Publications (48)33.52 Total impact

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    ABSTRACT: IntroductionLe mélanome primitif de la choroïde (MPC) est une pathologie rare, il constitue cependant la tumeur intraoculaire primitive la plus fréquente chez l’adulte. Son diagnostic est anatomopathologique, couplé souvent à une étude immunohistochimique. Le but de notre travail est de discuter les particularités anatomocliniques et évolutives de cette tumeur rare. Patients et méthodesNous rapportons 12 cas de MPC diagnostiqués et pris en charge au CHU Habib-Bourguiba de Sfax sur une période de 27 ans (1980–2007). RésultatIl s’agissait de huit hommes et quatre femmes ayant un âge moyen de 58 ans, avec des extrêmes de 30 et 76 ans. La symptomatologie clinique était dominée par une baisse de l’acuité visuelle. L’examen oculaire avait révélé dans la majorité des cas une tumeur postérieure pigmentée avec décollement rétinien dans quatre cas. L’échographie avait objectivé un processus expansif hypoéchogène dans tous les cas. L’imagerie par résonance magnétique (IRM) était pratiquée dans six cas seulement et avait évoqué le diagnostic de mélanome. Une angiographie fluorescéinique était pratiquée dans un seul cas et avait montré une tumeur vascularisée. Une énucléation a été effectuée dans dix cas et une exentération dans les deux autres cas. Deux malades avaient bénéficié d’une radiothérapie adjuvante et un autre d’une chimiothérapie postopératoire. L’étude histologique, couplée à l’immunohistochimie, avait confirmé le diagnostic de mélanome.dans tous les cas. L’évolution était favorable pour six cas avec un recul moyen de 20 mois; une récidive locale était constatée dans trois cas et des métastases hépatiques dans deux cas dont un est décédé à 22mois postopératoires. Unmalade était perdu de vue. ConclusionL’énucléation, considérée comme le traitement de choix des mélanomes de la choroïde, est un geste radical et mutilant; cependant, de nouvelles modalités thérapeutiques ont tendance pour une approche conservatrice évitant une chirurgie d’énucléation. IntroductionChoroidal primary melanoma is the most common primary intraocular malignant tumour. The diagnosis is based on ophthalmoscopy, fluorescent angiography, B-scan ultrasonography and histological exam. Tumour markers like Melan A, HMB-45 and Protein S100 add to diagnostic accuracy. Our objective is to discuss the clinical and pathological data of choroïdal primary melanoma of and the prognosis of this rare tumor. Patients and methodsWe report twelve cases of choroidal primary melanoma during a period of 27 years (1980–2007). ResultsThere were eight men and four women ranging in age from 30 to 76 years (mean: 58 years). The most frequent symptom at presentation was decreased visual acuity. The ophtalmologic examination revealed a posterior pigmented tumour with retinal detachment in four cases. The ultra-sonography showed an intraocular hypoechoic tumour. Magnetic resonance (MRI), achieved in only six cases, suspected the diagnostic of melanoma. The fluorescent angiography was achieved in single case and showed a vascular tumour. Enucleation was performed in ten cases and an exentration in two cases; adjuvant radiotherapy was performed in two cases and chemotherapy in one case. The histologic exam with immunohistochimical study confirmed the diagnostic of choroidal melanoma. The outcome was favourable in six cases with with a middle average follow-up of 20 months, reccurence in three cases and two patients had hepatic metastasis, one of whom died; the last patient was lost sight of the fact. ConclusionEnucleation is still performed for choroidal melanoma; however, the past decades, numerous eye salvaging therapies for the tumour have been developed. Mots clésMélanome de la choroïde–Histologie–Immunohistochimie–Énucléation KeywordsChoroid melanoma–Histology–Immunohistochemical study–Enucleation
    Oncologie 12/2010; 12:125-131. DOI:10.1007/s10269-010-1965-9 · 0.08 Impact Factor
  • F Cheikhrouhou · F Makni · S Neji · H Sellami · A Masmoudi · H Turki · Z Ben Zina · J Fki · A Ayadi
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    ABSTRACT: Demodicidosis is an ectoparasitosis, common to humans and many mammals. It is caused by the proliferation of a mite Demodex sp in the pilosebaceous follicles. Its pathogenic role remains controversial. The aim of our study was to report epidemiological and clinical particularities of cases of demodicidosis diagnosed in our region. Over a period of nine years (January 2000 to December 2008), 427 cases of demodicidosis were diagnosed. 73.2% of cases were blepharitis and 26.8% of cases were facial dermatosis. The mean age was 44 years. Women were slightly more affected (56%) than men. Among 787 chronic blepharitis, 243 cases were due to Demodex sp (30.9%). They were treated with yellow oxide of mercury (Ophtergine® 1%). In the face, this mite has been isolated from erythematous and pruritic papulopustular lesions, and their distribution was as follows: cheeks (22.1%), forehead (13.4%), and nose (11.5%). The diagnosis was confirmed by parasitological examination of scales showing more than 5 Demodex sp/cm(2) and response to treatment with metronidazole (Flagyl®) for three months. Currently, there were a large number of arguments for the incrimination of Demodex sp in pathogenesis of dermatosis and blepharitis. Dermatologists and ophthalmologists must therefore think to this mite. The density of Demodex sp found by parasitological exam is a determining factor in establishing an anti-Demodex treatment whose effectiveness is a further argument for the diagnosis.
