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Chudzinski R, Levron A, Agard E, Douma I, Billant J, Dot C. Comparison of corneal topography maps obtained using the IOLMaster 700 ® and the Anterion ® in candidates for toric IOL implantation. Eye (Lond) 2024:10.1038/s41433-024-03094-1. [PMID: 38653750 DOI: 10.1038/s41433-024-03094-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 03/06/2024] [Accepted: 04/12/2024] [Indexed: 04/25/2024] Open
Abstract
OBJECTIVES To compare central corneal topography (CT) obtained using the IOLMaster 700® biometer to corneal topography obtained using a Swept-Source OCT-based predicated topographer (PT), in candidates for toric intraocular lens (IOL) implantation. METHODS A retrospective comparative study was conducted in consecutive patients undergoing a routine cataract surgery assessment with significant astigmatism on keratometry. Each patient was examined using both the IOLMaster 700® (Carl Zeiss Meditec, Jena, Germany) and the Anterion® (Heidelberg Engineering, Heidelberg, Germany) for routine preoperative measurements. The corneal axial anterior power map obtained with each device was then anonymized and analysed independently by two ophthalmologists using a reading grid. The reading grid assessed the usual parameters describing astigmatism and evaluated if a toric IOL was indicated or a second topography examination was needed to confirm the indication. RESULTS In total, 169 eyes of 120 patients were included. The inter-examination agreement for the astigmatism description ranged from 56 to 85% depending on the reader and parameter. The decision to implant a toric IOL based on the axial map was the same in 59-60% of cases depending on the examiner. A second examination was needed in 18-25% and 8-14% of cases after CT and PT, respectively. The IOLMaster 700® central anterior axial map allowed toric IOL implantation in 58-70% of cases with no need for second corneal examination. CONCLUSION The agreement between the anterior axial maps obtained using both devices was good. However, in about a quarter of the cases, dedicated topography had to be performed to confirm the surgical indication.
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Affiliation(s)
- Roman Chudzinski
- Department of Ophthalmology, Edouard Herriot University Hospital, Hospices Civils de Lyon, France
| | | | | | | | - Jérémy Billant
- Department of Ophthalmology, Edouard Herriot University Hospital, Hospices Civils de Lyon, France
- Desgenettes Military Hospital, Lyon, France
| | - Corinne Dot
- Department of Ophthalmology, Edouard Herriot University Hospital, Hospices Civils de Lyon, France.
- Desgenettes Military Hospital, Lyon, France.
- French Military Health Service Academy of Val de Grâce, Paris, France.
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Bouvarel H, Agard E, Billant J, Levron A, Chudzinski R, Plas H, Bernier R, Sejournet L, Chaperon M, Dot C. Correction: Long-term real-life outcomes of the Clareon® hydrophobic intraocular lens: the Clarte study in 191 eyes : 3-years real-life outcomes of the Clareon® intraocular lens. BMC Ophthalmol 2024; 24:178. [PMID: 38641586 PMCID: PMC11027327 DOI: 10.1186/s12886-024-03451-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2024] Open
Affiliation(s)
- Hugo Bouvarel
- Department of Ophthalmology, Hospices Civils de Lyon, E. Herriot University Hospital, Lyon, France.
| | - Emilie Agard
- Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France
| | - Jérémy Billant
- Department of Ophthalmology, Hospices Civils de Lyon, E. Herriot University Hospital, Lyon, France
- Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France
| | - Antoine Levron
- Department of Ophthalmology, Hospices Civils de Lyon, E. Herriot University Hospital, Lyon, France
| | - Roman Chudzinski
- Department of Ophthalmology, Hospices Civils de Lyon, E. Herriot University Hospital, Lyon, France
| | - Hélène Plas
- Department of Ophthalmology, Hospices Civils de Lyon, E. Herriot University Hospital, Lyon, France
| | - Raphaël Bernier
- Department of Ophthalmology, Hospices Civils de Lyon, E. Herriot University Hospital, Lyon, France
| | - Lucas Sejournet
- Department of Ophthalmology, Hospices Civils de Lyon, E. Herriot University Hospital, Lyon, France
| | - Mayeul Chaperon
- Department of Ophthalmology, Hospices Civils de Lyon, E. Herriot University Hospital, Lyon, France
| | - Corinne Dot
- Department of Ophthalmology, Hospices Civils de Lyon, E. Herriot University Hospital, Lyon, France
- Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France
- French Military Medical Academy, Val-de-Grâce, Paris, France
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Bouvarel H, Agard E, Billant J, Levron A, Chudzinski R, Plas H, Bernier R, Sejournet L, Chaperon M, Dot C. Long-term real-life outcomes of the Clareon® hydrophobic intraocular lens: the Clarte study in 191 eyes : 3-years real-life outcomes of the Clareon® intraocular lens. BMC Ophthalmol 2024; 24:133. [PMID: 38532367 PMCID: PMC10964544 DOI: 10.1186/s12886-024-03393-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 03/13/2024] [Indexed: 03/28/2024] Open
Abstract
BACKGROUND To describe and analyze the real-life refractive, functional and safety outcomes of the Clareon® intraocular lens (IOL) after 3 years. METHODS Data was collected retrospectively for observational purposes between July 2017 and December 2019 in the ophthalmology department of Desgenettes military hospital in Lyon, France. Eyes that underwent cataract surgery with Claeron® implantation were consecutively included. Patients with a systemic or ocular condition that could affect the visual outcome were excluded. Postoperative corrected (CDVA) and uncorrected (UDVA) distance visual acuities as well as capsule and IOL transparency were assessed at 1 month and 3 years. RESULTS A total of 326 eyes were analyzed at one month and 191 eyes were reassessed at the 3-year follow-up visit. At 3 years, the mean CDVA was 0.003 LogMAR (95% confidence interval [CI]: -0.003 to -0.01) and the mean UDVA was 0.075 (95% CI: 0.054 to 0.095). Three quarters of the patients had an UDVA ≥ 0.097 logMAR (20/25 Snellen equivalent) and 50% had an UDVA ≥ 0 (20/20). The absence of glistening was reported in 95.3% of cases and 4.7% [9] of patients experienced a clinically significant posterior capsular opacification (PCO) for which Nd:YAG treatment was required. CONCLUSIONS This real-life study reports high-performance and stable long-term refractive outcomes of the Clareon® IOL with good safety in terms of PCO and glistening.
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Affiliation(s)
- Hugo Bouvarel
- Department of Ophthalmology, Hospices Civils de Lyon, E. Herriot University Hospital, Lyon, France.
| | - Emilie Agard
- Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France
| | - Jérémy Billant
- Department of Ophthalmology, Hospices Civils de Lyon, E. Herriot University Hospital, Lyon, France
- Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France
| | - Antoine Levron
- Department of Ophthalmology, Hospices Civils de Lyon, E. Herriot University Hospital, Lyon, France
| | - Roman Chudzinski
- Department of Ophthalmology, Hospices Civils de Lyon, E. Herriot University Hospital, Lyon, France
| | - Hélène Plas
- Department of Ophthalmology, Hospices Civils de Lyon, E. Herriot University Hospital, Lyon, France
| | - Raphaël Bernier
- Department of Ophthalmology, Hospices Civils de Lyon, E. Herriot University Hospital, Lyon, France
| | - Lucas Sejournet
- Department of Ophthalmology, Hospices Civils de Lyon, E. Herriot University Hospital, Lyon, France
| | - Mayeul Chaperon
- Department of Ophthalmology, Hospices Civils de Lyon, E. Herriot University Hospital, Lyon, France
| | - Corinne Dot
- Department of Ophthalmology, Hospices Civils de Lyon, E. Herriot University Hospital, Lyon, France
- Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France
- French Military Medical Academy, Val-de-Grâce, Paris, France
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Leroux P, Agard E, Billant J, Levron A, Bouvarel H, Badri Y, Douma I, Pradat P, Dot C. Long Intervals between Intravitreal Injections Using a Treat-and-Extend Protocol in a Real-Life Context in AMD: The LIRE Study. Ophthalmologica 2023; 247:44-57. [PMID: 38104545 PMCID: PMC10836925 DOI: 10.1159/000535806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023]
Abstract
INTRODUCTION The aim of the study was to assess the outcome of long treat-and-extend (TE) anti-VEGF intravitreal injection (IVI) intervals (≥every 12 weeks [Q12W]) in neovascular age-related macular degeneration (nAMD). The aims of this retrospective study were to determine the proportion of nAMD eyes treated ≥ Q12W, to analyze their longitudinal, functional, and anatomical outcomes, and to compare functional and anatomical outcomes between eyes that rapidly versus slowly reached a Q12W regimen and between eyes directly treated with versus initiating lately the TE regimen. METHODS All patients receiving IVIs for nAMD were screened. The longitudinal, functional, and anatomical characteristics of Q12W-treated eyes were reported at different timepoints. RESULTS Ninety-one eyes were included (38% of our total nAMD cohort). The mean TE regimen time to reach a Q12W interval was 20.1 ± 16.2 months. During this time, a mean number of 12.1 ± 9.3 IVIs were needed. The mean best-corrected visual acuity was 68 letters at the time of diagnosis and was maintained (p > 0.05). Eyes that rapidly reached a Q12W interval had a shorter follow-up before TE regimen initiation (p = 0.04) and received fewer IVIs (p = 0.02) than eyes that slowly reached a Q12W interval. Eyes directly treated with the TE regimen reached a Q12W interval more rapidly than eyes with late TE initiation. The neovascularization subtype was not a predictor of outcome in TE-treated eyes. CONCLUSION ≥Q12W eyes represent an important part of the nAMD population in our real-life study. No baseline anatomical characteristics were associated with the outcome under a TE regimen, although early TE regimen initiation allowed extending more rapidly the IVI interval.
