Institute Hedi Raies Dophtalmologie

Tunis, Tunisia

Institute Hedi Raies Dophtalmologie

Tunis, Tunisia

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Chebbi A.,Institute Hedi Raies Dophtalmologie | Bouguila H.,Institute Hedi Raies Dophtalmologie | Boussaid S.,Institute Hedi Raies Dophtalmologie | Ayari-Jeridi H.,Institute Hedi Raies Dophtalmologie | And 5 more authors.
Journal Africain du Cancer | Year: 2015

Purpose: The aim of this study was to analyze the different histopathological risk factors influencing the prognosis of retinoblastoma.Patients and methodes: Hundred sixty eight patients whether 172 eyes were included in this study, including 50 cases of bilateral retinoblastoma and 112 cases of unilateral retinoblastoma.Histological examination of enucleated globes has determined the degree of choroidal, scleral, optic nerve, and anterior chamber invasion. The degree of differentiation was also analyzed.Results: The global survival rate was 87,5%. The histopronostic factors identified were the extraretinal involvement with extension within the choroid (p=0,011), sclera (p=0,001), optic nerve resection line (p=0,001), post-laminar optic nerve involvement (p=0,133) and anterior chamber invasion (p=0,02).Conclusion: The prognosis of retinoblastoma mainly depends on the extraretinal invasion. These histoprognostic risk factors should be considered for therapeutic management. © 2014, Springer-Verlag France.


Chebbi A.,Institute Hedi Raies dOphtalmologie | Bouguila H.,Institute Hedi Raies dOphtalmologie | Boukari M.,Institute Hedi Raies dOphtalmologie | Lajmi H.,Institute Hedi Raies dOphtalmologie | And 6 more authors.
Journal Francais d'Ophtalmologie | Year: 2015

Summary Purpose To discuss possible factors that could influence the prognosis of primary malignant conjunctival tumors. Patients and methods We retrospectively analyzed medical records of 79 patients followed for primary malignant conjunctival tumors between January 1997 and July 2011. Results The mean age at the time of diagnosis was 61.1 years; male/female ratio was 2.59. The mean tumor size was 13.9mm. The histological type was invasive squamous cell carcinoma in 43 cases (54.4%), epithelial dysplasia in 11 cases (13.9%), carcinoma in situ in 7 cases, conjunctival malignant melanoma in 5 cases, conjunctival lymphoma in 4 cases and other rare tumors in 9 cases. We performed an excisional biopsy with a safety margin in 89.8% of cases, associated with cryotherapy in 46.6% of cases. Enucleation was performed in two cases and orbital exenteration in 5 cases. We noted tumor recurrence in 33.3% of patients after an average period of 9.5 months. Radiation therapy was indicated in 44 cases (55.7%). The mean follow-up of our patients was 42 months. Tumor recurrences were statistically associated with a history of xeroderma pigmentosum (PCombining double low line0.012), a diagnostic delay more than 11 months (PCombining double low line0.001), caruncular location (PCombining double low line0.004), tumor size greater than 10mm (PCombining double low line0.044), scleral extension (PCombining double low line0.011), initial treatment limited to excisional biopsy (PCombining double low line0.033) and histopathologic involvement of the margin of the tumor resection (PCombining double low line0.008). Conclusion A better understanding of the prognostic factors of primary malignant conjunctival tumors is essential for management and may improve the prognosis of these tumors. © 2015 Elsevier Masson SAS.


Chebbi A.,Institute Hedi Raies Dophtalmologie | Bouguila H.,Institute Hedi Raies Dophtalmologie | Lajmi H.,Institute Hedi Raies Dophtalmologie | Fekiih O.,Institute Hedi Raies Dophtalmologie | And 5 more authors.
Journal Africain du Cancer | Year: 2015

Purpose: The aim of this study was to report our experience in ocular surface squamous neoplasia management and to analyze the tumor recurrence risk factors.Materials and methods: We included 69 patients having an ocular surface squamous neoplasia. All of them underwent a complete ophthalmological examination with a precise evaluation of the extension. The treatment was based on surgery, cryotherapy, topical chemotherapy, and brachytherapy.Results: The mean age in our series was of 60.5 (±20.3) years with a sex-ratio of 2.28. The tumor was in the bulbar conjunctiva in 62 cases (89.8%) and in the tarsal conjunctiva in 7 cases (10%). The mean tumor size was of 12.3 mm. The histopathological analysis showed an invasive carcinoma in 51 cases (74%) and conjunctival intraepithelial neoplasia in 18 cases (26%). A locoregional extension was noted in 55 patients (69.6%). The tumor recurrence rate was 31.8%. The global survival rate was 93% at 3 years. Recurrence risk factors found in our study were the medial canthus location (P = 0.002), the tumoral size superior to 10 mm (P = 0.02), the sclera extension (P = 0.01), and the initial treatment (P = 0.03). There was no correlation with the anatomoclinical aspect (P = 0.6) and the corneal extension (P = 0.2).Conclusion: The global survival rate of the ocular surface squamous neoplasia (OSSN) is excellent because of the low locoregional extension and distance rates. The main problem with these tumors is the high rate of recurrence. © 2014, Springer-Verlag France.


