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The new vaccine against trachoma is established upon a stimulation of MALT system by oral route. The amount of IgA produced using chlamydia trachomatis serovar C is sufficient to allow a protection against infections of the same species of chlamydiae and/or of others varieties. There is a cross immunity between different serovars and different species. The vaccine could bring a protection against trachoma, chlamydial infection of human and animals.

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PURPOSE: Malignant tumours of the eye and adnexa are generally rare, and in the absence of a French national register of declaration of cancers, only an approximate evaluation can be made. We studied the epidemiology of tumours of the eye and adnexa from the laboratory results of anatomical pathology of biopsies examinated at the laboratory of Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts in Paris. MATERIALS AND METHODS: Statistical analysis of the results of histological diagnoses, their sites and the personal histories recovered from the laboratory registers from 1925-1995, a period of 70 years, were carried out. RESULTS: 1705 malignant tumours of the eye and adnexa diagnosed over 70 years consisted of 760 melanomas (44.6%), 450 carcinomas (26.4%), 338 retinoblastomas (19.8%), 95 haematopoetic tumours (5.6%), and 62 diverse others (3.6%). These tumours were localised in: the endo-ocular (1035 cases), lids (398 cases), conjunctiva (119 cases), orbit (90 cases), lacrimal glands (23 cases), caruncle (10 cases), eye lashes (8 cases), optic nerve (6 cases), cornea (3 cases), lacrimal sac (2 cases) and undefined (11 cases). CONCLUSION: In our study, endo-ocular tumours are the most frequently seen of all tumours of the eye and adnexa (60.7%) and are essentially represented by melanomas in the elderly and by retinoblastomas in the newborn and infants. Carcinomas are the most frequent lid malignant pathology whose presence increases with age. Tumours originating from haematopoetic tissues are often seen in the sub-epithelial tissues of orbit, lids, conjunctiva and lacrimal gland.

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PURPOSE: An epidemiological study of the aetiology of enucleation was conducted in patients seen at the Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris. The enucleated globes were systematically sent to the laboratory for histological examination. METHODS AND MATERIALS: Histological results of the cases from the register of Anatomo-Pathology section of the laboratory of the C.H.N.O. des Quinze-Vingts, over a 70-year period from 1925-1995 were used; 3,246 globes were examined, that is, 32.83% of all histological examinations. RESULTS: In our series, malignant tumours were the most frequent cause of enucleation (32%), followed by trauma (18%), glaucoma (16%), atrophies-dystrophies (16%) and inflammatory causes (12%). Globes without histological pathology were rare (0.12%). The majority of ophthamic tumours with histological confirmation were melanomas (65.2%) in old age and retinoblastomas (32.5%) in the newborn and early infancy. Our results are compared with those of other authors. CONCLUSION: Great improvements in medicine and diagnostic techniques have taken place, these last decades, and with the possibilities of early diagnosis, enucleation has become rare as it is being replaced by conservative management.

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PURPOSE: Benign tumors and the inflammations of the eye and its adnexa are about twice as frequent as malignant tumours. Because of the aesthetic value or functional importance and the diagnostic difficulties that they can induce, we thought it interesting to conduct an epidemiological study including the localization and the different histological forms of benign tumors and inflammations of theeye. MATERIAL AND METHODS: This study was carried out for a period of 70 years between 1925 and 1995, utilizing case histories and results of the histological examinations of the Pathology Department of the Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts in Paris. The statistics included the histological diagnostic, the localization and the civil data. RESULTS: Benign tumors and inflammations of the eye and its adnexa corresponded respectively to 25.9% and 7.1% of the histological results accomplished in the laboratory. Papilloma (31.4%) and cysts (28.2%) were the most frequent benign tumors. Chalazions represent the most frequent aetiology of inflammation (49%), followed by granuloma (30%). Our results are compared to those of other laboratories. CONCLUSION: While malignant tumors account for the majority of endo-ocular tumors, benign tumors and inflammatory processes are almost always extra-ocular involving the conjunctiva and the eye lids (in particular the inferior eye lid). Papilloma and cysts together account for about 50% of the benign tumors and inflammations of the eye.