    Bulletin de la Société de pathologie exotique 10/2010; 103(4):238-42.
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    ABSTRACT: L’objectif de notre travail a été de rapporter les particularités épidémiologiques et cliniques des cas de démodécidose diagnostiqués dans la région de Sfax. Sur une période de neuf ans (janvier 2000–décembre 2008), nous avons colligé 427 cas de démodécidose sous forme de blépharites (73,2 % des cas) et d’atteinte du visage (26,8 % des cas). L’âge moyen était de 44 ans. Les femmes étaient légèrement plus concernées (56 %) que les hommes. Deux cent quarantetrois parmi 787 cas de blépharite chronique ont été dus à Demodex sp (30,9 %). Ils ont été traités par une pommade d’oxyde jaune de mercure (Ophtergine® 1 %). Au niveau du visage, cet acarien a été isolé de lésions érythémateuses et papulopustuleuses prurigineuses touchant surtout les joues (22,1 %), le front (13,4 %) et le nez (11,5 %). Le diagnostic a été confirmé sur la richesse de l’examen parasitologique des squames montrant plus de cinq Demodex sp par centimètre carré et la réponse au traitement à base de métronidazole (Flagyl®) pendant trois mois. Actuellement, un grand nombre d’arguments plaident pour l’incrimination du Demodex sp dans les dermatoses du visage ainsi que dans la blépharite. Il faut donc sensibiliser les dermatologues et les ophtalmologues à penser à cette affection, surtout que la densité du Demodex sp retrouvée par l’examen parasitologique constitue le facteur déterminant dans l’instauration d’un traitement anti-Demodex, dont l’efficacité est un argument de plus pour le diagnostic. Demodicidosis is an ectoparasitosis, common to humans and many mammals. It is caused by the proliferation of a mite Demodex sp in the pilosebaceous follicles. Its pathogenic role remains controversial. The aim of our study was to report epidemiological and clinical particularities of cases of demodicidosis diagnosed in our region. Over a period of nine years (January 2000 to December 2008), 427 cases of demodicidosis were diagnosed. 73.2% of cases were blepharitis and 26.8% of cases were facial dermatosis. The mean age was 44 years. Women were slightly more affected (56%) than men. Among 787 chronic blepharitis, 243 cases were due to Demodex sp (30.9%). They were treated with yellow oxide of mercury (Ophtergine® 1%). In the face, this mite has been isolated from erythematous and pruritic papulopustular lesions, and their distribution was as follows: cheeks (22.1%), forehead (13.4%), and nose (11.5%). The diagnosis was confirmed by parasitological examination of scales showing more than 5 Demodex sp/cm2 and response to treatment with metronidazole (Flagyl®) for three months. Currently, there were a large number of arguments for the incrimination of Demodex sp in pathogenesis of dermatosis and blepharitis. Dermatologists and ophthalmologists must therefore think to this mite. The density of Demodex sp found by parasitological exam is a determining factor in establishing an anti-Demodex treatment whose effectiveness is a further argument for the diagnosis. Mots clésDémodécidose- Demodex sp-Blépharite chronique-Dermatose-Sfax-Tunisie KeywordsDemodicidosis- Demodex sp-Chronic blepharitis-Dermatosis-Tunisia
    Bulletin de la Société de pathologie exotique 10/2010; 103(4):238-242. DOI:10.1007/s13149-010-0066-8
  • M Frigui · M Kechaou · M Jemal · Z Ben Zina · J Feki · Z Bahloul