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Affiliation(s)
- Pierre Leroux
- Department of Ophthalmology, Edouard Herriot University Hospital, Hospices Civils de Lyon, Lyon, France,
- University Claude Bernard Lyon 1, Villeurbanne, France,
| | - Emilie Agard
- Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France
| | - Jérémy Billant
- Department of Ophthalmology, Edouard Herriot University Hospital, Hospices Civils de Lyon, Lyon, France
- Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France
| | - Antoine Levron
- Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France
| | - Hugo Bouvarel
- Department of Ophthalmology, Edouard Herriot University Hospital, Hospices Civils de Lyon, Lyon, France
- University Claude Bernard Lyon 1, Villeurbanne, France
| | - Yannis Badri
- Department of Ophthalmology, Edouard Herriot University Hospital, Hospices Civils de Lyon, Lyon, France
- University Claude Bernard Lyon 1, Villeurbanne, France
| | - Ikrame Douma
- Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France
| | - Pierre Pradat
- Centre for Clinical Research, Croix-Rousse Hospital, Hospices Civils de Lyon, Lyon, France
| | - Corinne Dot
- Department of Ophthalmology, Edouard Herriot University Hospital, Hospices Civils de Lyon, Lyon, France
- Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France
- French Military Academy of Val-de-Grâce, Paris, France
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Billant J, Douma I, Agard E, Levron A, Bouvarel H, Leroux P, Badri Y, Dot C. [Late steroid-induced ocular hypertension after intravitreal dexamethasone implants: A series of 20 cases]. J Fr Ophtalmol 2023:S0181-5512(23)00410-2. [PMID: 37758545 DOI: 10.1016/j.jfo.2023.03.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/27/2023] [Accepted: 03/29/2023] [Indexed: 09/29/2023]
Abstract
INTRODUCTION Steroid-induced ocular hypertension (OHT) occurs in approximately one third of cases after dexamethasone implant (DEXi) injection. Among these, more than one fifth occur after the third DEXi intravitreal injection (IVI). Our goal was to analyze the clinical profiles of these late responders. MATERIAL AND METHODS A real-life, retrospective, observational study was conducted to assess demographic characteristics and intraocular pressure (IOP) responses in late responders (IOP ≥ 21mmHg, n DEXi ≥ 4). The following parameters were analyzed: IOP 2 months after IVI and number of glaucoma medications needed. The IOP response compared to baseline was defined as low (< +6mmHg), moderate (≤ +15mmHg) or high (> 15mmHg). RESULTS Late steroid-induced OHT occurred in 20.8% of cases. Twenty eyes (18 patients) were included. The mean duration of follow-up was 3.8±1.9 years. They received a mean number of 9.5±4.2 IVI. The first OHT peak, measured at 25.3±3.2mmHg (21-31), occurred after 6.8±2.3 IVI. Approximately 65% of OHT spikes occurred between the fourth and sixth IVI; 35% occurred later. At maximum, 1.7±1.0 glaucoma medications and 0.75±0.79 SLT procedures were required to control the OHT, with no filtering surgery required. The ratio of "low," "moderate," and "high" responders was 5%, 85% and 10% respectively. CONCLUSION Late steroid-induced OHT occurs after at least 3 DEXi in one fifth of multi-injected patients, requiring long-term IOP monitoring. This case series identifies mostly moderate responder profiles, whose IOP rise often remains well-controlled with medical management or laser treatment (SLT).
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Affiliation(s)
- J Billant
- Service d'ophtalmologie, hôpital d'instruction des Armées Desgenettes, Lyon, France.
| | - I Douma
- Service d'ophtalmologie, hôpital d'instruction des Armées Desgenettes, Lyon, France
| | - E Agard
- Service d'ophtalmologie, hôpital d'instruction des Armées Desgenettes, Lyon, France
| | - A Levron
- Service d'ophtalmologie, hôpital d'instruction des Armées Desgenettes, Lyon, France
| | - H Bouvarel
- Service d'ophtalmologie, hôpital d'instruction des Armées Desgenettes, Lyon, France
| | - P Leroux
- Service d'ophtalmologie, hôpital d'instruction des Armées Desgenettes, Lyon, France
| | - Y Badri
- Service d'ophtalmologie, hôpital d'instruction des Armées Desgenettes, Lyon, France
| | - C Dot
- Service d'ophtalmologie, hôpital d'instruction des Armées Desgenettes, Lyon, France; École du Val-de-Grâce, Paris, France; Service d'ophtalmologie, hôpital Édouard-Herriot, hospices civils de Lyon, Lyon, France
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Rémignon CH, Levron A, Agard E, Douma I, El-Chehab H, Brunet O, Sejournet L, Billant J, Dot C. Impact of Total Corneal Astigmatism Estimated With the Abulafia-Koch Formula Versus Measured With a SS-OCT Biometer on the Refractive Outcomes of a Toric Intraocular Lens in Cataract Surgery. J Refract Surg 2023; 39:171-179. [PMID: 36892238 DOI: 10.3928/1081597x-20230103-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
PURPOSE To compare the impact of total corneal astigmatism (TCA) estimated with the Abulafia-Koch formula (TCAABU) versus measured by Total Keratometry (TK), swept-source optical coherence tomography (OCT) coupled with telecentric keratometry (TCATK) on the refractive outcomes after cataract surgery with toric intraocular lens (IOL) implantation. METHODS Two hundred one eyes of 146 patients who underwent cataract surgery with toric IOL implantation (XY1AT; HOYA Corporation) were included in this single-center, retrospective study. For each eye, TCAABU (estimated from the anterior keratometry values measured with the IOLMaster 700 [Carl Zeiss Meditec AG]) and TCATK (measured using TK IOLMaster 700) were entered into the HOYA Toric Calculator. Patients were operated on based on TCAABU. For each eye, centroid and mean absolute error in predicted residual astigmatism (EPA) were calculated according to TCA used (TCAABU or TCATK). The cylinder power and the axis of the posterior chamber IOL were compared. RESULTS The mean uncorrected distance visual acuity was 0.07 ± 0.12 logMAR, the mean spherical equivalent was 0.11 ± 0.40 D, and mean residual astigmatism was 0.35 ± 0.36 D. Mean centroid EPA was 0.28 D at 132° with TCAABU and 0.35 D at 148° with TCATK (P(x) < .001; P(y) < .01). Mean absolute EPA was 0.46 ± 0.32 D with TCAABU and 0.50 ± 0.37 D with TCATK (P < .01). In the with-the-rule astigmatism subgroup, a deviation from the target of less than 0.50 D was achieved in 68% of eyes with TCAABU versus 50% of eyes with TCATK. The proposed posterior chamber IOL was different depending on the calculation methods used in 86% of cases. CONCLUSIONS Both calculation methods showed excellent results. However, the predictability error was significantly reduced when TCAABU was used compared to TCATK measured with the IOLMaster 700 in the whole cohort. Finally, TCA was overestimated by TK in the with-the-rule astigmatism subgroup. [J Refract Surg. 2023;39(3):171-179.].
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Bouvarel H, Hamard P, Agard E, Billant J, El Chehab H, Dot C. Macular edema in Cogan-Reese syndrome. Am J Ophthalmol Case Rep 2022; 25:101318. [PMID: 35128161 PMCID: PMC8810354 DOI: 10.1016/j.ajoc.2022.101318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 06/19/2021] [Accepted: 01/20/2022] [Indexed: 11/10/2022] Open
Abstract
PURPOSE Iridocorneo-endothelial (ICE) syndrome is known as a rare spectrum causing glaucoma, corneal and iris damages. Retinal complications are uncommon. OBSERVATIONS We report the case of a middle-aged woman suffering from a Cogan-Reese Syndrome (CRS) with refractory ocular hypertension (OHT) who presented a cystoid macular edema (CME) during follow up. CONCLUSIONS AND IMPORTANCE We suspect the CME to be inflammatory linked to the pathophysiological hypotheses of the CRS. The CME was successfully treated with topical nonsteroidal anti-inflammatory drugs (NSAID). No consensus is available on its duration. A recurrence happened when treatment was stopped, its reintroduction was successful.
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Affiliation(s)
- Hugo Bouvarel
- Hôpital d'Instruction des Armées Desgenettes, 108 Boulevard Pinel, 69003, Lyon, France
| | - Pascale Hamard
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28 Rue de Charenton, 75012, Paris, France
| | - Emilie Agard
- Hôpital d'Instruction des Armées Desgenettes, 108 Boulevard Pinel, 69003, Lyon, France
| | - Jérémy Billant
- Hôpital d'Instruction des Armées Desgenettes, 108 Boulevard Pinel, 69003, Lyon, France
| | - Hussam El Chehab
- Hôpital d'Instruction des Armées Desgenettes, 108 Boulevard Pinel, 69003, Lyon, France
| | - Corinne Dot
- Hôpital d'Instruction des Armées Desgenettes, 108 Boulevard Pinel, 69003, Lyon, France
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Verrecchia S, Chiambaretta F, Kodjikian L, Nakouri Y, El Chehab H, Mathis T, Badri Y, Chudzinski R, Levron A, Chaperon M, Agard E, Pradat P, Dot C. A prospective multicentre study of intravitreal injections and ocular surface in 219 patients: IVIS study. Acta Ophthalmol 2021; 99:877-884. [PMID: 33733603 DOI: 10.1111/aos.14797] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 01/20/2021] [Accepted: 01/22/2021] [Indexed: 12/20/2022]
Abstract
PURPOSE To assess the impact of intravitreal injections (IVTI) on ocular surface of patients treated with multiple injections. METHODS Prospective, tricentric study conducted in patients treated with unilateral IVTI. An asepsis protocol with povidone-iodine was used for all patients during IVTI. The primary endpoint was the difference between the pre-IVTI Ocular Surface Disease Index (OSDI 1) score and that measured on day one (D1) post-IVTI (OSDI 2). Secondary endpoints were the evaluation of predictive factors for OSDI scores, pain assessment on D1, and the Lacrydiag® analysis of tears from the injected eye versus contralateral eye before IVTI. RESULTS Two hundred and nineteen patients with a mean age of 75.9 ± 10 years were included. The mean OSDI2-OSDI1 difference was 19.2 ± 20.6 (p < 0.001). The mean noninvasive tear break-up time was 6.41 ± 4.59 seconds in the injected eye versus 7.36 ± 4.36 seconds in the contralateral eye (p < 0.001). In the multivariate analysis, the factors significantly associated with the OSDI 2 score were the OSDI 1 score (p < 0.001), the pain score on D1 (p < 0.001) the number of instilled glaucoma eye drop (p = 0.01) and a centre effect (centres 2 and 3 versus centre 1, p < 0.001). CONCLUSION Our results confirm the impairment of the ocular surface and quality of life immediately after an IVTI. These results suggest 3 levels of action to improve the immediate tolerance: improving the basal status of the ocular surface, reducing the contact time with povidone-iodine that might be toxic to the surface, and improving immediate post-IVTI treatment.
