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Tick S, Cornut PL, De Bats F, Wolf B, Souied EH, Cohen SY. [Update from France Macula Federation: Treatment of Wet AMD]. J Fr Ophtalmol 2018; 41:862-867. [PMID: 30361178 DOI: 10.1016/j.jfo.2018.06.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 06/26/2018] [Accepted: 06/27/2018] [Indexed: 01/08/2023]
Abstract
PURPOSE To update the recommendations of the France Macula Federation for treatment of wet age-related macular degeneration (AMD). METHODS Analysis of literature and expert opinion. RESULTS The FFM recommends initiating anti-VEGF therapy as soon as possible after diagnosis of exudative AMD. There has been no major change in the last several years concerning the procedure of intravitreal injection itself. However, the litigious points are discussed: simultaneous bilateral injection; antibiotic therapy; medico-legal aspects. All anti-VEGF strategies possess advantages and limitations. The strategy should be left to the ophthalmologists' preference. However, the chosen strategy should be explained to patients and strictly followed. CONCLUSION The treatment of wet-AMD is more precisely codified than before. However, various strategies still coexist.
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Affiliation(s)
- S Tick
- Centre hospitalier national d'ophtalmologie des XV-XX, 28, rue de Charenton, 75012 Paris, France; Centre ophtalmologique Vincennes, 17, bis rue des Meuniers, 94300 Vincennes, France
| | - P-L Cornut
- Centre pôle vision, clinique du Val d'Ouest, Croix rousse, 39, chemin de la Vernique, 69130 Écully, France
| | - F De Bats
- Centre pôle vision, clinique du Val d'Ouest, Croix rousse, 39, chemin de la Vernique, 69130 Écully, France; Hôpital de la Croix-Rousse, 103 grande rue de la Croix-Rousse, 69004 Lyon, France
| | - B Wolf
- Centre ophtalmologique de la maison rouge, 6, rue de l'Église, 67000 Strasbourg, France
| | - E H Souied
- Service d'ophtalmologie et université Paris Est, 61, avenue du Général de Gaulle, 94000 Créteil, France
| | - S Y Cohen
- Service d'ophtalmologie et université Paris Est, 61, avenue du Général de Gaulle, 94000 Créteil, France; Centre ophthalmologique d'imagerie et de laser, 11, rue Antoine Bourdelle, 75015 Paris, France.
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Wolff B, De Bats F, Tick S, Cornut PL, Souied É, Cohen SY. [Update from France Macula Federation: Diagnosis of wet AMD]. J Fr Ophtalmol 2018; 41:857-861. [PMID: 30348597 DOI: 10.1016/j.jfo.2018.05.004] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 05/09/2018] [Indexed: 11/24/2022]
Abstract
PURPOSE To update the recommendations of the France Macula Federation for the diagnosis of wet age-related macular degeneration (AMD). METHODS Analysis of literature and expert opinion. RESULTS The FMF recommends diagnosing wet AMD by combining the results of fundus examination (or color or monochromatic fundus photographs), optical coherence tomography (OCT) showing exudative signs, and morphological visualization of the neovascular membrane, which may be obtained non-invasively (OCT-angiography) or invasively (fluorescein and/or indocyanine green angiography). Under optimal conditions in which all these tools are available, the FMF recommends using non-invasive methods as first-line tools and resorting to dye angiography if diagnostic doubt remains. CONCLUSION As observed in other fields of medical imaging, non-invasive methods are preferred to invasive methods for the diagnosis of wet AMD, while the latter are reserved for more difficult cases.
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Affiliation(s)
- B Wolff
- Centre ophtalmologique de la maison rouge, 6, rue de l'Église, 67000 Strasbourg, France
| | - F De Bats
- Centre Ophtalmologique pôle vision, 69130 Ecully, France; Hôpital de la Croix-Rousse, 69004 Lyon, France
| | - S Tick
- Centre hospitalier national d'ophtalmologie des XV-XX, 28, rue de Charenton, 75012 Paris, France
| | - P-L Cornut
- Centre Ophtalmologique pôle vision, 69130 Ecully, France
| | - É Souied
- Service d'ophtalmologie, université Paris Est, 94000 Créteil, France
| | - S Y Cohen
- Centre hospitalier national d'ophtalmologie des XV-XX, 28, rue de Charenton, 75012 Paris, France; Centre ophthalmologique d'imagerie et de laser, 11, rue Antoine-Bourdelle, 75015 Paris, France.
