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To compare the rate of retinal detachment in a group of patients treated with intravitreal ganciclovir to the rate of retinal detachment in a group of patients treated with systemic ganciclovir.A retrospective non-randomized comparative case series was conducted. The participants were 186 consecutive patients with cytomegalovirus (CMV) retinitis treated at two centres over the period from June 1990 to May 1997. Of the 186, 133 patients had systemic therapy of whom 113 had intravenous ganciclovir or foscarnet and 20 had oral ganciclovir, and 53 patients had intravitreal induction and maintenance therapy. The main outcome measure was the rate of retinal detachment, which was calculated using person-months-at-risk denominators. The effect measure used in the main comparative analysis was the hazard ratio obtained from multiple regression using the Cox proportional hazards model.Retinal detachment occurred in three of 53 patients in the intravitreal therapy group, one of 20 patients receiving oral maintenance therapy and 21 of 113 patients receiving intravenous maintenance therapy. The risk of retinal detachment with systemic therapy was 14-fold higher than with intravitreal therapy (P0.001)and up to fourfold higher with oral maintenance therapy.Intravitreal therapy offers a significant advantage over systemic therapy in the treatment of CMV retinitis by substantially reducing the risk of CMV-related retinal detachment.

International audience; Ferroquine (FQ, SSR97193) is currently the most advanced organometallic drug candidate and about to complete phase II clinical trials as a treatment for uncomplicated malaria. This ferrocenecontaining compound is active against both chloroquine-susceptible and chloroquine-resistant Plasmodium falciparum and P. vivax strains and/or isolates. This article focuses on the discovery of FQ, its antimalarial activity, the hypothesis of its mode of action, the current absence of resistance in vitro and recent clinical trials.; La ferroquine (FQ, SSR97193) est actuellement le candidat médicament organométallique le plus avancé dans son développement industriel et, en tant que traitement du paludisme non compliqué, il devrait bientôt voir s’achever des études cliniques de phase II. Ce composé à base de ferrocène est extrêmement actif contre des isolats et/ou des clones de Plasmodium falciparum et de P. vivax sensibles ou résistants à la chloroquine. Cet article présente la découverte de la FQ, son activité antipaludique, les hypothèses liées à son mode d’action, l’absence actuelle de résistance in vitro et, enfin, les récents essais cliniques.

OBJECTIVE--To investigate reasons for an increase in cases of Acanthamoeba keratitis related to contact lenses. DESIGN--Case-control study. Cases were contact lens related acanthamoeba keratitis patients treated between 1 September 1989 and 31 August 1992. Controls were lens users without lens related disease who presented as new patients to the casualty department from 1 March 1992 to 31 August 1992. All subjects completed a questionnaire detailing lens use and hygiene practices. SETTING--Eye hospital. SUBJECTS--35 cases with acanthamoeba keratitis and 378 controls. MAIN OUTCOME MEASURES--Relative risks comparing different contact lens types, socioeconomic classification, age, sex, lens use, lens wearing experience, hygiene compliance, and hygiene systems. RESULTS--The crude relative risk for developing acanthamoeba keratitis with the use of daily wear disposable lenses was 49.45 (95% confidence interval 6.53 to 2227; P < 0.001) compared with conventional soft lenses (the referent). Multivariable analysis showed that this increased risk could be largely attributed to lack of disinfection (relative risk 55.86 (10 to 302); P < 0.001) and use of chlorine based disinfection (14.63 (2.8 to 76); P = 0.001) compared with other chemical systems (the referent). None of the other outcome measures showed a significant association. CONCLUSIONS--Both failure to disinfect daily wear soft contact lenses and the use of chlorine release lens disinfection systems, which have little protective effect against the organism, are major risk factors for acanthamoeba keratitis. These risks have been particularly common in disposable lens use. Over 80% of acanthamoeba keratitis could be avoided by the use of lens disinfection systems that are effective against the organism.

The survey was conducted in 3 out of the 18 administrative regions (aimaks); 4345 people aged > or = 40 years were examined, which represented 95.7% of the proposed sample. The prevalences of blindness and low vision in the sample were 1.5% (95% CI, 0.8-2.3%) and 8.1% (95% CI, 5.5-10.7%), respectively, from which the prevalences of blindness and low vision in the Mongolian population aged 40 years and older were estimated to be 1.4% and 7.7%, respectively. The prevalence of climatic droplet keratopathy was high (ranging from 15% to 50%) in this population, which included a large number of semi-nomadic cattle breeders, and was responsible for 7.2% of the blindness and 19.3% of the low vision. Cataract and glaucoma were the commonest blinding disorders, each accounting for around 35% of the blindness. Trauma accounts for a high proportion of those monocularly blind. Trachoma and xerophthalmia were not found.