Anomalies et complications vasculaires dans les drusen du nerf optique [Vascular anomalies and complications of optic nerve drusen]

BACKGROUND: Drusen of the optic disc are associated with slowly progressive optic neuropathy, characterized by accumulation of acellular laminated concretions in the prelaminar portion of the optic nerve. Papillary hemorrhages and vascular shunts have been reported with disc drusen but their frequency and clinical significance is not well known. METHODS: Retrospective study of fundus photographs of 116 patients with disc drusen referred to the National Hospital for Neurology and Neurosurgery, London, between 1965 and 1991. RESULTS: Hemorrhages were found in 23 eyes from 16/116 (13.8%) patients. Most cases (68.8%, 11/16 cases) occurred in patients with buried drusen, and most hemorrhages were deeply located. Vascular shunts were present in 6.9% (8/116 cases), most frequently in patients with exposed drusen (6/8 cases), most being of the venous type (7/8 cases). DISCUSSION: Vascular anomalies are not rare in disc drusen, as 20.7% (24/116 cases) of our patients presented either disc hemorrhages or shunt vessels. Their presence supports the hypothesis of the slowly progressive nature of disc drusen and the more advanced stage of optic neuropathy in such eyes.

Qu'est-ce que la pensée du politique ? Une introduction au projet philosophique de Claude Lefort

L'article se donne pour tâche d'introduire à la « pensée du politique » du philosophe français Claude Lefort, et surtout de marquer l'originalité de ce projet philosophique par rapport à la philosophie politique classique. Opposée au présupposé du réalisme normatif qui fonde la pensée classique, et basée au contraire sur la conviction que la signification est constitutive du social, la « pensée du politique » de Lefort prend la forme d'une interrogation de la diversité des formes de société. Ce biais interprétatif permet seul de retrouver une dimension normative