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Poli M, Cornut PL, Nguyen AM, De Bats F, Denis P. Accuracy of peripapillary versus macular vessel density in diagnosis of early to advanced primary open angle glaucoma. J Fr Ophtalmol 2018; 41:619-629. [PMID: 30150018 DOI: 10.1016/j.jfo.2018.02.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [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: 12/07/2017] [Revised: 01/31/2018] [Accepted: 02/07/2018] [Indexed: 02/06/2023]
Abstract
PURPOSE To evaluate macular and peripapillary vessel density (mVD, pVD) using optical coherence tomography angiography (OCT-A) in healthy subjects, patients with ocular hypertension (OHT) and primary open-angle glaucoma (POAG) patients. METHODS In this prospective observational study, OCT-A images were obtained from 60 eyes of 36 healthy, ocular hypertension (OHT), preperimetric glaucoma (PPG), early glaucoma (EG) and moderate and advanced POAG subjects. Superficial mVD was acquired over a 6×6-mm cube centered on the foveal avascular zone and pVD over a 4.5×4.5-mm cube centered on the optic disc. Peripapillary retinal nerve fiber layer (pRNFL) and ganglion cell complex (GCC) thickness was calculated using spectral-domain OCT. Correlations between vascular, structural and Humphrey VF indices were evaluated (Spearman's rank correlation coefficient). RESULTS Median pVD and mVD in the PPG eyes were lower than in healthy eyes (51.87% and 47.23% versus 55.70% and 53.61%, respectively; P<0.001 and P=0.003), but higher than in mild glaucoma eyes (46.21% and 41.98%, P<0.001 compared to normal eyes) and moderate to advanced glaucoma eyes (37.45% and 39.89%, P<0.0001 compared to normal eyes). The highest correlations were found between structural parameters and pVD (r=0.87 and 0.86 for pRNFL and GCC, P<0.0001), followed by mVD (r=0.69 for both pRNFL and GCC, P<0.0001). Correlations with mean VF sensitivity were similar for pVD and mVD (r=0.61 and 0.56) and for GCC and pRNFL (r=0.60 and 0.52, P<0.0001 for all). CONCLUSIONS VD measured with OCT-A shows reduction in POAG. Detection of this damage differentiates PPG from normal and perimetric POAG eyes with a high correlation with structural parameters. Peripapillary VD accuracy is higher than mVD in detecting the disease. These results suggest that OCT-A could improve POAG diagnosis and understanding of the pathophysiologic mechanisms behind glaucoma.
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Affiliation(s)
- M Poli
- Centre ophtalmologique, pôle vision Val d'Ouest, clinique du Val d'Ouest, 69130 Ecully, France; Department of ophthalmology, Lyon Sud University Hospital, 69310 Pierre-Bénite, France.
| | - P-L Cornut
- Centre ophtalmologique, pôle vision Val d'Ouest, clinique du Val d'Ouest, 69130 Ecully, France
| | - A-M Nguyen
- Centre ophtalmologique, pôle vision Val d'Ouest, clinique du Val d'Ouest, 69130 Ecully, France; Department of ophthalmology, Croix-Rousse University Hospital, 69004 Lyon, France
| | - F De Bats
- Centre ophtalmologique, pôle vision Val d'Ouest, clinique du Val d'Ouest, 69130 Ecully, France; Department of ophthalmology, Croix-Rousse University Hospital, 69004 Lyon, France
| | - P Denis
- Department of ophthalmology, Croix-Rousse University Hospital, 69004 Lyon, France
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Bellocq D, De Bats F, Rabilloud M, Kodjikian L. Real study: Re-treatment evaluated on visual acuity for Lucentis ® in neovascular AMD. J Fr Ophtalmol 2018; 41:397-401. [PMID: 29779934 DOI: 10.1016/j.jfo.2017.10.014] [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: 06/28/2017] [Accepted: 10/20/2017] [Indexed: 10/16/2022]
Abstract
PURPOSE To assess the value of a monthly injection of Lucentis® until stable visual acuity (VA) is obtained for three consecutive months without exudation in patients with neovascular age macular degeneration (AMD). METHODS Prospective, single-center, non-controlled trial including naïve AMD patients with neovascularization. An assessment of VA and a spectral domain optical coherence tomography (SD-OCT) were performed at baseline and every month. Monthly injections of Lucentis® were performed over three months. The monthly injections were then continued until three consecutive stable VA results were obtained with no signs of exudation. RESULTS Fifteen out of the 21 patients included were anatomically good responders. A mean gain of +14Le (9) was obtained up to the point at which there was no exudation. There was no additional gain from this point until 3 consecutive stable VA results were obtained. During the PRN phase, an additional mean gain of +3.2Le (7.7) was obtained. CONCLUSION This initial VA-guided regimen with ranibizumab might prevent the slight decrease in VA observed during the first year of PRN studies.