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Affiliation(s)
- Sarah Verrecchia
- Department of Ophthalmology Desgenettes Military Hospital Lyon France
- Department of Ophthalmology Croix‐Rousse University Hospital Hospices Civils de Lyon Lyon France
| | | | - Laurent Kodjikian
- Department of Ophthalmology Croix‐Rousse University Hospital Hospices Civils de Lyon Lyon France
- UMR‐CNRS 5510 Matéis Villeurbanne Université Claude Bernard Lyon 1 University of Lyon Lyon France
| | - Yasemin Nakouri
- Gabriel‐Montpied University Hospital Center Clermont Ferrand France
| | - Hussam El Chehab
- Department of Ophthalmology Desgenettes Military Hospital Lyon France
| | - Thibaud Mathis
- Department of Ophthalmology Croix‐Rousse University Hospital Hospices Civils de Lyon Lyon France
| | - Yannis Badri
- Department of Ophthalmology Desgenettes Military Hospital Lyon France
| | - Roman Chudzinski
- Department of Ophthalmology Desgenettes Military Hospital Lyon France
| | - Antoine Levron
- Department of Ophthalmology Desgenettes Military Hospital Lyon France
| | - Mayeul Chaperon
- Department of Ophthalmology Desgenettes Military Hospital Lyon France
| | - Emilie Agard
- Department of Ophthalmology Desgenettes Military Hospital Lyon France
| | - Pierre Pradat
- Department of Ophthalmology Croix‐Rousse University Hospital Hospices Civils de Lyon Lyon France
| | - Corinne Dot
- Department of Ophthalmology Desgenettes Military Hospital Lyon France
- French Military Health Service Academy Val de Grâce Paris France
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Rochet E, Levron A, Agard E, Chehab HE, Plas H, Bouvarel H, Chirpaz N, Billant J, Dot C. Should Artificial Tears Be Used During the Preoperative Assessment of Toric IOLs Before Age-Related Cataract Surgery? The TORIDE Study. J Refract Surg 2021; 37:759-766. [PMID: 34756138 DOI: 10.3928/1081597x-20210826-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To assess the impact of the use of artificial tears during the preoperative work-up performed before age-related cataract surgery, when a toric intraocular lens (IOL) was indicated. METHODS This was a monocentric prospective study assessing 73 eyes of 51 patients, included consecutively after a preoperative work-up performed without artificial tears (no artificial tears group), when a toric IOL was indicated. Each included patient underwent a second series of examinations: biometry using the IOLMaster 700 (Carl Zeiss Meditec AG) and topography using the OPD-Scan II (Nidek), 1 minute after artificial tears instillation (artificial tears group; hyaluronate de sodium 0.15%, threalose 3% [Théalose; Théa]). Changes in anterior corneal astigmatism and subsequent changes in toric IOL calculation were analyzed. The error in predicted residual astigmatism was calculated. RESULTS Anterior corneal astigmatism and total corneal astigmatism measured with the IOLMaster 700 were significantly modified when artificial tears were instilled before the examinations (1.51 ± 0.57 diopters [D], range: 0.75 to -3.55 vs 1.42 ± 0.63 D, range: 0.42 to 3.35 D; P = .043 and 1.59 ± 0.54 D, range: 0.87 to 3.48 vs 1.51 ± 0.59 D, range: 0.56 to 3.27 D, P = .038, respectively). This modification led to a change in IOL cylinder calculation in 43.8% of cases and to a change in implantation axis greater than 10° in 17.7% of cases. These changes were significantly greater in patients with a breakup time (BUT) less than 5 seconds (57.5% and 27.8%, with P = .009 and .029, respectively). In the subgroup of patients with a BUT of less than 5 seconds, the mean absolute error in predicted astigmatism was significantly lower after artificial tears instillation (0.48 ± 0.50 D, range: 0.00 to 2.79 vs 0.37 ± 0.25 D, range: 0.00 to 1.10 D, P = .048). CONCLUSIONS Dry eye significantly impacted toric IOL calculations and should be taken into account during the preoperative assessments. Using artificial tears reduced the number of refractive errors. [J Refract Surg. 2021;37(11):759-766.].
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Levron A, El Chehab H, Agard E, Bernard A, Verrecchia S, Badri Y, Dot C. Impact of estimated total keratometry on the refractive outcomes of the XY1AT toric intraocular lens in cataract surgery. J Fr Ophtalmol 2021; 44:e487-e492. [PMID: 34340885 DOI: 10.1016/j.jfo.2021.02.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 02/10/2021] [Accepted: 02/17/2021] [Indexed: 10/20/2022]
Affiliation(s)
- A Levron
- Military Hospital of Desgenettes, 108, boulevard Pinel, 69003 Lyon, France.
| | - H El Chehab
- Military Hospital of Desgenettes, 108, boulevard Pinel, 69003 Lyon, France
| | - E Agard
- Military Hospital of Desgenettes, 108, boulevard Pinel, 69003 Lyon, France
| | - A Bernard
- Military Hospital of Desgenettes, 108, boulevard Pinel, 69003 Lyon, France
| | - S Verrecchia
- Military Hospital of Desgenettes, 108, boulevard Pinel, 69003 Lyon, France
| | - Y Badri
- Military Hospital of Desgenettes, 108, boulevard Pinel, 69003 Lyon, France
| | - C Dot
- Military Hospital of Desgenettes, 108, boulevard Pinel, 69003 Lyon, France; French Military Health Service Academy of Val-de-Grâce, 74, boulevard de Port-Royal, 75005 Paris, France
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Levron A, El Chehab H, Agard E, Chudzinski R, Billant J, Dot C. Impact of measured total keratometry versus anterior keratometry on the refractive outcomes of the AT TORBI 709-MP toric intraocular lens. Graefes Arch Clin Exp Ophthalmol 2021; 259:1199-1207. [PMID: 33449216 DOI: 10.1007/s00417-020-05046-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 11/28/2020] [Accepted: 12/04/2020] [Indexed: 02/08/2023] Open
Abstract
PURPOSE The aim of this study was to compare the visual and refractive outcomes of total keratometry (TK) versus anterior keratometry (AK) measurements of the IOLMaster 700® (Carl Zeiss Meditec AG, Jena, Germany) in surgery for age-related cataract with preexisting corneal astigmatism. METHODS Monocentric retrospective comparative study. The IOLMaster 700® biometer was used in the 2 groups: in AK mode (AK group) and in TK mode (TK group), for toric IOL (AT TORBI 709 MP) calculation with ZCALC®, Zeiss toric IOL calculator. A 2:1 matching was made between the AK and TK groups. Uncorrected distance visual acuity (UDVA), the correction index and the error in predicted residual astigmatism were analyzed 1 month postoperatively using the vector analysis by the Alpins method. RESULTS The whole cohort included 405 eyes distributed as follows after 2:1 matching: 158 eyes in the AK group and 79 eyes in the TK group. The mean UDVA was similar in both groups (0.07 ± 0.10 LogMAR; p = 0.587). No significant difference in mean absolute error in predicted residual astigmatism (0.37 ± 0.33 D versus 0.35 ± 0.26 D; p = 0.545) and in mean centroid error in predicted residual astigmatism (0.19 ± 0.49 at 3° and 0.06 ± 0.46 at 0°; p = 0.008 and 0.161 respectively for the x- and y-components) was found between the AK and TK groups. CONCLUSION TK of the IOLMaster 700® gives excellent refractive and visual outcomes, comparable to those obtained in AK mode, without showing its superiority for corneas with regular astigmatism.
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Affiliation(s)
- Antoine Levron
- Department of Ophthalmology, Military Hospital of Desgenettes, 108, Boulevard Pinel, 69003, Lyon, France.
| | - Hussam El Chehab
- Department of Ophthalmology, Military Hospital of Desgenettes, 108, Boulevard Pinel, 69003, Lyon, France
| | - Emilie Agard
- Department of Ophthalmology, Military Hospital of Desgenettes, 108, Boulevard Pinel, 69003, Lyon, France
| | - Roman Chudzinski
- Department of Ophthalmology, Military Hospital of Desgenettes, 108, Boulevard Pinel, 69003, Lyon, France
| | - Jeremy Billant
- Department of Ophthalmology, Military Hospital of Desgenettes, 108, Boulevard Pinel, 69003, Lyon, France
| | - Corinne Dot
- Department of Ophthalmology, Military Hospital of Desgenettes, 108, Boulevard Pinel, 69003, Lyon, France.,French Military Health Service Academy of Val de Grâce, Paris, France
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Mathis T, Mendes M, Dot C, Bouteleux V, Machkour‐Bentaleb Z, El Chehab H, Agard E, Denis P, Kodjikian L. Increased choroidal thickness: a new indicator for monitoring diabetic macular oedema recurrence. Acta Ophthalmol 2020; 98:e968-e974. [PMID: 32301578 DOI: 10.1111/aos.14447] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2019] [Accepted: 03/28/2020] [Indexed: 01/22/2023]
Abstract
PURPOSE The aim of this study was to determine whether choroidal thickness (CT) increases at the time of exudative recurrence in diabetic patients with unilateral diabetic macular oedema (DME) treated with intravitreal injections of anti-VEGF or dexamethasone. METHODS A real-life, prospective, two-centre study was conducted over a 9-month period investigating diabetic patients presenting with unilateral DME treated with anti-VEGF or dexamethasone intravitreal injections, and CT was measured manually, using the enhanced depth imaging module of the spectral domain optical coherence tomography. Choroidal thickness (CT) was measured in the morning, in both the affected and healthy eye of each patient at two timepoints: when the macula was 'dry' (T0) and at the time of exudative recurrence (T1). RESULTS A total of 51 patients with unilateral DME were included. Mean CT in the affected eye was significantly thicker at the time of exudative recurrence (210.8 ± 44.1 μm at T0 versus 238.0 ± 49.0 μm at T1, p < 0.001). There was no significant variation in CT in the fellow eye (214.4 ± 52.3 µm at T0 versus 218.9 ± 53.4 µm at T1, p = 0.53). The type of intravitreal injection, the number of injections and the CT at T0 had no influence on the change in CT. CONCLUSION This study found that CT increased significantly in the affected eye at the time of recurrence of DME treated with anti-VEGF or dexamethasone injections. Choroidal thickness (CT) could constitute an interesting new indicator for monitoring patients with DME.
