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Primary open-angle glaucoma. Primary open-angle glaucoma is a progressive optic neuropathy with characteristic morphological changes at the optic nerve head and retinal fiber layer in the absence of other ocular disease. The diagnosis is difficult and based on conjunction of elevated intraocular pressure (inconstant) loss of retinal fiber layer and visual field defects., Competing Interests: D. Bensmail déclare des interventions ponctuelles pour Thea et Densemore, et avoir été pris en charge lors de congrès par Cristalens.

Purpose: To determine long-term efficacy of selective Laser Trabeculoplasty (SLT) over 12 years in chronic open-angle glaucoma (OAG) patients., Methods: In this retrospective study, all patients treated by SLT between 1997 and 1999 for OAG were included and followed up every 6 months. The procedure was performed with a Coherent Selecta 7000 Nd:YAG with 100 ± 10 non overlapping 400 μm spots over 360 degrees centered on the trabecular meshwork. Patients were excluded in the case of prior filtration surgery or Argon laser trabeculoplasty. Our primary study parameter was the number of patients requiring filtration surgery within the follow-up period. Our secondary parameters were intraocular pressure (IOP) and SLT-related complications., Results: We included 46 eyes of 28 patients. The 12-year success rate was 26.1%. Thirty-nine percent of all eyes underwent filtration surgery (failure) during the follow-up period, and 34.8% were lost to follow-up. In the pigmentary glaucoma (PG) subgroup, the 12-year success rate was 16%, while it was 37.5% in the Primary OAG subgroup. The overall mean IOP was 22.8 mm Hg (D.S. 3.78) prior to laser, 16.08 mm Hg (D.S. 2.7) at 1 year and 15 mm Hg (D.S. 1.8) at 12 years. The mean number of medications was 1.6 (D.S. 0.8) prior to SLT, 1.36 (D.S. 0.8) at 1 year, and 1.3 (D.S. 1.2), 12 years after SLT respectively. No patients had a second SLT treatment. No significant complications occurred during follow-up., Conclusion: Selective laser trabeculoplasty may at times be a useful resource to lower IOP in patients with OAG. Nonetheless, the failure rate is significant especially in PG, which requires confirmation by larger prospective studies., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)

Urinary symptoms are frequent in case of neurologic diseases, symptoms depends on the pathology as well as the extend and the location of the disease. Initial evaluation includes clinical, biological, urodynamic and radiologic assessment in order to precise symptoms quality of life and risk factors of medical complications. Treatment efficacy, adaptation to incapacities, evolution of the disease and complications require close follow up specially in the spinal cord injury and myelomeningocele population. Multidisciplinary approach is often required to optimise treatment strategy.

Introduction: The incidence of complications after baclofen pump implantation is relatively high. Diagnosis of these complications can be difficult. A diagnostic tree would be a useful tool in cases of suspected malfunctioning of the intrathecal bacolfen infusion system and would standardise the diagnostic procedure., Method: From results in the literature and the experience of our department, we designed a diagnostic tree to aid in finding the cause of a recrudescence of spasticity in patients with implanted baclofen pumps., Results: The potential causes of recrudescence of spasticity are described and a diagnostic pathway is proposed., Discussion: The aim of a standardised hierarchical method of diagnosis of the cause of increased spasticity in patients with intrathecal baclofen pumps is to gain time in the diagnosis and treatment. Such diagnosis should improve patient care by permitting rapid restoration of an adequate level of baclofen infusion as well as decreasing the length of hospital stay and, as a consequence, the cost relating to malfunctioning pumps.

Some recent studies in children with spasticity demonstrated the safety of multimuscle injections of botulinum toxin (BT) type A with doses markedly higher than those recommended. Data about efficacy and safety of multifocal injections of BT in adult patients with spasticity are very limited. However numerous clinical situations for example, spinal cord injury, multiple sclerosis, brain injury, stroke or cerebral palsy seem to justify this type of patient management. Controlled studies are expected in the future to evaluate the efficacy and safety of multisite injections of BT. They may encourage physicians to perform such multifocal injections with high doses of BT. A better understanding of distant spread of BT is also warranted.

TINU is a rare disease of unknown etiology that associates acute tubulointerstitial nephritis and uveitis in a context of systemic symptoms (asthenia, weight loss, fever) and inflammatory biological signs. We report a new case in a 10-year-old girl with unilateral uveopapillitis and renal insufficiency caused by interstitial nephritis (creatininemia: 225 micro mol/l). Complete recovery was obtained with high-dose systemic corticotherapy, with the patient remaining free of disease 2.5 years after the end of treatment. The disappearance of renal lesions was histologically verified.