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Affiliation(s)
- D Bellocq
- Department of Ophthalmology, Croix-Rousse University Hospital, Hospices Civils de Lyon, University of Lyon I, 69004 Lyon, France; CNRS UMR 5510 Mateis, 69621 Villeurbanne, France.
| | - F De Bats
- Department of Ophthalmology, Croix-Rousse University Hospital, Hospices Civils de Lyon, University of Lyon I, 69004 Lyon, France; CNRS UMR 5510 Mateis, 69621 Villeurbanne, France; Polevision, Clinique du Val d'Ouest, 69130 Ecully, France
| | - M Rabilloud
- Université de Lyon, 69000 Lyon, France; Université Lyon 1, 69622 Villeurbanne, France; CNRS, UMR5558, laboratoire de biométrie et biologie évolutive, 69622 Villeurbanne, France; Service de Biostatistique, Hospices Civils de Lyon, 162, avenue Lacassagne, 69003 Lyon, France
| | - L Kodjikian
- Department of Ophthalmology, Croix-Rousse University Hospital, Hospices Civils de Lyon, University of Lyon I, 69004 Lyon, France; CNRS UMR 5510 Mateis, 69621 Villeurbanne, France
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Zerbib J, Bourhis A, Cornut P, De Bats F, Grenet T, Gualino V, Halfon J, Massé H, Srour M, Streho M, Tick S, Wolff B, San Nicolas N. Erratum à « Prise en charge de la DMLA exsudative en France en 2015 » [J. Fr. Ophtalmol. 40 (9) (2017) 723–30]. J Fr Ophtalmol 2018; 41:107. [DOI: 10.1016/j.jfo.2017.11.001] [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: 11/10/2017] [Accepted: 11/13/2017] [Indexed: 11/28/2022]
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Zerbib J, Bourhis A, Cornut PL, De Bats F, Grenet T, Gualino V, Halfon J, Massé H, Srour M, Streho M, Tick S, Wolff B, San Nicolas N. [Management of wet AMD in France in 2015]. J Fr Ophtalmol 2017; 40:723-730. [PMID: 29055730 DOI: 10.1016/j.jfo.2017.05.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 04/13/2017] [Accepted: 05/17/2017] [Indexed: 11/18/2022]
Abstract
PURPOSE AND CONTEXT Intravitreal administration of anti-VEGF agents, available in France since 2007, allows stabilization and improvement in visual acuity in wet age-related macular degeneration (AMD). In the past few years, the management of this disease has evolved in terms of both diagnostic methods and treatment schedules, which have been adapted to the pathophysiology of AMD. The goal of this survey, performed in a representative sample of French ophthalmologists, was to describe the evolution of medical practices one year after a similar survey (Massé et al., J Fr Ophtalmol 2016; 39: 40-7). METHOD The survey was performed from December, 2014 to March, 2015 in 191 ophthalmologists (53 general ophthalmologists and 98 retina specialists) with an on-line questionnaire. This questionnaire was designed by a committee of ophthalmologists to describe practices concerning screening, diagnosis, treatment and follow-up of wet AMD. RESULTS An initial intravitreal injection of an anti-VEGF agent was usually performed within 10 days after the diagnosis of wet AMD by 98% of ophthalmologists and within 5 days by 63%. The treatment protocols favored by retina specialists were pro re nata (PRN) for 58%, Observe and Plan for 25% and Treat and Extend for 17%. Bilateral intravitreal injections were performed on the same day by 46% of retina specialists, mostly for the convenience of the patient and because of the low infectious risk. The initial protocol was maintained by one third of retina specialists throughout the course of treatment, while two thirds of them reported that they reassessed the protocol on average after 5 months. CONCLUSION This survey on the practices of the ophthalmologists in wet AMD highlights an improvement in the time course of patient management and an evolution of treatment schedules toward individualized protocols.
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Affiliation(s)
- J Zerbib
- Nice Rétina, 5, rue Eugène-Emmanuel, 06000 Nice, France.