Chebbi A.,Institute Hedi Raies Dophtalmologie | Aleya N.B.,Institute Hedi Raies Dophtalmologie | Lajmi H.,Institute Hedi Raies Dophtalmologie | Malek I.,Institute Hedi Raies Dophtalmologie | And 3 more authors.
Journal Africain du Cancer | Year: 2014

Introduction: The primary malignant tumors of the eyelids are common especially among the elderly and have varied clinical and pathological aspects.Materials and Methods: This is a retrospective study, covering 85 patients followed for primary malignancy of the eyelids. The diagnosis of malignancy was confirmed by histological examination of tumor resection specimens or tumor biopsies.Results: The average age of our patients was 69 years, ranging from 12 to 97 years.We found 8.7% cases of xeroderma pigmentosum and 0.9% cases of albinism. Sun exposure and smoking were found in 34% and 31.3% of cases. The tumor was unilateral in 95.7% of cases and at the lower eyelid in 57.5% and upper eyelid in 21.7%.Discussion: The primary malignant tumors of the eyelids mainly affect the elderly, but can occur in young subjects in whom they are more aggressive. The causal factor most frequently mentioned is sun exposure. In addition, certain general conditions may favor the development of these tumors. The clinical appearance of the tumor can predict its malignancy, but histological study makes the diagnosis.Conclusion: The prognosis of this condition is related to their locoregional, metastatic potential, and histological type. The main known risk factor is sun exposure. © 2014, Springer-Verlag France.


Taamallah-Malek I.,Institute Hedi Raies dOphtalmologie | Chebbi A.,Institute Hedi Raies dOphtalmologie | Bouladi M.,Institute Hedi Raies dOphtalmologie | Nacef L.,Institute Hedi Raies dOphtalmologie | And 2 more authors.
Journal Francais d'Ophtalmologie | Year: 2013

We report the case of 20-year-old patient who presented in emergency with bilateral massive, spontaneous subconjunctival hemorrhage. Clinical findings suggested a blood dyscrasia, which was confirmed by blood cell count. The patient was urgently referred to hematology where the diagnosis of acute lymphoblastic leukemia was made. This case highlights the importance of working up any unusual subconjunctival hemorrhage, as it may reveal, in certain cases, a severe life-threatening disease. © 2012 Elsevier Masson SAS.


Zghal I.,Institute Hedi Raies dOphtalmologie | Malek I.,Institute Hedi Raies dOphtalmologie | Amel C.,Institute Hedi Raies dOphtalmologie | Soumaya O.,Institute Hedi Raies dOphtalmologie | And 2 more authors.
Journal Francais d'Ophtalmologie | Year: 2013

Summary Necrotizing viral retinitis is associated with infection by the Herpes family of viruses, especially herpes simplex virus (HSV), varicella zoster virus (VZV) and occasionally cytomegalovirus (CMV). When the diagnosis is suspected clinically, antiviral therapy must be instituted immediately. We report the case of a patient presenting with necrotizing viral retinitis 3 months following intravitreal injection of triamcinolone acetonide for diabetic macular edema. Fluorescein angiography demonstrated a superior temporal occlusive vasculitis. A diagnostic anterior chamber paracentesis was performed to obtain deoxyribo-nucleic acid (DNA) for a polymerase chain reaction (PCR) test for viral retinitis. PCR was positive for CMV. The patient was placed on intravenous ganciclovir. CMV retinitis is exceedingly rare in immunocompetent patients; however, it remains the most common cause of posterior uveitis in immunocompromised patients. The incidence of this entity remains unknown. Local immunosuppression, the dose and the frequency of injections may explain the occurrence of this severe retinitis. © 2013 Elsevier Masson SAS.


PubMed | Institute Hedi Raies dophtalmologie
Type: Case Reports | Journal: Journal francais d'ophtalmologie | Year: 2013

We report the case of 20-year-old patient who presented in emergency with bilateral massive, spontaneous subconjunctival hemorrhage. Clinical findings suggested a blood dyscrasia, which was confirmed by blood cell count. The patient was urgently referred to hematology where the diagnosis of acute lymphoblastic leukemia was made. This case highlights the importance of working up any unusual subconjunctival hemorrhage, as it may reveal, in certain cases, a severe life-threatening disease.

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