Mapping of a congenital microcoria locus to 13q31-q32

Congenital microcoria is an autosomal dominant disorder characterized by a pupil with a diameter <2 mm. It is thought to be due to a maldevelopment of the dilator pupillae muscle of the iris, and it is associated with juvenile-onset glaucoma. A total genome search for the location of the congenital microcoria gene was launched in a single large family. We found linkage between the disease and markers located on 13q31-q32 (Zmax = 9.79; theta = 0). Haplotype analysis narrowed the linked region to an interval <8 cM between markers D13S1239 proximally and D13S1280 distally.

[Multiple pilomatricoma. Apropos of a case]

Pilomatricoma is a benign, solitary tumor. The histopathologic findings of viable basaloid cells in the periphery, shadow cells in the central part and foci of calcification are characteristic of pilomatricoma. The microscopic aspect of multiple pilomatricomas was not different from solitary pilomatricomas. Though, some consider them as a pathognomonic sign of myotonic dystrophy. Complete surgical excision is the best management.

Multivariate analysis versus vector analysis to assess surgically induced astigmatism

PURPOSE

To present a multivariate probability computation method for assessing surgically induced astigmatism.

SETTING

Department of Ophthalmology, Rennes University Hospital, Rennes School of Medicine, France.

METHODS

The multivariate method was used to evaluate 100 patients who had cataract surgery by phacoemulsification. Keratometry was recorded on the day before and 12 days after surgery. Surgically induced astigmatism was assessed by the multivariate method as well as by most of the published vector analysis methods.

RESULTS

The mean surgical induced astigmatism (+/- SD) with the multivariate analysis was 1.18 +/- 0.36 diopters (D) for the cylinder power and 25.00 +/- 5.50 degrees for the cylinder axis. With the vector analysis, the mean surgically induced astigmatism was 1.67 +/- 0.54 D with the Naylor, Jaffe, and Holladay methods; 0.45 +/- 0.30 D with the latest Naeser method; 1.34 +/- 0.38 D with the Cravy method (Cravy's vector); and -0.05 +/- 0.42 D for Cravy's delta K.

CONCLUSION

Although vector methods constitute interesting geometrical models, their number and their lack of linearity and explicit expression of results make them unsuitable for statistical analysis. Instead, a reliable, easily programmable method that uses existing software is recommended.

Excimer laser photorefractive keratectomy to correct astigmatism

PURPOSE

To evaluate the efficacy of excimer laser photorefractive keratectomy (PRK) to correct astigmatism.

SETTING

Hôpital Morvan, Brest, France.

METHODS

A 193 nm excimer laser was used to perform toric ablation with an expanding slit to flatten the cornea in the steeper meridian and/or to correct myopia with an iris diaphragm in 72 eyes (55 patients): 68 eyes for compound myopic astigmatism and 4 for astigmatism only.

RESULTS

Preoperative cylinder was -2.14 diopters (D) +/- 1.99 (SD) (range -0.50 to -5.50 D); 6 months postoperatively, it was -1.75 +/- 1.34 D (range -0.25 to -5.25 D). Preoperative spherical equivalent was -5.33 +/- 3.22 D (range -0.25 to -14.50 D); 6 months postoperatively, it was -0.86 +/- 2.32 D (range 2.50 to -9.75 D). The axial error was within 30 degrees. Uncorrected visual acuity was 0.50 or better in 64.5% of patients.

CONCLUSIONS

Overall patient satisfaction seemed the result of the myopic correction; cylindrical correction was incomplete. Future software refinements should improve the results. In particular, single elliptical ablation seems to offer theoretical advantages.

Association of congenital microcoria with myopia and glaucoma. A study of 23 patients with congenital microcoria

BACKGROUND

Congenital microcoria, a bilateral condition of the iris dilatator, is defined as a pupil with a diameter of less than 2 mm when looking at a distant object. Although it is usually a hereditary condition resulting from autosomal dominant transmission with no marked difference between the sexes, it is sometimes sporadic. The ocular abnormalities associated with this condition (myopia, astigmatism, and glaucoma) have never been linked to the malformation.

METHOD

Forty-two members of a family were examined: 23 had microcoria and 19 did not. The two groups were studied to identify symptoms of the condition and its associated abnormalities.

RESULTS

There was a very strong correlation between microcoria and myopia (Fisher's exact test, P < 0.00001), between microcoria and astigmatism (Fisher's exact test, P < 0.0001), and between microcoria and glaucoma (Fisher's exact test, P = 0.011).

CONCLUSIONS

There is a statistical correlation among myopia, glaucoma, and microcoria, and the disorders are associated with the condition in a nonfortuitous way. The functional prognosis for microcoria appears to be extremely poor because of refractive disorders and, particularly, a link between microcoria and glaucoma that is difficult to explain.

[Importance of studying deficiencies of IgG subclasses (IgG2 and IgG4) in immuno-allergologic practice]

Levels of the sub-classes of immunoglobulins IgG2 and IgG4 have been established by radial diffusion with monoclonal antibodies in 150 subjects. 49 (42 adults and 7 children) showed either a low level of IgG2 (less than 0.42 g/l n = 11) or a reduced level of IgG4 (less than 0.05 g/l n = 38). A single patient had a double deficit, 38 subjects had a superinfection of which 17 had a severe form and in 77% of these cases a level of IgG4 of less than 0.05 g/l.

[Surgery of 6th nerve paralysis. 74 cases]

85% of abducens palsies recover spontaneously; then their surgical treatment has not to be hastened. However many non regressive cases are frequently observed. Whatever they may be, partial or complete, uni or bilateral, always they give a great functional handicap which warrants a surgical care. The analysis of 74 successive cases allows to reveal some rules concerning the operative plan. In that respect the electro-oculographic recording often provides many essential informations. The recovery of a normal oculo-motor balance is usual in monolateral paresis. In bilateral complete palsies, in spite of muscle transposition procedures, we can only expect to reduce torticollis and to restore the ocular alignment in primary position, but abduction remains always impaired or fully impeded.