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This study reviewed 43 patients with Sjögren's syndrome. All of the patients complained of either dry eye and/or dry mouth. Their clinical records were compared with results of three laboratory diagnostic tests to determine the most sensitive test. Out of 30 patients who complained of both dry eye and dry mouth, 10 had positive conjunctival impressions, 20 had positive gingival impressions and 24 had positive salivary gland biopsies. Of 5 patients who suffered from only dry mouth, 2 had positive conjunctival impressions, 3 had positive gingival impressions and 3 had positive salivary gland biopsies. Of 7 patients with only dry eye complaints, there were 3 positive conjunctival impressions, 5 positive gingival impressions, and 6 positive salivary gland biopsies. Out of 6 healthy controls without complaints of dry eyes/mouth, there were no positive conjunctival impressions, 4 positive gingival impressions, and 5 positive salivary gland biopsies. Gingival impression appears to be nearly as sensitive as salivary gland biopsy in this group of patients suffering from Sjögren's Syndrome.

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A protocol associating chemoprophylaxis and two-agent flash antibioprophylaxis was performed for more than two years in order to prevent postoperative endophthalmitis in elective open-globe surgery. The aim of this study is to appreciate whether antibiotic therapy is really useful as a complement to chemoprophylaxis. Three successive conjunctival scrapings were performed in the operating room: two before surgery (one before and one after conjunctival disinfection by povidone iodine), and the third one at the end of the operation. The total number of positive scrapings significantly decreased after disinfection but, some changes appeared on the final scrapings positive and negative. The risks of a positive scraping after the disinfection are greater if the scraping was initially positive. The persistence of a positive scraping after disinfection is noted in about 20% of cases. Therefore, there is a risk for microorganisms to penetrate into the eye, still present on the conjunctiva after povidone iodine. This risk is an argument to carry on the flash antibiotic therapy before surgery, in order to obtain a high intravitreal concentration of antibiotics at the precise time when the bacteria may penetrate into the eye, and to stop their multiplication.

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We report external ocular side effects after treatment with acitretin, a new synthetic vitamin A analogue and the main metabolite of etretinate. A patient treated with 20-25 mg/day of acitretin for psoriasis suffered from chronic blepharoconjunctivitis. Schirmer tests, tear lysozyme were normal while rose bengal and fluorescein staining disclosed epithelial punctate defects and tear break-up time was shortened. Meibomian glands of the lower lid were photographed with transillumination and appeared atrophic. Conjunctival cytology and biopsy showed snake-like chromatine appearance, keratinized epithelial cells and some lymphocytes infiltrates. Accessory salivary gland histological aspects were nonspecific. There was a clear relationship between restarting the acitretin therapy and recurrence of ocular symptoms. Acitretin, like other retinoids, may induce or exacerbate blepharoconjunctivitis in patients with psoriasis.

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In intraocular parasitosis the immunologic reactions in the vitrectomy-fluids depend on the parasitic agent: there is a lymphocytical reaction without any IgE production in toxoplasmic chorioretinitis, whereas there is a strong hypersensitivity reaction with a local IgE production as well as the presence of eosinophils and an antigenic stimulation in fluids with toxocara parasitosis. The electrophoretic patterns are quite similar in both cases.

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The biochemical agents involved in fern formation on drying tears were investigated by studying the different patterns of ferning of tears from normal and pathological eyes, mucus glycoprotein, saliva, serum, and various salt solutions. We conclude that the ferning phenomenon observed when a drop of tears is allowed to dry at room temperature on a clean microscope slide is to a large extent determined by the electrolyte concentration, especially the ratio of monovalent sodium and potassium ions to divalent calcium and magnesium ions. The presence of a biopolymer is essential, but this need not specifically be mucus as previously thought. The test may therefore be useful clinically in indicating the need for further tear analysis.

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Serum histamine levels are significantly lowered in patients with human immunodeficiency virus (HIV) infection. Treatment with zidovudine has no effect on histaminaemia, but HIV-positive patients with thrombocytopenic purpura who underwent splenectomy are known to have had a rise in serum histamine levels after the operation. This parameter might be used as prognostic factor in the evaluation of patients with HIV infection.

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Ultrastructural study, by Scanning and Transmission Electron Microscopy, of three choroidal melanomas allows us to depict main features and cellular types of melanomas and to discuss our results with precedent studies. One case of balloon-cell tumor shows an unusual (from unknown genesis) substance, intra- or extracellularly located, but always near pigment cells expansions.

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