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Affiliation(s)
- Thibaud Mathis
- Service d’ophtalmologie Hôpital de la Croix Rousse Lyon France
- UMR‐CNRS 5510 Matéis Villeurbanne France
| | - Maud Mendes
- Service d’ophtalmologie Hôpital de la Croix Rousse Lyon France
- Service d’ophtalmologie Hôpital des Instructions des Armées de Desgenettes Lyon France
| | - Corinne Dot
- Service d’ophtalmologie Hôpital des Instructions des Armées de Desgenettes Lyon France
- Ecole du Val‐de‐Grâce Paris France
| | - Victor Bouteleux
- Service d’ophtalmologie Hôpital de la Croix Rousse Lyon France
- Service d’ophtalmologie Hôpital des Instructions des Armées de Desgenettes Lyon France
| | | | - Hussam El Chehab
- Service d’ophtalmologie Hôpital des Instructions des Armées de Desgenettes Lyon France
| | - Emilie Agard
- Service d’ophtalmologie Hôpital des Instructions des Armées de Desgenettes Lyon France
| | - Philippe Denis
- Service d’ophtalmologie Hôpital de la Croix Rousse Lyon France
| | - Laurent Kodjikian
- Service d’ophtalmologie Hôpital de la Croix Rousse Lyon France
- UMR‐CNRS 5510 Matéis Villeurbanne France
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Chudzinski R, El Chehab H, Mouchel R, Agard E, Levron A, Chaperon M, Rochepeau C, Rodier-Bonifas C, Burillon C, Dot C. [Descemet's membrane detachment after phacoemulsification: Series of 9 cases]. J Fr Ophtalmol 2020; 43:1002-1008. [PMID: 33036803 DOI: 10.1016/j.jfo.2020.02.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 02/12/2020] [Accepted: 02/25/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE Descemet's membrane detachment (DMD) is a rare but potentially serious complication of cataract surgery. Although there are no consensual guidelines regarding the diagnosis or treatment of DMD, incorrect treatment may result in irreversible corneal changes with visual sequellae. The purpose of our study is to describe the diagnosis and treatment of DMD. METHODS We report a series of 9 cases of DMD, their diagnosis, treatment and outcomes. We tested the HELP protocol retrospectively against our 9 real-life cases. RESULTS Two cases recovered with simple medical management, 4 required air-bubble descemetopexy, and three required keratoplasty. Our study revealed that the main factor associated with poor outcomes is late diagnosis and management. CONCLUSION Our series illustrates the importance of proactive management and timely diagnosis by performing anterior segment OCT in the setting of persistent postoperative corneal edema.
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Affiliation(s)
- R Chudzinski
- Hôpital d'instruction des armées Desgenettes, 108, boulevard Pinel, 69003 Lyon, France.
| | - H El Chehab
- Hôpital d'instruction des armées Desgenettes, 108, boulevard Pinel, 69003 Lyon, France
| | - R Mouchel
- Hôpital Édouard-Herriot, hospices civils de Lyon, 5, place d'Arsonval, 69003 Lyon, France
| | - E Agard
- Hôpital d'instruction des armées Desgenettes, 108, boulevard Pinel, 69003 Lyon, France
| | - A Levron
- Hôpital d'instruction des armées Desgenettes, 108, boulevard Pinel, 69003 Lyon, France
| | - M Chaperon
- Hôpital d'instruction des armées Desgenettes, 108, boulevard Pinel, 69003 Lyon, France
| | - C Rochepeau
- Hôpital Édouard-Herriot, hospices civils de Lyon, 5, place d'Arsonval, 69003 Lyon, France
| | - C Rodier-Bonifas
- Hôpital Édouard-Herriot, hospices civils de Lyon, 5, place d'Arsonval, 69003 Lyon, France
| | - C Burillon
- Hôpital Édouard-Herriot, hospices civils de Lyon, 5, place d'Arsonval, 69003 Lyon, France
| | - C Dot
- Hôpital d'instruction des armées Desgenettes, 108, boulevard Pinel, 69003 Lyon, France
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Chehab HE, Dot C, Mathis T, Agard E, Kodjikian L. Contribution of swept-source OCT-angiography in analysis of choroidal osteoma and its quiescent neovascular complications: A case study. Am J Ophthalmol Case Rep 2020; 19:100769. [PMID: 32551403 PMCID: PMC7287234 DOI: 10.1016/j.ajoc.2020.100769] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 03/17/2020] [Accepted: 06/01/2020] [Indexed: 11/26/2022] Open
Abstract
Purpose Choroidal osteoma (CO) is a rare benign tumor of the choroid. Improvements in Optical Coherence Tomography (OCT) technologies, notably swept-source (SS), enables a better visualization of the choroid with deeper signal penetration in the tissues. Observation We describe SS-OCT and OCT-angiography findings in a 30-year-old patient with CO. The best visualization of the choroid allows even more precise analysis beyond the identification of classical structures of trabecular bone and denser cortical bone. OCT-Angiography show in this case a quiescent choroidal neovascularization without exudation on B-scan OCT. Conclusions and importance SS-OCT and OCT-angiography allow a nearly histological description of choroidal osteoma. Patient consent Written consent to publish this case has not been obtained. This report does not contain any personal identifying information.
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Affiliation(s)
- Hussam El Chehab
- Ophthalmology Department, Military Hospital of Desgenettes, Lyon, France
- Corresponding author. Ophthalmology Department, Military Hospital of Desgenettes, 108, Bd Pinel, 69003, Lyon, France.
| | - Corinne Dot
- Ophthalmology Department, Military Hospital of Desgenettes, Lyon, France
- French Military Health Service Academy, Val de Grâce, Paris, France
| | - Thibaud Mathis
- Ophthalmology Department, Croix-Rousse Teaching Hospital, Lyon, France
| | - Emilie Agard
- Ophthalmology Department, Military Hospital of Desgenettes, Lyon, France
| | - Laurent Kodjikian
- Ophthalmology Department, Croix-Rousse Teaching Hospital, Lyon, France
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El Chehab H, Kodjikian L, Lagenaite-Desmaizère C, Agard E, De Bats F, Mathis T, Dot C. Idiopathic polypoidal choroidal vasculopathy in Caucasians: The POLYON real-life study in 50 naive patients. Eur J Ophthalmol 2019; 30:948-955. [DOI: 10.1177/1120672119874674] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: Polypoidal choroidal vasculopathy is a common disease in Asia, but it has been less described in the Caucasian population. The aim of this real-life observational study was to describe the diagnostic and therapeutic practices as well as the prognosis in this population. Method: Fifty Caucasian patients with polypoidal choroidal vasculopathy were included in this study. All patients underwent angiography to confirm the diagnosis. Patients were divided into two treatment groups: patients of group 1 only received anti–vascular endothelial growth factor injections and those of group 2 required photodynamic therapy rescue in addition to intravitreal injections in case of suboptimal (anatomically or functionally) response. Clinical (visual acuity, fundus examination), paraclinical (retinal pigment epithelium detachment height and central retinal thickness on optical coherence tomography), and therapeutic (number of intravitreal injections) criteria were analyzed after 24 months. Results: Patient mean age was 73.9 ± 9.1 years, and half of the patients had age-related macular degeneration. In the whole cohort, the initial visual acuity was equivalent to the final visual acuity (59.9 ± 24.0 letters vs 62.5 ± 21.1 letters, p = 0.259). In group 1, the final visual acuity was significantly increased (from 56.9 ± 24.7 letters to 63.4 ± 21.6 letters, p = 0.016), while in group 2, it remained stable (from 61.7 ± 23.4 letters to 61.0 ± 21.4 letters, p = 0.249). The number of intravitreal injections was similar between both groups. Conclusion: In a Caucasian population, polypoidal choroidal vasculopathy seems to have a later onset. A non-standardized management allows stabilizing the functional prognosis. Patients requiring photodynamic therapy rescue have a poorer prognosis.
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Affiliation(s)
- Hussam El Chehab
- Service d’ophtalmologie, Hôpital d’Instruction des Armées DESGENETTES, Lyon, France
| | - Laurent Kodjikian
- Service d’ophtalmologie, Centre Hospitalo-Universitaire de la Croix-Rousse, Lyon, France
| | | | - Emilie Agard
- Service d’ophtalmologie, Hôpital d’Instruction des Armées DESGENETTES, Lyon, France
| | - Flore De Bats
- Clinique du Val d’Ouest, Pôle Vision, Ecully, France
| | - Thibaud Mathis
- Service d’ophtalmologie, Centre Hospitalo-Universitaire de la Croix-Rousse, Lyon, France
| | - Corinne Dot
- Service d’ophtalmologie, Hôpital d’Instruction des Armées DESGENETTES, Lyon, France
- École du Val-de-Grâce, Paris, France
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Bouteleux V, Kodjikian L, Mendes M, Agard E, Machkour-Bentaleb Z, El-Chehab H, Denis P, Mathis T, Dot C. Increased choroidal thickness: a new feature to monitor age-related macular degeneration recurrence. Graefes Arch Clin Exp Ophthalmol 2018; 257:699-707. [PMID: 30554268 DOI: 10.1007/s00417-018-04216-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 11/27/2018] [Accepted: 12/06/2018] [Indexed: 11/25/2022] Open
Abstract
PURPOSE The main objective of this study was to assess choroidal thickness (CT) changes during an exudative recurrence of age-related macular degeneration (AMD). METHODS A real-life prospective non-interventional 9-month study was conducted in two centers in consecutive patients with exudative AMD between November 2016 and July 2017. CT was measured manually in both eyes based on enhanced-depth imaging spectral-domain optical coherence tomography at different follow-up visits scheduled in the morning. RESULTS A total of 134 patients were included. Ninety-five patients presented at least one episode, defined by a follow-up visit under controlled condition (dry retina) followed by a visit for exudative recurrence. A total of 119 episodes were analyzed. The mean CT change in the treated eye was + 8.45 ± 13.52 μm (p < 0.001) and + 5.62 ± 14.77 μm (p = 0.009) respectively in the subfoveal area and nasal area. No significant change in CT was observed in the fellow eye. No significant association between CT changes and treatment, number of intravitreal injections, and blood pressure was observed. CONCLUSION CT increased in case of exudative recurrence of neovascular AMD. The increase was mild but significant. Thus, CT could be used as a monitoring criterion, like the central retinal thickness, in AMD management.
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Affiliation(s)
- Victor Bouteleux
- Hôpital d'Instruction des Armées Desgenettes, 108 Boulevard Pinel, 69003, Lyon, France.
- Hôpital de la Croix-Rousse - HCL, 103 Grande rue de la Croix Rousse, 69004, Lyon, France.