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    ABSTRACT: The objective of this study was to analyse the incidence and the main characteristics of optic neuropathy in Behçet's disease. A retrospective review of a well-documented population of 376 Tunisian patients with Behçet's disease was performed. All patients fulfilled three or more criteria defined by the International Study Group for Behçet's Disease. The diagnosis of optic neuropathy was based on the clinical examination, visual field, visual evoked potentials and retinal angiography. Eighteen patients (4.7 %) presented an optic nerve involvement. The mean age at presentation of these patients (10 men and nine women) was 39.11+/-12.9 years (range 17 to 73). The mean vision at presentation was 4.2/10+/-2.9, the vision was less than 1/10 in 34.5 % of eyes. The optic neuropathy was anterior in 89 % cases (26 eyes, 90 %), posterior in one case (2 eyes, 7 %); one patient (1 eye, 3 %) presented an optic atrophy. The optic neuropathy was associated with other ocular lesions in 13 cases (72.2 %). It was an inflammatory neuropathy in four cases (22.3 %) and a stasis papilledema complicating a benign intracranial hypertension in five cases (27.8 %). Corticosteroids were administrated in 17 cases (94.4 %), cyclophosphamide in six cases (33.3 %) and anticoagulant therapy in one patient (5.6 %). After a mean duration of 79 months (range: three months to 12 years), a third of the patients (8 eyes, 27.5 %) have a visual loss. Optic neuropathy is a rare ocular involvement in Behçet's disease. It can be related to an inflammatory neuropathy, a stasis papilledema complicating a benign intracranial hypertension or an ischemic neuropathy. The association of optic neuropathy with other ocular lesions could be responsible for a diagnostic delay. Its treatment relies on systemic corticosteroids and immunosuppressive drugs. The prognosis remained poor, with a third of the patients having lost their sight.
    La Revue de Médecine Interne 05/2009; 30(6):486-91. DOI:10.1016/j.revmed.2008.12.021 · 1.32 Impact Factor
  • Journal Français d Ophtalmologie 04/2009; 32. DOI:10.1016/S0181-5512(09)73746-5 · 0.36 Impact Factor
  • Journal Français d Ophtalmologie 04/2009; 32. DOI:10.1016/S0181-5512(09)73751-9 · 0.36 Impact Factor
  • Journal Français d Ophtalmologie 04/2009; 32. DOI:10.1016/S0181-5512(09)73732-5 · 0.36 Impact Factor
  • W Kharrat · K Turki · H Ben Amor · D Sellami · A Sellami · A Trigui · B Kamoun · Z Ben Zina · J Feki
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    ABSTRACT: Vitreous hemorrhage is a frequent complication of proliferated diabetic retinopathy. Vitrectomy has vastly improved its prognosis. The purpose of this study was to evaluate the use of silicone oil in vitreal surgery in this indication. We present a retrospective study of 15 eyes that underwent vitrectomy and silicone oil injection for vitreal hemorrhage complicating proliferative diabetic retinopathy. For each patient, we noted the clinical and echographic features, the surgical procedure, and the postoperative outcome after a mean period of 20 months. The indications for silicone injection were recurrent vitreal hemorrhage (seven eyes), aggressive fibrovascular proliferations (five eyes), and iatrogenic retinal breaks (three eyes). Anatomic success was noted in ten cases. Four patients had a hemorrhage reoccurrence after silicone oil removal and one patient developed neovascular glaucoma. Silicone cataract (seven eyes) and emulsification of silicone (one eye) were noted. The use of silicone oil in vitreal surgery for complicated proliferated diabetic retinopathy contributes a hemostatic and plugging effect, but it still has a number of disadvantages such as the need to remove it and its own side effects. It can be beneficial in cases of rubeosis or recurrent hemorrhage. However, it is essentially indicated in recurrent hemorrhage in monophthalmos patients.
