarely show intraorbital extension or cause intracranial complications. They are generally asymptomatic. Symptoms are generally of late onset and are a consequence of tumoral growth and compression of neighbouring organs, as it is the case in our patients. Tumoral exophtalmos is the major ophthalmological sign. The computed tomography is of a great contribution, not only for diagnosis but also for the choice of the surgical approach. The classical surgical technique consists generally in a surgical excision of the osteoma. This surgery may induce ocular or neurochirurgical complications., Conclusion: Osteomas of the paranasal sinuses are usually asymptomatic. If they become voluminous, they may cause orbital manifestations and serious complications. The rarity of ethmoidal osteoma with orbital growth made our cases interesting to report.