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Introduction Les lesions precancereuses du carcinome mucineux (CM) sont rarement objectivees au moment du diagnostic histologique.

Galectin-3 is a specific soluble lectin of the beta-galactoside family. It plays an important role in cell adherence, proliferation, and differentiation. It has also been shown that galectin-3 expression correlates with tumor progression in several types of cancers. We investigated the involvement of galectin-3 in colorectal cancer development. We performed a comparative immunohistochemical analysis of galectin-3 expression in term of intensity and distribution in normal mucosa, in primary tumor and in metastasis from 200 patients with colorectal cancer selected among 325 cases. We also compared the galectin-3 staining according to the histological subtype (mucinous vs non mucinous), tumoral differentiation and stage of tumor. We showed a strong and diffuse positive staining of galectin-3 in both adjacent and distanced normal mucosa, in well differentiated adenocarcinoma and in metastasis. However, we note a progressive decrease of galectin-3 staining according to the decreasing degree of tumoral differentiation. We also observed a loss of this protein in adenocarcinoma with mucinous component50%, where the positive staining was limited only to the well differentiated areas of tumor. These data suggest that galectin-3 play an important role in colorectal cancer progression concerning the non mucinous carcinoma and can be used as a prognostic factor to predict poor outcome of patients. In mucinous subtype, galectin-3 might be implicated in one or many step of its genesis perhaps through the control of cellular adhesion and interaction with mucin produced. Adenocarcinoma with mucinous component50% would be integrate to mucinous carcinoma, not to non mucinous ones. These investigations could open perspectives for therapeutic means targeted to improve the prognosis of this neoplasm.

But De recents travaux ont montre l’incrimination des molecules d’adhesion dans la pathogenie de la retinopathie diabetique. Ces molecules d’adhesion s’expriment sur diverses cellules intervenant dans divers processus inflammatoires et de neovascularisation. Le but dans cette etude est d’analyser l’expression de la molecule d’adhesion intercellulaire de type 1 (ICAM-1) dans la conjonctive des patients diabetiques sans retinopathie et de la comparer a celle des patients non-diabetiques. Methodes Quinze biopsies conjonctivales ont ete prelevees chez des patients diabetiques sans retinopathie ophtalmoscopique et angiographique. La conjonctive humaine « normale » a ete prelevee chez cinq patients lors d’une cure chirurgicale de cataracte senile. L’analyse immunohistochimique a ete effectuee par la methode d’immunoperoxydase indirecte, en utilisant un anticorps monoclonal dirige contre ICAM-1. Resultats La molecule d’adhesion ICAM-1 etait presente au niveau des cellules epitheliales, endotheliales vasculaires et inflammatoires. Un profil different d’expression a ete trouve chez les patients diabetiques pour une meme duree de diabete. Dans la conjonctive humaine normale, l’expression d’ICAM-1 etait tres faible. Conclusion Cette etude preliminaire montre que la molecule ICAM-1 est presente au niveau de la conjonctive des patients diabetiques sans retinopathie clinique. Ce resultat pourrait permettre une nouvelle approche de la pathogenie de la retinopathie diabetique.

Introduction Les resultats anatomiques et fonctionnels du traitement des decollements de retine par dechirures geantes ont ete nettement ameliores par le developpement des techniques de vitrectomie et, surtout, l’utilisation des perfluorocarbones liquides. Dans ce travail, nous rapportons les resultats du traitement du decollement de retine par dechirure geante chez 17 patients. Materiels et methodes Cette etude a porte sur 17 yeux de patients, âges de 18 a 61 ans, presentant un decollement de retine par dechirure geante. La taille de la dechirure allait de 90° a 220°. Une proliferation vitreo-retinienne stade C etait presente dans deux yeux. L’acuite visuelle preoperatoire variait de 8/10 e a « une perception lumineuse ». Tous les patients ont eu un cerclage avec une vitrectomie a trois voies, une mise a plat de la retine par perfluorocarbone liquide, un endolaser, une cryoapplication et un tamponnement transitoire par huile de silicone. Resultats Le recul moyen etait de 20 mois ± 16. Une recidive du decollement de retine a ete notee dans 5 cas sous silicone et dans 2 cas apres ablation de silicone. Le succes anatomique au dernier recul a ete obtenu pour 14 yeux (82,3 %). Sur le plan fonctionnel, l’acuite visuelle s’est amelioree dans tous les cas de succes anatomique sauf un. Les complications postoperatoires les plus frequentes etaient la cataracte qui a ete notee dans 10 yeux parmi 12 phaques et l’hypertonie qui a ete retrouvee dans 4 cas. Conclusion La vitrectomie avec tamponnement interne par huile de silicone permet d’ameliorer le pronostic anatomique et fonctionnel du decollement de la retine par dechirure geante. Les recidives sont dues le plus souvent a la reproliferation vitreo-retinienne. Les complications postoperatoires les plus frequentes demeurent l’opacification cristallinienne et l’hypertonie.