- Service d'Ophtalmologie, Hopital de la Croix Rousse, 103 grande rue de la Croix Rousse, 69317, Lyon cedex 04, France.
| | - Laurent Kodjikian
- Hôpital de la Croix-Rousse - HCL, 103 Grande rue de la Croix Rousse, 69004, Lyon, France
| | - Maud Mendes
- Hôpital d'Instruction des Armées Desgenettes, 108 Boulevard Pinel, 69003, Lyon, France
- Hôpital de la Croix-Rousse - HCL, 103 Grande rue de la Croix Rousse, 69004, Lyon, France
| | - Emilie Agard
- Hôpital d'Instruction des Armées Desgenettes, 108 Boulevard Pinel, 69003, Lyon, France
| | | | - Hussam El-Chehab
- Hôpital de la Croix-Rousse - HCL, 103 Grande rue de la Croix Rousse, 69004, Lyon, France
| | - Philippe Denis
- Hôpital de la Croix-Rousse - HCL, 103 Grande rue de la Croix Rousse, 69004, Lyon, France
| | - Thibaud Mathis
- Hôpital de la Croix-Rousse - HCL, 103 Grande rue de la Croix Rousse, 69004, Lyon, France
- CNRS UMR, 5510 Matéis, 69621, Villeurbanne, France
| | - Corinne Dot
- Hôpital d'Instruction des Armées Desgenettes, 108 Boulevard Pinel, 69003, Lyon, France
- Ecole du Val-de-Grâce, 74 Boulevard de Port-Royal, 75005, Paris, France
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Agard E, El Chehab H, Vie AL, Voirin N, Coste O, Dot C. Retinal vein occlusion and obstructive sleep apnea: a series of 114 patients. Acta Ophthalmol 2018; 96:e919-e925. [PMID: 30188014 DOI: 10.1111/aos.13798] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 03/24/2018] [Indexed: 12/22/2022]
Abstract
PURPOSE Evaluate the prevalence of obstructive sleep apnea (OSA) in patients with retinal vein occlusion (RVO). METHODS A prospective and controlled study including 114 patients from January to September 2016, who were divided into two groups: 69 patients with RVO (RVO+) and 45 controls (RVO-), matched for age, sex and disease. All the patients completed a simple questionnaire and the Epworth Sleepiness Scale and underwent a RUSleeping® (portable monitoring device and then continuously monitored the subject's respiration to detect respiratory events). In addition, all patients with RVO were administered OSA screening with a polysomnography (PSG) during an overnight stay in the hospital, which was analysed by a single sleep apnea specialist. RESULTS Sleep apnea was suspected in 73.9% in the RVO group and 63% in the control group based on the simple questionnaire; 22% in the RVO group and 4.3% in the control group according to the Epworth Sleepiness Scale; 82.6% in the RVO group and 55.6% in the control group (p = 0.005) according to RUSleeping® . Multivariate logistic regression analysis (based on RUsleeping® ) confirmed that RVO was associated with OSA (adjusted odds ratio, 5.65, [1.60-19.92], p = 0.007). All patients in the RVO group were confirmed by PSG, and finally, 91.5% were diagnosed with moderate-to-severe OSA. Among the RVO+ patients, the mean apnea-hypopnoea index (AHI) was 42.2 events per hour (7.7-96.5). OSA was moderate in 22% patients and severe in 69.5% patients. There was no significant relationship between RVO severity and the PSG data variables. CONCLUSION The systematic screening of OSA with the gold standard PSG found a high prevalence of OSA in patients with RVO. The OSA is probably a risk factor associated with RVO. Polysomnography remains the gold standard method; nevertheless, the RUsleeping® RTS portable monitoring device can assess the presence and severity of sleep apnea with a low failure rate and a single use, prior to PSG, which is less available in clinical practice. Further studies with larger samples are needed to clarify the association.
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Affiliation(s)
- Emilie Agard
- Department of Ophthalmology; Desgenettes Military Hospital; Lyon France
- French Military Health Service Academy; Val de Grâce; Paris France
| | - Hussam El Chehab
- Department of Ophthalmology; Desgenettes Military Hospital; Lyon France
- French Military Health Service Academy; Val de Grâce; Paris France
| | - Anne-Laure Vie
- Department of Ophthalmology; Desgenettes Military Hospital; Lyon France
| | | | | | - Corinne Dot
- Department of Ophthalmology; Desgenettes Military Hospital; Lyon France
- French Military Health Service Academy; Val de Grâce; Paris France
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El Chehab H, Agard E, Dot C. Comparison of two biometers: A swept-source optical coherence tomography and an optical low-coherence reflectometry biometer. Eur J Ophthalmol 2018; 29:547-554. [PMID: 30295063 DOI: 10.1177/1120672118802918] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE The technological improvements in optical biometers have made cataract surgery evolve to the level of refractive surgery. This study assessed the correlation and agreement between a biometer using swept-source optical coherence tomography technology (IOLMaster 700; Carl Zeiss Meditec, Jena, Germany) and a biometer using optical low-coherence reflectometry (Lenstar; Haag Streit, Koeniz, Switzerland). PROCEDURES Optical biometric measurements were taken with the IOLMaster 700 and the Lenstar on 129 eyes of 129 patients referred for cataract surgery. We compared biometric data (axial length, mean keratometry, central pachymetry, anterior chamber depth, lens thickness, and horizontal white-to-white measurement) and the emmetropic intraocular lens power calculated with SRK/T and Haigis formulas. Correlation and agreement for these parameters were evaluated. RESULTS Only anterior chamber depth measurements (3.05 ± 0.07 vs 3.07 ± 0.07, p < 0.001) and the white-to-white measurement (11.97 ± 0.07 vs 12.06 ± 0.07, p < 0.001) differed significantly between the machines. Correlations and agreements were excellent, with perfect agreement for axial length measurement (r = 1, intraclass correlation coefficient = 1). Emmetropic intraocular lens power did not differ between devices with SRK/T formula (20.94 ± 0.51 vs 20.92 ± 0.50, p = 0.51). With Haigis formula, there was a statistically significant difference (21.04 ± 0.52 vs 20.84 ± 0.52, p < 0.001). CONCLUSION This study suggests that there is a very high correlation and agreement for the biometric measurements and calculation of intraocular lens implant power with the SRK/T formula.
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Affiliation(s)
- Hussam El Chehab
- Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France
| | - Emilie Agard
- Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France.,French Military Health Service Academy of Val-de-Grâce, Paris, France
| | - Corinne Dot
- Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France.,French Military Health Service Academy of Val-de-Grâce, Paris, France
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El Chehab H, Agard E, Dot C. Cephalic region war injuries in children: Experience in French NATO hospital in Kabul Afghanistan. Injury 2018; 49:1703-1705. [PMID: 29908849 DOI: 10.1016/j.injury.2018.06.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 05/25/2018] [Accepted: 06/08/2018] [Indexed: 02/02/2023]
Abstract
BACKGROUNDS The NATO KAIA Hospital (Kabul International Airport), under French command, provided medical support for NATO forces in the Kabul region from 2009 to 2014. Medical assistance to civilians was an additional mission which included support for children who were war injured. The objective of this study was to analyze characteristics of cephalic injuries in children victims of war trauma. METHODS A retrospective study was conducted and commenced with the hospital opening (July 2009) to March 2012 on all children (<15years) with war trauma. We distinguished cephalic lesions in cranial (neuro-surgical), ophthalmological and neck regions. We analyzed mechanism, region, severity score, surgeries and resuscitation efforts. RESULTS 217 children were operated on with 81 war traumas (mean age 10.2years). 36 children (44.4%) had a cephalic injury. 52.9% of the injured had an ophthalmological injury, 38.2% a cranial region injury and 29.4% a neck lesion. Mortality rate was 5.6% (1 hemorrhagic shock and 1 cerebral wound) in this cephalic lesion group. Ophthalmic injuries were the most common of cephalic injuries; 19 children of which 7 had a bilateral injury (26 eyes). In this group, fragmentary injuries were the most frequent (64% of eyes). In cerebral lesion group, the lesions were linked to a bullet or a shrapnel in 9 of 13 children. This mechanism systematically caused a crania-cerebral wound. Explosion (fragmentary and shrapnel) was the most important in the neck lesions (7 children of 10). CONCLUSIONS The cephalic lesions were the second most common region in children during our experience in Afghanistan. Lack of protection (helmet) in children may explain the frequency of cephalic wounds.
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Affiliation(s)
- Hussam El Chehab
- Military Hospital of Desgenettes, Ophthalmology Department, Lyon, France.
| | - Emilie Agard
- Military Hospital of Desgenettes, Ophthalmology Department, Lyon, France
| | - Corinne Dot
- Military Hospital of Desgenettes, Ophthalmology Department, Lyon, France; French Military Health Service Academy of Val de Grâce, Paris, France
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Mounier A, Agard E, Douma I, Chehab HE, Vie AL, Dot JM, Dot C. Macular toxicity and blind spot enlargement during a treatment by voriconazole: A case report. Eur J Ophthalmol 2018; 28:NP11-NP14. [DOI: 10.1177/1120672117750051] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: To report a case of macular toxicity and blind spot enlargement during voriconazole treatment. Methods: This is a case report. Results: We describe a 77-year-old man treated by voriconazole for pulmonary aspergillosis, who complained of visual disorders such as dyschromatopsia and visual hallucinations 3 days after voriconazole initiation. Initial ophthalmological examination found no loss of visual acuity. The anterior and posterior segments presented no anomalies. The chromatic vision evaluated with the Lanthony 15-Hue Desaturated Test demonstrated dyschromatopsia in the left eye along the tritan axis, and the Goldmann visual field examination found a blind spot enlargement in both eyes. The multifocal electroretinogram found a global decrease in the foveal peak in both eyes. Visual evoked potential showed asymmetric data and lower amplitudes of the P(100) wave on the left eye. No anomalies were observed on spectral domain macular optical coherence tomography. As a first step, based on presumed dose-dependent toxicity, voriconazole dose was reduced. No improvements were noted. The voriconazole treatment was then discontinued and replaced with itraconazole. After 1 month, visual field and multifocal electroretinogram had improved and visual hallucinations had disappeared. Conclusion: Voriconazole can cause potentially serious visual side effects. Adapting treatment based on plasma concentrations of voriconazole did not prevent the appearance of visual side effects in this case. Therapeutic drug switching within the same drug family seems to be an effective alternative to preserve ocular function.