    Journal francais d'ophtalmologie 03/2009; 32(2):98-103. · 0.36 Impact Factor
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    ABSTRACT: Introduction Vitreous hemorrhage is a frequent complication of proliferated diabetic retinopathy. Vitrectomy has vastly improved its prognosis. The purpose of this study was to evaluate the use of silicone oil in vitreal surgery in this indication. Methods We present a retrospective study of 15 eyes that underwent vitrectomy and silicone oil injection for vitreal hemorrhage complicating proliferative diabetic retinopathy. For each patient, we noted the clinical and echographic features, the surgical procedure, and the postoperative outcome after a mean period of 20 months. Results The indications for silicone injection were recurrent vitreal hemorrhage (seven eyes), aggressive fibrovascular proliferations (five eyes), and iatrogenic retinal breaks (three eyes). Anatomic success was noted in ten cases. Four patients had a hemorrhage reoccurrence after silicone oil removal and one patient developed neovascular glaucoma. Silicone cataract (seven eyes) and emulsification of silicone (one eye) were noted. Discussion The use of silicone oil in vitreal surgery for complicated proliferated diabetic retinopathy contributes a hemostatic and plugging effect, but it still has a number of disadvantages such as the need to remove it and its own side effects. It can be beneficial in cases of rubeosis or recurrent hemorrhage. However, it is essentially indicated in recurrent hemorrhage in monophthalmos patients.
    Journal Français d Ophtalmologie 02/2009; 32(2):98-103. DOI:10.1016/j.jfo.2009.01.002 · 0.36 Impact Factor
  • Journal Français d Ophtalmologie 04/2008; 31:210-210. DOI:10.1016/S0181-5512(08)71297-X · 0.36 Impact Factor
  • Journal Français d Ophtalmologie 04/2008; 31:157-157. DOI:10.1016/S0181-5512(08)71087-8 · 0.36 Impact Factor
  • Journal Français d Ophtalmologie 04/2008; 31:159-159. DOI:10.1016/S0181-5512(08)71096-9 · 0.36 Impact Factor
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    ABSTRACT: The aim of this study was to evaluate the frequency and main risk factors for corneal graft rejection. This retrospective study included 285 eyes in 256 patients who underwent a penetrating keratoplasty (KPT) from January 1995 to December 2004. The minimum follow-up was 12 months to evaluate graft evolution. Except for complications, the follow-up was weekly, then monthly for 6 months, and ultimately quarterly during the first year. Thereafter the follow-up was performed semi-annually. Patients were informed about the functional signs for which they have to urgently consult. Immunologic rejection of the corneal graft occurred in 128 KPT in 112 patients (rejection frequency = 41%). The identified main risk factors were new vascularization of the recipient cornea over 2 or more quadrants, corneal opacity due to an infectious origin, posttraumatic corneal opacity or congenital glaucoma, graft diameter >8 mm, and therapeutic KPT. Rejection of the corneal graft is the primary cause of KPT failure. One out of 2 graft failures was due to rejection. Two criteria are unanimously recognized as risk factors for rejection: neovascularization of recipient cornea and antecedents of corneal rejection. The rejection must be treated early to not endanger graft success, which imposes a close follow-up for grafted patients.
    Transplantation Proceedings 10/2007; 39(8):2609-11. DOI:10.1016/j.transproceed.2007.08.020 · 0.95 Impact Factor
  • Journal Français d Ophtalmologie 04/2007; 30. DOI:10.1016/S0181-5512(07)80253-1 · 0.36 Impact Factor
  • Journal Français d Ophtalmologie 04/2007; 30. DOI:10.1016/S0181-5512(07)80356-1 · 0.36 Impact Factor
  • Journal Français d Ophtalmologie 04/2007; 30. DOI:10.1016/S0181-5512(07)80281-6 · 0.36 Impact Factor
  • K. Dabbeche · B. Kamoun · W. Kharrat · S. Abid · H. Boumoud · Z. Ben Zina · J. Feki
    Journal Français d Ophtalmologie 04/2007; 30. DOI:10.1016/S0181-5512(07)80406-2 · 0.36 Impact Factor
  • Journal Français d Ophtalmologie 04/2007; 30. DOI:10.1016/S0181-5512(07)80450-5 · 0.36 Impact Factor
  • Journal Français d Ophtalmologie 04/2007; 30. DOI:10.1016/S0181-5512(07)80247-6 · 0.36 Impact Factor
  • Journal Français d Ophtalmologie 04/2007; 30. DOI:10.1016/S0181-5512(07)80254-3 · 0.36 Impact Factor