But Le but de cette etude est d’analyser la topographie de la tete du nerf optique par l’ophtalmoscope laser a balayage confocal dans les hypertonies oculaires (HTO) et de la comparer a celle d’une population normale. Materiels et methodes Nous avons examine 25 patients avec HTO isolee et 27 patients normaux. Tous les patients ont beneficie d’un examen ophtalmologique complet. L’analyse de la tete du NO a ete faite par l’ophtalmoscope laser a balayage confocal type Heidelberg retina tomograph (HRT). La surface du disque, la surface et le volume de l’excavation, le rapport C/D, la surface et le volume de l’anneau neuroretinien, la profondeur moyenne et maximale de l’excavation, la mesure de la forme de l’excavation, la hauteur de la variation du contour, l’epaisseur moyenne et la surface de la couche des fibres nerveuses retiniennes ont ete mesurees. Resultats Sur l’ensemble des parametres stereometriques etudies, nous avons constate une reduction significative du volume de l’anneau neuroretinien, de la variation de la hauteur du contour et de l’epaisseur de la couche des fibres nerveuses retiniennes chez les patients presentant une HTO par rapport aux sujets normaux. Conclusion Le HRT semble etre d’un apport potentiel dans le depistage precoce des alterations de la couche des fibres nerveuses retiniennes dans les HTO.

· Background: In order to study growth factors in the pathogenesis and recurrence of pterygium, we grew pterygium tissues in culture and compared fibroblasts from primary and from recurrent pterygia with reference to the fibroangiogenic growth factors basic fibroblast growth factor (b-FGF), platelet-derived growth factor (PDGF), transforming growth factor β (TGF-β) and tumor necrosis factor α (TNF-α). · Methods: We used indirect immunohistochemical procedures against human b-FGF, PDGF, TGF-β and TNF-α. As controls, we used cultured normal human conjunctival fibroblasts. A serum-free conditioned medium (CM) from confluent fibroblasts derived from primary and recurrent explants was assessed by enzyme-linked immunosorbent assay to determine the level of the above-mentioned growth factors. · Results: Immunoreactivity of b-FGF was stronger in recurrent than in primary pterygium fibroblasts. PDGF immunolabeling was stronger in primary than in recurrent pterygium fibroblasts. TGF-β and TNF-α immunolabeling was weak in both pterygia. All these growth factors were very sparse in normal conjunctival fibroblasts. Basic-FGF and TGF-β1 were found in the CM from both primary and recurrent pterygium, while PDGF and TNF-α were not detectable. · Conclusion: The strong immunoreactivity and the release of b-FGF in cultured fibroblasts of recurrent pterygia suggest that fibroblasts may play an important role in the recurrence of pterygium.

To study drug therapy for pterygium, especially the effect of a fumagillin analog, TNP-470, a potent anti-angiogenic compound, on the growth of cultured fibroblasts obtained from primary pterygia and normal human conjunctiva.Cultured pterygium fibroblasts (PF) were exposed to different concentrations of TNP-470 every other day for 7 days (Treatment A) and to a single dose before 4 days of culture (Treatment B). Human normal conjunctival fibroblasts (HCF) were treated with TNP-470 every other day for 7 days. The cells were observed daily by phase contrast microscopy. Cell proliferation was assessed by counting cells with a hemocytometer. Trypan blue uptake was used to determine cell viability at harvest.TNP-470 induced a significant inhibition of PF and HCF proliferation in a dose-dependent manner (P.0001). At the lowest dose of TNP-470 (100 pg/ml), the cumulative inhibitory effect of TNP-470 was more potent than the sustained inhibitory effect observed by treatment B in one high dose. Nevertheless, the cytotoxic effect was dose-dependent and more marked after treatment A than after treatment B. After washing out of the drug, partial reversibility was observed at doses lower than 5 mg/ml with a significant increase of viability. HCF were less sensitive to TNP-470 and doses less than 5 mg/ml were not cytotoxic.TNP-470 appears to have a marked inhibitory effect on PF proliferation, and it may be of considerable value in the prevention of pterygium growth and recurrence.