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Affiliation(s)
- Anaïs Mounier
- Department of Ophthalmology, Hôpital d’Instruction des Armées Desgenettes, Lyon, France
| | - Emilie Agard
- Department of Ophthalmology, Hôpital d’Instruction des Armées Desgenettes, Lyon, France
| | - Ikrame Douma
- Department of Ophthalmology, Hôpital d’Instruction des Armées Desgenettes, Lyon, France
| | - Hussam El Chehab
- Department of Ophthalmology, Hôpital d’Instruction des Armées Desgenettes, Lyon, France
| | - Anne L Vie
- Department of Ophthalmology, Hôpital d’Instruction des Armées Desgenettes, Lyon, France
| | - Jean M Dot
- Department of Pneumology, Hôpital d’Instruction des Armées Desgenettes, Lyon, France
| | - Corinne Dot
- Department of Ophthalmology, Hôpital d’Instruction des Armées Desgenettes, Lyon, France
- French Military Health Service Academy, Val-de-Grâce, Paris, France
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Mairot A, El Chehab H, Agard E, Rezkallah A, Bouteleux V, Dot C. Low-power versus medium-power toric intraocular lenses in cataract surgery, about 110 eyes. J Fr Ophtalmol 2018; 41:302-307. [DOI: 10.1016/j.jfo.2017.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 12/15/2017] [Accepted: 12/20/2017] [Indexed: 11/24/2022]
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Raucau M, El Chehab H, Agard E, Lagenaite C, Dot C. [Toric lens implantation in cataract surgery: Automatic versus manual horizontal axis marking, analysis of 50 cases]. J Fr Ophtalmol 2018; 41:136-144. [PMID: 29426763 DOI: 10.1016/j.jfo.2017.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2017] [Revised: 08/21/2017] [Accepted: 08/21/2017] [Indexed: 11/15/2022]
Abstract
SUBJECT The main objective of our study is to evaluate the contribution of automated conjunctival recognition in the alignment of toric implants by comparing the automatic alignment optimized with Callisto™ to the manual marking of the horizontal axis. MATERIALS AND METHODS We performed a prospective, descriptive, and monocentric study on patients undergoing cataract surgery with toric implantation (Asphina 709 Zeiss), operated by a surgeon with good experience in toricity, between September 2016 and March 2017. We analyzed the agreement between the manual marking of the 0°-180° axis versus the one automatically generated by the Callisto™, as well as the alignment of the IOL and the refractive results at 1 month. RESULTS We included 50 eyes of 26 patients. The corrected mean astigmatism was 1.9 D. The mean difference between the 2 axes was 4.7° [0°-12.3°]. Only 50 % of the preoperative manual markings were consistent with the automatic measurement (<5°). At one month, the average rotation recorded was 4.3° [0°-29°]. The alignment was identical for 70 % (n=35) of the IOL (≤5°). As for residual subjective astigmatism, it was on average 0.58 D. The mean visual acuity without correction was 8/10 and 55 % had 10/10 without correction. DISCUSSION The refractive performance depends on the preoperative measurement, the correct alignment of the IOL and its stability in the bag. Our study shows the value of automatic conjunctival recognition in the determination of the axis of peroperative alignment, even in an experienced operator. This precision is essential for a good refractive result, especially since the residual astigmatism in case of misalignment will increase with the power of the implant. CONCLUSION Our study shows excellent refractive results, whatever the initial astigmatism, using the automatic alignment. The precision of the toric implantation opens the way to the toric multifocal implantation under the best conditions.
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Affiliation(s)
- M Raucau
- Service d'ophtalmologie, HIA de Desgenettes, 108, boulevard Pinel, 69003 Lyon, France.
| | - H El Chehab
- Service d'ophtalmologie, HIA de Desgenettes, 108, boulevard Pinel, 69003 Lyon, France
| | - E Agard
- Service d'ophtalmologie, HIA de Desgenettes, 108, boulevard Pinel, 69003 Lyon, France
| | - C Lagenaite
- Service d'ophtalmologie, HIA de Desgenettes, 108, boulevard Pinel, 69003 Lyon, France
| | - C Dot
- Service d'ophtalmologie, HIA de Desgenettes, 108, boulevard Pinel, 69003 Lyon, France
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Raucau M, El Chehab H, Agard E, Lagenaite C, Dot C. Toric lens implantation in cataract surgery: Automated versus manual horizontal axis marking, analysis of 50 cases. J Fr Ophtalmol 2018; 41:e1-e9. [PMID: 29331293 DOI: 10.1016/j.jfo.2017.11.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 09/30/2017] [Accepted: 11/14/2017] [Indexed: 11/30/2022]
Abstract
SUBJECT The main objective of our study was to evaluate the contribution of automated conjunctival registration in the alignment of toric intraocular lenses by comparing automated registration optimized with Callisto® to manual marking of the horizontal axis. MATERIALS AND METHODS We performed a prospective, descriptive, monocentric study on patients undergoing cataract surgery with a toric intraocular lens (Asphina 709 Zeiss), performed by a surgeon with good experience in toric implants, between September 2016 and March 2017. We analyzed the agreement between the manual marking of the 0-180° axis versus the one automatically generated by the Callisto™, as well as the alignment of the IOL and the refractive results at 1 month. RESULTS We included 50 eyes of 38 patients. The mean corrected astigmatism was 1,9 D. The mean difference between the 2 axes was 4,7° [0-12.3°]. Only 50 % of the preoperative manual markings were consistent with the automated measurement (<5°). At one month, the mean rotation recorded was 4,3° [0-29°]. The alignment was identical for 70 % (n=35) of the IOLs (≤5°). As for residual subjective astigmatism, the mean was 0.58 D. The mean visual acuity without correction was 8/10 and 55 % saw 10/10 without correction. DISCUSSION Refractive performance depends on preoperative measurement, correct alignment of the IOL and its stability in the bag. Our study shows the value of automated conjunctival registration in the determination of the intraoperative axis of alignment, even with an experienced surgeon. This precision is essential for a good refractive result, especially since residual astigmatism in the case of misalignment will increase with the power of the implant. CONCLUSION Our study shows excellent refractive results, regardless of the initial astigmatism, using automated alignment. Precision of toric implantation opens the way to toric multifocal implantation under the best conditions.
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Affiliation(s)
- M Raucau
- Service d'ophtalmologie, HIA de Desgenettes, Bron, 1, place du Change, 69005 Lyon, France.
| | - H El Chehab
- Service d'ophtalmologie, HIA de Desgenettes, Bron, 1, place du Change, 69005 Lyon, France
| | - E Agard
- Service d'ophtalmologie, HIA de Desgenettes, Bron, 1, place du Change, 69005 Lyon, France
| | - C Lagenaite
- Service d'ophtalmologie, HIA de Desgenettes, Bron, 1, place du Change, 69005 Lyon, France
| | - C Dot
- Service d'ophtalmologie, HIA de Desgenettes, Bron, 1, place du Change, 69005 Lyon, France
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El Chehab H, Agard E, Dot C. [Evaluation of surgical simulation sessions of the French society of ophthalmology. A new surgical instruction method]. J Fr Ophtalmol 2017; 40:636-641. [PMID: 28882391 DOI: 10.1016/j.jfo.2017.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 03/08/2017] [Accepted: 03/09/2017] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Since 2013, at the French society of ophthalmology (FSO) meetings, two simulators for intraocular surgeries have been available. The goal of this study was to assess the satisfaction of the participants in these organized training sessions. MATERIALS AND METHODS A questionnaire was mailed to participants in the FSO sessions as well as those carried out during the annual congress. This questionnaire collected data on the participants and the practical modalities of the sessions, and assessed participants' feelings and satisfaction with these sessions. RESULTS The participants in the SFO sessions were young members of the SFO (31.8±12.3 years). 53.8 % were in training, looking to improve a problematic surgical step (capsulorhexis in 51.5 %). They spent nearly 5hours on simulators (4.8hours) and were alone on a simulator 50 % of the time. The sessions held during the annual congress were used by older physicians (41.9±26.4 years) already in practice (66.6 %). The goal of such training was curiosity in a third of the cases (to try the simulators). The majority spent less than an hour on the devices and were at least two participants per machine. Despite these differences, participants cited a role for their surgical learning curve and recommended such training to their colleagues. CONCLUSIONS The participants' enthusiasm for this new training technique is highlighted by the results of this study.
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Affiliation(s)
- H El Chehab
- Service d'ophtalmologie, hôpital d'instruction Desgenettes, 108, boulevard Pinel, 69003 Lyon, France.
| | - E Agard
- Service d'ophtalmologie, hôpital d'instruction Desgenettes, 108, boulevard Pinel, 69003 Lyon, France
| | - C Dot
- Service d'ophtalmologie, hôpital d'instruction Desgenettes, 108, boulevard Pinel, 69003 Lyon, France; École du Val-de-Grâce, 1, place Alphonse-Laveran, 75005 Paris, France
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El Chehab H, Agard E, Loria O, Théo L, Dot C. Interest of analysis of circumpapillary retinal nerve fibers layer thickness at different measurement diameters. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.01125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | - E. Agard
- Ophthalmology; HIA Desgenettes; Lyon France
| | - O. Loria
- Ophthalmology; HIA Desgenettes; Lyon France
| | - L. Théo
- Ophthalmology; HIA Desgenettes; Lyon France
| | - C. Dot
- Ophthalmology; HIA Desgenettes; Lyon France
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Rezkallah A, Malcles A, Dot C, Voirin N, Agard E, Vie A, Denis P, Kodjikian L. Evaluation of efficacy and safety of dexamethasone intravitreal implants between vitrectomized and non-vitrectomized eyes in a real-life study. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.01115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- A. Rezkallah
- Ophthalmology; Hopital de La Croix Rousse; Lyon France
| | - A. Malcles
- Ophthalmology; Hôpitaux Universitaires de Genève; Geneve Switzerland
| | - C. Dot
- Ophthalmology; Hôpital d'instruction des armées Desgenettes; Lyon France
| | - N. Voirin
- Ophthalmology; Hopital de La Croix Rousse; Lyon France
| | - E. Agard
- Ophthalmology; Hôpital d'instruction des armées Desgenettes; Lyon France
| | - A.L. Vie
- NeuroOphthalmology; Hôpital Neurologique; Lyon France
| | - P. Denis
- Ophthalmology; Hopital de La Croix Rousse; Lyon France
| | - L. Kodjikian
- Ophthalmology; Hopital de La Croix Rousse; Lyon France
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Lereuil T, Agard E, Elchehab H, Dot C. Iatrogenic intraocular pressure elevation after repeated intravitreal injection, a prospective cohort study. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.03564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- T. Lereuil
- Ophtalmology; Desgenettes Military Hospital; Lyon France
| | - E. Agard
- Ophtalmology; Desgenettes Military Hospital; Lyon France
| | - H. Elchehab
- Ophtalmology; Desgenettes Military Hospital; Lyon France
| | - C. Dot
- Ophtalmology; Desgenettes Military Hospital; Lyon France
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Loria O, Raucau M, Agard E, El Chehab H, Lereuil T, Dot C. Toric lens implantation in cataract surgery: risk factors of post-operative lens rotation, analysis of 50 cases. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.03581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- O. Loria
- Ophthalmology; HIA Desgenettes; Lyon France
| | - M. Raucau
- Ophthalmology; HIA Desgenettes; Lyon France
| | - E. Agard
- Ophthalmology; HIA Desgenettes; Lyon France
| | | | - T. Lereuil
- Ophthalmology; HIA Desgenettes; Lyon France
| | - C. Dot
- Ophthalmology; HIA Desgenettes; Lyon France
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Agard E, El Chehab H, Vanquaethem H, Malclès A, Drouet A, Dot C, Guilloton L. [Bilateral infiltrative optic neuropathy as presenting sign of Waldenström macroglobulinemia]. J Fr Ophtalmol 2017; 40:e95-e96. [PMID: 28318712 DOI: 10.1016/j.jfo.2016.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Revised: 12/18/2015] [Accepted: 01/04/2016] [Indexed: 11/16/2022]
Affiliation(s)
- E Agard
- Service d'ophtalmologie, hôpital d'instruction des armées desgenettes, 108, boulevard Pinel, 69275 Lyon cedex 03, France.