Recent research has incriminated adhesion molecules in the pathogenesis of diabetic retinopathy. These molecules have been found to be expressed in many cells participating in inflammatory processes and neovascularization. The purpose of our investigation was to study the expression of intercellular adhesion molecule type 1 (ICAM-1) in the conjunctiva of diabetic patients without retinopathy in comparison with normal human conjunctiva.Fifteen conjunctival biopsies were obtained from diabetic patients without retinopathy. The ocular fundus examination and retinal fluorescein angiography were normal. The normal human conjunctiva were taken from five patients undergoing senile cataract surgery. Immunohistochemical analysis consisted of indirect immunoperoxidase using the monoclonal antibody ICAM-1.The adhesion molecule ICAM-1 was immunolocalized in epithelial, vascular endothelial, and inflammatory cells. The expression of this molecule was different in diabetic patients for the same duration. In the normal human conjunctiva, the expression of ICAM-1 was very low.This preliminary study shows that ICAM-1 is present in the conjunctiva of diabetic patients without retinopathy and thus may add new insights into the pathogenesis of diabetic retinopathy.

Cervico-oculo-acoustic syndrome is an uncommon syndrome consisting of Klippel Feil syndrome, deafness, and Duane syndrome. We relate a new case of cervico-oculo-acoustic syndrome.We report the case of 15-month-old girl referred for esotropia of the right eye. Ocular examination revealed type 1 Stilling Duane syndrome in the right eye, in which we also noted microcornea, iris coloboma, and papillary and inferior chorioretinal coloboma sparing the macular area. The left eye was normal. The physical examination revealed Klippel Feil syndrome characterized by an extremely short neck with limited movement, a low posterior head line and fusion of the cervical vertebrae on radiography. The association of hearing loss (due to agenesis of the external ear) with Klippel Feil syndrome and Stilling Duane syndrome confirmed the diagnosis of cervico-oculo-acoustic syndrome.This case is unique because of the association of cervico-oculo-acoustic syndrome with ocular coloboma of the right eye. This association has not been reported previously in the literature.

Anatomical and functional results of the treatment of retinal detachment associated with giant retinal tear have been markedly improved with the development of the vitrectomy procedure and especially the use of perfluorocarbon liquids. In this study, we report treatment results of retinal detachment associated with giant tear in 17 patients.Our study included 17 patients (17 eyes), aged between 18 and 61 years, with retinal detachment associated with giant retinal tear. The size of the tear was between 90 degrees and 220 degrees . Proliferative vitreoretinopathy grade C was present in two eyes. Preoperative visual acuity ranged between 40/50 and light perception. All patients underwent scleral buckling, vitrectomy, perfluorocarbon liquid injection to flatten the retina, endophotocoagulation, cryoapplication and temporary silicone oil tamponade.Mean follow-up was 20 months +/- 16. Recurrent retinal detachment occurred in five eyes under silicone oil and in two eyes after its removal. Anatomical success at final follow-up was obtained in 14 eyes (82.3%). Visual acuity improved in all cases with anatomical success in all but one. The most frequent postoperative complications were cataract in 10 cases among 12 phakic eyes and ocular hypertension in four cases.Vitrectomy with internal silicone oil tamponade improves the anatomical and functional prognosis of retinal detachment associated with giant retinal tear. Recurrent retinal detachment is usually due to relapsing proliferative vitreoretinopathy. The most frequent postoperative complications remain lens opacification and ocular hypertension.