| | - H El Chehab
- Service d'ophtalmologie, hôpital d'instruction des armées desgenettes, 108, boulevard Pinel, 69275 Lyon cedex 03, France
| | - H Vanquaethem
- Service de médecine interne, hôpital d'instruction des armées desgenettes, 108, boulevard Pinel, 69275 Lyon cedex 03, France
| | - A Malclès
- Service d'ophtalmologie, hôpital d'instruction des armées desgenettes, 108, boulevard Pinel, 69275 Lyon cedex 03, France
| | - A Drouet
- Service de neurologie, hôpital d'instruction des armées desgenettes, 108, boulevard Pinel, 69275 Lyon cedex 03, France
| | - C Dot
- Service d'ophtalmologie, hôpital d'instruction des armées desgenettes, 108, boulevard Pinel, 69275 Lyon cedex 03, France
| | - L Guilloton
- Service de neurologie, hôpital d'instruction des armées desgenettes, 108, boulevard Pinel, 69275 Lyon cedex 03, France
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Mendes M, El Chehab H, Bouteleux V, Agard E, Russo A, Dot C. Macular ganglion cell layer abnormalities in Spectral Domain (SD)-OCT outside glaucomatous neuropathy. Acta Ophthalmol 2016. [DOI: 10.1111/j.1755-3768.2016.0341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Bouteleux V, Tick S, El Chehab H, Mendes M, Agard E, Russo A, Dot C. Retinal astrocytic hamartomas: 2 cases of atypical clinical presentation. Acta Ophthalmol 2016. [DOI: 10.1111/j.1755-3768.2016.0308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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El Chehab H, Agard E, Russo A, Boujnah Y, Dot C. Intraocular Pressure Spikes after Aflibercept Intravitreal Injections. Ophthalmologica 2016; 236:43-7. [DOI: 10.1159/000446878] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 05/17/2016] [Indexed: 11/19/2022]
Abstract
The objective of this study was to assess the intraocular pressure (IOP) as well as the anatomical modifications of the anterior segment following an aflibercept injection. Patients underwent an aflibercept intravitreal injection (IVI) (0.05 ml) with a 30.5-gauge needle and an antireflux system. IOP was assessed before injection (T0), immediately after (T1), and 5 min (T5), 15 min (T15), and 45 min (T45) after the IVI. Before the IVI and immediately after the T1 measurement, a PENTACAM® acquisition was used to evaluate the anterior chamber parameters (anterior chamber volume, depth and measure of the iridocorneal angle). At T0, IOP was 12.9 ± 1.3 mm Hg. IOP significantly increased after IVI (42.7 ± 3 mm Hg, p < 0.001). IOP returned to baseline at T45 (13.0 ± 1.2 mm Hg, p = 0.877). Anterior chamber volume decreased after IVI (160.6 vs. 168.3 mm3, p = 0.002). No significant changes were found for iridocorneal angle and anterior chamber depth. Aflibercept IVI causes an acute increase in IOP over a short period without iridocorneal angle closure.
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Agard E, Pegat A, Vanquaethem H, El Chehab H, Dot C, Guilloton L. Neuropathie optique infiltrative bilatérale révélatrice d’une maladie de Waldenström. Rev Neurol (Paris) 2016. [DOI: 10.1016/j.neurol.2016.01.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Lagenaite-Desmaizières CF, Douma I, Agard E, El Chehab H, Ract-Madoux G, Dot C. [A rare cause of ophthalmoplegia, report of a case of mycormycosis]. J Fr Ophtalmol 2016; 39:e21-3. [PMID: 26832318 DOI: 10.1016/j.jfo.2014.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2014] [Revised: 12/05/2014] [Accepted: 12/15/2014] [Indexed: 10/22/2022]
Affiliation(s)
| | - I Douma
- HIA Desgenettes, 108, boulevard Pinel, 69003 Lyon, France
| | - E Agard
- HIA Desgenettes, 108, boulevard Pinel, 69003 Lyon, France
| | - H El Chehab
- HIA Desgenettes, 108, boulevard Pinel, 69003 Lyon, France
| | - G Ract-Madoux
- HIA Desgenettes, 108, boulevard Pinel, 69003 Lyon, France
| | - C Dot
- HIA Desgenettes, 108, boulevard Pinel, 69003 Lyon, France
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35
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Agard E, Elchehab H, Ract-Madoux G, Russo A, Lagenaite C, Dot C. Repeated intravitreal anti-vascular endothelial growth factor injections can induce iatrogenic ocular hypertension, especially in patients with open-angle glaucoma. Can J Ophthalmol 2015; 50:127-31. [PMID: 25863852 DOI: 10.1016/j.jcjo.2014.11.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Revised: 10/30/2014] [Accepted: 11/05/2014] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To report the rate of intraocular pressure (IOP) elevation after repeated intravitreal injections (IVIs) of anti-vascular endothelial growth factor (anti-VEGF) agents and to determine the risk factors. METHODS A total of 193 patients (217 eyes) undergoing ranibizumab (n = 196) or bevacizumab (n = 21) IVIs were prospectively examined. The incidence of ocular hypertension (OHT) after these injections was investigated with respect to the number of injections, pre-existing open-angle glaucoma, diabetes, YAG capsulotomy, age, and sex. RESULTS A total of 1461 IVIs was performed. After a mean of 6.7 ± 7.1 IVIs (range, 1-49), 4.6% (n = 10) had IOP elevation more than 25 mm Hg and required medical treatment (1.4% of them spiked above 30 mm Hg). Patients with pre-existing glaucoma experienced higher prevalence of OHT (12.9%) and greater rates than the control group (19.6 ± 5.7 mm Hg vs 16.4 ± 3.9 mm Hg, p < 0.001). No significant difference was found in the diabetes subgroup (n = 66, p = 0.62) or in the YAG capsulotomy subgroup (n = 24, p = 0.51) compared with the control group. The IOP peak was significantly correlated with the total number of IVIs (p = 0.0002, r = 0.25). CONCLUSIONS Serial IVIs may lead to persistent IOP elevation that requires IOP-lowering therapy. The risk is correlated with the number of injections and increases in the glaucoma population, and must be checked during follow-up.
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Affiliation(s)
- Emilie Agard
- Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France
| | - Hussam Elchehab
- Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France
| | | | - Aurélie Russo
- Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France
| | | | - Corinne Dot
- Department of Ophthalmology, Desgenettes Military Hospital, Lyon, France.
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El Chehab H, Agard E, Russo A, Malcles A, Dot C. Intra-ocular pressure spike after Aflibercept and Ranibizumab intravitreal injections. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.0430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | - E. Agard
- Ophthalmology; HIA Desgenettes; Lyon France
| | - A. Russo
- Ophthalmology; HIA Desgenettes; Lyon France
| | - A. Malcles
- Ophthalmology; HIA Desgenettes; Lyon France
| | - C. Dot
- Ophthalmology; HIA Desgenettes; Lyon France
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Vié A, Kodjikian L, Malcles A, Agard E, El Chehab H, Russo A, Dot C. Tolerance of Dexamethasone intravitreal implant in GAO patients according to their initial treatment and repeated intravitreal injections. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.0393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- A.L. Vié
- Ophtalmology; Croix-Rousse Hospital; Lyon France
| | - L. Kodjikian
- Ophtalmology; Croix-Rousse Hospital; Lyon France
| | - A. Malcles
- Ophtalmology; Desgenettes Military Hospital; Lyon France
| | - E. Agard
- Ophtalmology; Desgenettes Military Hospital; Lyon France
| | - H. El Chehab
- Ophtalmology; Desgenettes Military Hospital; Lyon France
| | - A. Russo
- Ophtalmology; Desgenettes Military Hospital; Lyon France
| | - C. Dot
- Ophtalmology; Desgenettes Military Hospital; Lyon France
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Malcles A, Russo A, Agard E, El-Chehab H, Dot C. Treatment of peripheral exudative hemorrhagic chorioretinopathy by intravitreal injections of Aflibercept: report of 4 cases. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.0671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- A. Malcles
- Ophthalmology; Desgenettes Hospital; Lyon France
| | - A. Russo
- Ophthalmology; Desgenettes Hospital; Lyon France
| | - E. Agard
- Ophthalmology; Desgenettes Hospital; Lyon France
| | - H. El-Chehab
- Ophthalmology; Desgenettes Hospital; Lyon France
| | - C. Dot
- Ophthalmology; Desgenettes Hospital; Lyon France
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Malclès A, Ronsin S, Agard E, Abouaf L, Tilikete C, Vighetto A, Biotti D. Isolated oculomotor nerve palsy revealing infectious mononucleosis. Acta Ophthalmol 2015; 93:e518-9. [PMID: 25752335 DOI: 10.1111/aos.12636] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Ariane Malclès
- Neuro-Ophthalmology Unit; Lyon Civil Hospitals; Neurological Hospital; Lyon 1 University; Bron Cedex France
| | - Solène Ronsin
- Neuro-Ophthalmology Unit; Lyon Civil Hospitals; Neurological Hospital; Lyon 1 University; Bron Cedex France
| | - Emilie Agard
- Neuro-Ophthalmology Unit; Lyon Civil Hospitals; Neurological Hospital; Lyon 1 University; Bron Cedex France
| | - Lucie Abouaf
- Neuro-Ophthalmology Unit; Lyon Civil Hospitals; Neurological Hospital; Lyon 1 University; Bron Cedex France
| | - Caroline Tilikete
- Neuro-Ophthalmology Unit; Lyon Civil Hospitals; Neurological Hospital; Lyon 1 University; Bron Cedex France
| | - Alain Vighetto
- Neuro-Ophthalmology Unit; Lyon Civil Hospitals; Neurological Hospital; Lyon 1 University; Bron Cedex France
| | - Damien Biotti
- Neuro-Ophthalmology Unit; Lyon Civil Hospitals; Neurological Hospital; Lyon 1 University; Bron Cedex France
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Dot C, El Chehab H, Russo A, Agard E. [Ocular hypertension after intravitreal steroid injections: Clinical update as of 2015]. J Fr Ophtalmol 2015; 38:656-64. [PMID: 26099427 DOI: 10.1016/j.jfo.2015.03.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 03/24/2015] [Accepted: 03/30/2015] [Indexed: 12/19/2022]
Abstract
Intravitreal injections are a therapeutic delivery method best suited to the treatment of retinal diseases. Recent years have been marked by the use of anti-VEGF agents as well as the arrival of sustained-release corticosteroid implants in France, replacing triamcinolone acetonide. A common complication of IVT steroids is secondary ocular hypertension (OHT) resulting from increased outflow resistance. This article summarizes current understanding. OHT induced by topical steroids has been described for 60 years. Intravitreal use also shows a temporary effect if the exposure is short, dose dependence, and varying incidence depending on the drug used. Sustained release formulations and discontinuing treatment have reduced the risk of induced OHT. Risk factors that induce OHT must be clearly identified prior to an injection. Most cases of OHT can be controlled medically, although differences exist between different drugs. In cases where it cannot be controlled, removal of the implant, selective laser trabeculoplasty, and filtration surgery can be discussed.