To analyze optic nerve head topography using confocal the scanning laser ophthalmoscope (CSLO) in ocular hypertension in comparison to normal eyes.We examined 25 patients with ocular hypertension and 27 normal controls. All of them had a complete ophthalmic examination. Optic nerve head analysis was performed by using a CSLO-type Heidelberg retina tomograph (HRT). The following stereometric parameters were evaluated: disc area, area and volume of cup, cup/disc ratio, area and volume of neuroretinal rim, mean and maximal cup depth, cup shape measure, height variation contour, mean retinal nerve fiber layer thickness, and retinal nerve fiber layer (RNFL) cross-section area.In ocular hypertension eyes, rim volume, height variation contour and RNFL thickness showed a statistically significant reduction compared to normal eyes.HRT appears to be an important tool in detecting early damage of retinal nerve fiber layer in ocular hypertension.

· Background: This study was carried out to describe the clinical features and electron-microscopic characteristics of the capillaries in pterygium with conjunctival hemorrhage. · Methods: We compared the clinical findings in Japanese and Tunisian primary pterygia and in pterygium with and without bulbar conjunctival hemorrhages. The capillary fine structures of pterygium with bulbar conjunctival hemorrhages were studied by electron microscopy and compared with those without bulbar conjunctival hemorrhages. · Results: Conjunctival hemorrhages were noted in 16.4% of Tunisian patients but not in any Japanese patients. The former pterygia were significantly larger, more vascular and more frequently hyperemic than the latter. Pterygia with bulbar conjunctival hemorrhages were more hyperemic than without hemorrhages. Electron microscopy revealed interruptions of the endothelial cells and basement membrane of the capillaries in the pterygia with bulbar conjunctival hemorrhages, with blood cells escaping through the endothelial interruptions. · Conclusion: Conjunctival hemorrhage in pterygia may be caused by fragility of the endothelial cells and basement membrane in the capillaries, which easily induces hemorrhage when the eyes are irritated by rubbing or by conjunctival foreign bodies. Pterygium with conjunctival hemorrhage is more frequently found in Tunisians than in Japanese.

Some fibroangiogenic factors have recently been shown to play potential roles in fibrovascular diseases. The aim of this study was to examine whether there is any relationship between growth factors and pterygium genesis. Twenty-three primary pterygia and 4 normal conjunctiva specimens were analyzed by indirect immunohistochemistry using specific antibodies against basic fibroblast growth factor (b-FGF), platelet derived growth factor (PDGF), transforming growth factor-beta (TGF-beta) and tumor necrosis factor-alpha (TNF-alpha). Positive immunostaining of these growth factors was located in the epithelial cells, endothelial cells of vessels, basement membranes of vessels and epithelium, fibroblasts and infiltrating inflammatory cells in the pterygium. In the normal conjunctiva, positive immunolabeling for TGF-beta and PDGF was much weaker than in the pterygium. We conclude that growth factors may interact directly or indirectly in the pathogenesis of pterygium although proof of this awaits further studies.

Introduction Le syndrome cevico-oculo-acoustique est un syndrome rare, qui associe l’anomalie cervicale de Klippel Feil, une surdite et le syndrome de Duane. Nous rapportons un nouveau cas du syndrome cervico-oculo-acoustique chez un nourrisson, de sexe feminin, âge de 15 mois. Observation Un nourrisson, âge de 15 mois, de sexe feminin, fut adresse pour un strabisme convergent de l’œil droit. L’examen ophtalmologique mit en evidence un syndrome de Stilling Duane de type 1 a l’œil droit. Le reste de l’examen de l’œil droit montrait une microcornee, un colobome irien, un colobome chorioretinien inferieur englobant la papille, mais epargnant la macula. L’examen de l’œil gauche etait normal. Sur plan general, l’enfant presentait un syndrome malformatif de Klippel Feil avec un cou tres court, une implantation basse des cheveux, une limitation extreme des mouvements de la tete et une soudure des vertebres cervicales a la radiographie du rachis. L’association du syndrome de Klippel Feil a une agenesie du conduit auditif externe gauche et a un syndrome de Stilling Duane permit de retenir le diagnostic de syndrome cervico-oculo-acoustique de Wildervanck. Conclusion Cette observation est particuliere par l’association au syndrome cervico-oculo-acoustique de Wildervanck d’un syndrome malformatif oculaire de type colobomateux au niveau de l’œil droit. Cette association n’a pas ete precedemment rapportee dans la litterature.