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Affiliation(s)
- C Dot
- HIA Desgenettes, 108, boulevard Pinel, 69275 Lyon cedex 03, France.
| | - H El Chehab
- HIA Desgenettes, 108, boulevard Pinel, 69275 Lyon cedex 03, France
| | - A Russo
- HIA Desgenettes, 108, boulevard Pinel, 69275 Lyon cedex 03, France
| | - E Agard
- HIA Desgenettes, 108, boulevard Pinel, 69275 Lyon cedex 03, France
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Agard E, Biotti D, Malclès A, Vighetto A, Tilikete C, Desestret V. WITHDRAWN: A third nerve palsy with an Argyll Robertson pupil. IDCases 2014. [DOI: 10.1016/j.idcr.2014.10.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Guilloton L, Camarasa C, Agard E, Tondeur G, Dot C, Drouet A. Ataxie avec ophtalmoplégie : syndrome de Miller-Fisher avec positivité des anticorps anti-GQ1b. J Fr Ophtalmol 2014; 37:89-92. [DOI: 10.1016/j.jfo.2013.05.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2013] [Revised: 05/07/2013] [Accepted: 05/17/2013] [Indexed: 10/25/2022]
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Dot C, El Chehab H, Agard E, Russo A, Ract-Madoux G, Dussart C. [Optical quality after 2.2mm microincisional cataract surgery with bimanual I/A in 154 eyes]. J Fr Ophtalmol 2013; 36:868-73. [PMID: 24210935 DOI: 10.1016/j.jfo.2013.03.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Revised: 03/01/2013] [Accepted: 03/05/2013] [Indexed: 11/18/2022]
Abstract
PURPOSE A prospective study to analyze the effects of 2.2mm microincisional coaxial phacoemulsification with bimanual irrigation/aspiration on the optical quality of the cornea and whole eye. METHODS We compare two groups. Group A: 102 consecutive eyes undergoing this three-incision procedure and implanted with an Alcon® SN60WF IQ aspheric intraocular lens. Astigmatism, corneal and total asphericity, as well as H/B ratio were measured by OPD scann II, Nidek®, Japan, preoperatively (Day 0), 15 days postoperatively (Day 15) and 1 month postoperatively (M1). Group B: 52 eyes with corneal astigmatism greater than 1.25D, undergoing the same procedure but implanted with a Toric IOL (Alcon® Toric IQ SN6AT), followed in the same manner but with additional follow-up at 1 year. RESULTS Corneal surgically induced astigmatism (SIA) was essentially neutral: 0.065D ± 0.86 at Day 30 in group A, and 0.06D ± 0.34 at 1 month and -0.008D ± 0.4 at 12 months in group B. Corneal topographic astigmatism underwent a mean axis shift of 29.95° ± 27.6 in group A compared to 5.3° ± 3.7 in Group B, and remained stable at 1 year. Corneal asphericity did not change significantly between Day 0 and 30 in either group. H/B ratio increased significantly in both groups, with a gain of 22 % to 24 % after surgery. CONCLUSIONS This three-incision procedure does not degrade the optical quality of the cornea. Postoperative shift in the axis of astigmatism is only an issue in cases of low or asymmetric astigmatism and must be kept in mind for low-power toric IOL implantation.
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Affiliation(s)
- C Dot
- Service d'ophtalmologie, hôpital Desgenettes, 108, boulevard Pinel, 69275 Lyon cedex 03, France.
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Malclès A, Janin-Manificat H, Yhuel Y, Russo A, Agard E, El Chehab H, Ract Madoux G, Masse H, Burillon C, Dot C. [Anterior chamber migration of intravitreal dexamethasone implant (Ozurdex®) in pseudophakic eyes: report of three cases]. J Fr Ophtalmol 2013; 36:362-7. [PMID: 23318000 DOI: 10.1016/j.jfo.2012.11.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2012] [Revised: 10/31/2012] [Accepted: 11/05/2012] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Intravitreal implantation of Ozurdex(®) (Allergan Inc., Irvine, CA, USA) is being used widely for the treatment of macular edema secondary to retinal vein occlusion and in the setting of non-infectious posterior uveitis. We describe a complication little reported in the literature until now: migration of the dexamethasone implant into the anterior chamber. PATIENTS AND METHODS We report three cases of migration in two pseudophakic patients with iris claw lenses (on the anterior and posterior aspects of the iris) and in one pseudophakic patient with a posterior chamber IOL and zonular rupture. DISCUSSION The risk of anterior chamber migration of the Ozurdex(®) implant is increased in cases of prior vitrectomy (three cases), prone positioning and dilation of the pupil (mydriasis). Clinical tolerability of the implant in the anterior chamber is poor in all cases, with diffuse corneal edema. Endothelial cell loss occurs, as demonstrated by specular microscopy performed in two of our patients. Removal or repositioning of the Ozurdex(®) implant into the posterior segment must be performed without delay because of the risk of endothelial toxicity. CONCLUSION Patients without perfect zonular/posterior capsular integrity present a high risk of anterior chamber migration of the Ozurdex(®) implant. In such cases, anti-VEGF therapies should be discussed as an alternative.
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Affiliation(s)
- A Malclès
- Service d'ophtalmologie, hôpital d'instruction des armées Desgenettes, 108, boulevard Pinel, 69003 Lyon, France.
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Agard E, Malcles A, El Chehab H, Ract-Madoux G, Swalduz B, Aptel F, Denis P, Dot C. [Iridoschisis, a special form of iris atrophy]. J Fr Ophtalmol 2012; 36:368-71. [PMID: 23261208 DOI: 10.1016/j.jfo.2012.10.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Revised: 10/16/2012] [Accepted: 10/19/2012] [Indexed: 11/25/2022]
Abstract
Iridoschisis is a rare degenerative disease characterized by the separation of the anterior iris stroma from the posterior layer. The anterior layer splits into strands, and the free ends float freely in the anterior chamber. We report the case of a 57-year-old man, in whom we incidentally discovered isolated unilateral iris atrophy. The patient had no history of the common causes of atrophy (herpes, pigment dispersion, ocular trauma, etc.). During follow-up, the atrophy gradually worsened, with an increase in the number and bilaterality of the lesions. Ultrasound biomicroscopy (UBM) and optical coherence tomography (OCT) of anterior chamber showed thinning of the anterior iris and cleavage of the iris into two layers, an imaging result which, to our knowledge, has not yet been reported in the literature. Familiarity with iridoschisis is important, due to its frequent association with glaucoma, so that appropriate screening can be carried out at the time of diagnosis and on follow-up.
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Affiliation(s)
- E Agard
- Service d'ophtalmologie, HIA Desgenettes, 108, boulevard Pinel, 69003 Lyon, France.
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Agard E, Finkelstein D, Wallach E. Cultural diversity and informed consent. J Clin Ethics 2000; 9:173-6. [PMID: 9750989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- E Agard
- Johns Hopkins University, Baltimore, MD, USA
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Abstract
V(D)J recombination is responsible for the de novo creation of antigen receptor genes in T- and B-cell precursors. To the extent that lymphopoiesis takes place throughout an animal's lifetime, recombination errors present an ongoing problem. One type of aberrant rearrangement ensues when DNA sequences resembling a V(D)J joining signal are targeted by mistake. This study investigates the type of sequence likely to be subject to mistargeting, the level of joining-signal function associated with these sequences, and the number of such cryptic joining signals in the genome.
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Affiliation(s)
- S M Lewis
- Division of Biology, California Institute of Technology, Pasadena 91125, USA.
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Zingler K, Bélanger CA, Peters R, Agard E, Young JA. Identification and characterization of the viral interaction determinant of the subgroup A avian leukosis virus receptor. J Virol 1995; 69:4261-6. [PMID: 7769686 PMCID: PMC189164 DOI: 10.1128/jvi.69.7.4261-4266.1995] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
The cellular receptor for subgroup A avian leukosis viruses (ALV-A) has a small, 83-amino-acid extracellular domain containing a motif that is related in sequence to the ligand binding repeats of the low-density lipoprotein receptor. Extensive mutagenesis of the ALV-A receptor has identified two acidic amino acids (Asp-46 and Glu-47) and an adjacent aromatic amino acid (Trp-48) in the carboxy-terminal portion of this low-density lipoprotein receptor-related motif that are crucial for efficient viral entry. In addition, a 19-amino-acid peptide derived from this region efficiently and specifically blocked subgroup A viral infection when oxidized to form a disulfide bond previously predicted to form in the native receptor (C. Bélanger, K. Zingler, and J. A. T. Young, J. Virol. 69:1019-1024, 1995). Thus, the charged and aromatic amino acid determinants that are required for viral infection appear to lie on a small loop region of the ALV-A receptor. Previously, a single aromatic and one or more charged residues on the CD4 receptor for human and simian immunodeficiency viruses, and the MCAT receptor for ecotropic murine leukemia viruses, were shown to be important for viral entry. These results suggest that different retroviruses may recognize related determinants on structurally divergent cellular receptors.
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Affiliation(s)
- K Zingler
- Gladstone Institute of Virology and Immunology, University of California School of Medicine, San Francisco 94141-9100, USA
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