| | - A Bourhis
- Polyclinique Atlantique, avenue Claude-Bernard, BP 40419, 44819 Saint-Herblain cedex, France
| | - P L Cornut
- Centre ophtalmologique pôle vision, clinique du Val-d'Ouest, 39, chemin de la Vernique, 69130 Écully, France
| | - F De Bats
- Centre ophtalmologique pôle vision, clinique du Val-d'Ouest, 39, chemin de la Vernique, 69130 Écully, France
| | | | - V Gualino
- Clinique Honoré-Cave, 406, boulevard Montauriol, 82017 Montauban, France
| | - J Halfon
- Cabinet d'ophtalmologie des Halles-de-Tours, 13, place Gaston-Paillhou, 37000 Tours, France
| | - H Massé
- Centre hospitalier universitaire de Nantes, 1, place Alexis-Ricordeau, 44093 Nantes cedex 1, France
| | - M Srour
- Centre hospitalier intercommunal de Créteil, 40, avenue de Verdun, 94010 Créteil cedex, France
| | - M Streho
- Explore Vision, 4, rue Grandes-Terres, 92500 Rueil-Malmaison, France
| | - S Tick
- Hôpital des Quinze-Vingts, 28, rue de Charenton, 75571 Paris cedex, France
| | - B Wolff
- Centre ophtalmologique, Maison-Rouge, 6, rue de l'Église, 67000 Strasbourg, France; Fondation Adolphe-de-Rothschild, 25, rue Manin, 75019 Paris, France
| | - N San Nicolas
- Novartis France, 2 et 4, rue Lionel-Terray, BP 308, 92506 Rueil-Malmaison cedex, France
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Cornut PL, De Bats F. [Evaluation of central serous chorioretinopathy with true color confocal scanner]. J Fr Ophtalmol 2017; 40:450-451. [PMID: 28479039 DOI: 10.1016/j.jfo.2016.11.019] [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: 11/16/2016] [Accepted: 11/30/2016] [Indexed: 10/19/2022]
Affiliation(s)
- P-L Cornut
- Centre pôle vision Val d'Ouest, clinique du Val d'Ouest, 39, chemin de la Vernique, 69130 Écully, France.
| | - F De Bats
- Centre pôle vision Val d'Ouest, clinique du Val d'Ouest, 39, chemin de la Vernique, 69130 Écully, France
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Mathis T, De Bats F, Cahuzac A, Wolff B, Scemama Timsit C, Uzzan J, Kodjikian L, Mauget-Faÿsse M. Fundus autofluorescence and Photobleaching : Definitions. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.0149] [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: 10/23/2022]
Affiliation(s)
- T. Mathis
- Ophthalmology; Hôpital Croix-Rousse; Lyon France
| | - F. De Bats
- Ophthalmology; Pôle vision- clinique du Val d'ouest; Lyon France
| | - A. Cahuzac
- Ophthalmology; Fondation Ophtalmologique Rothschild; Paris France
| | - B. Wolff
- Ophthalmology; Fondation Ophtalmologique Rothschild; Paris France
| | | | - J. Uzzan
- Ophthalmology; Clinique Mathilde; Rouen France
| | - L. Kodjikian
- Ophthalmology; Hôpital Croix-Rousse; Lyon France
| | - M. Mauget-Faÿsse
- Ophthalmology; Fondation Ophtalmologique Rothschild; Paris France
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Affiliation(s)
- F. De Bats
- Ophthalmology; Croix Rousse Hospital; Lyon France
| | - B. Wolff
- Ophthalmology; Foundation Rothschild; Paris France
| | - T. Mathis
- Ophthalmology; Croix Rousse Hospital; Lyon France
| | | | - A. Cahuzac
- Ophthalmology; Foundation Rothschild; Paris France
| | - J. Uzzan
- Ophthalmology; Clinique Mathilde; Rouen France
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De Bats F, Vannier Nitenberg C, Fantino B, Denis P, Kodjikian L. Age-related macular degeneration screening using a nonmydriatic digital color fundus camera and telemedicine. ACTA ACUST UNITED AC 2013; 231:172-6. [PMID: 24356326 DOI: 10.1159/000356695] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 09/09/2013] [Indexed: 11/19/2022]
Abstract
PURPOSE To investigate the use of a nonmydriatic digital color fundus camera and telemedicine as screening tools for age-related macular degeneration (AMD). METHODS Nonmydriatic color fundus photography was performed on patients consulting health examination centers and transmitted by telemedicine to an ophthalmology department. Rates for different grades of AMD were calculated and also statistically related to the presence or absence of risk factors. RESULTS Among the 1,022 patients screened, a total of 1,363 color fundus photographs were interpreted, with 80% gradable images, allowing a diagnosis of AMD in 178 photographs. Among all the gradable images, 83.7% had no AMD (grade 0). The rates of AMD at grades 1, 2, 3 and 4 were 8%, 5.6%, 2.3% and 0.4%, respectively. A statistical odds ratio was found between the presence of AMD on fundus photographs and age, familial history of AMD or prior cataract surgery. CONCLUSIONS Nonmydriatic color fundus photography and telemedicine succeeded in screening for AMD.
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Affiliation(s)
- F De Bats
- Department of Ophthalmology, Croix-Rousse University Hospital, University of Lyon, Lyon, France
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De Bats F, Grange JD, Denis P, Kodjikian L. Néovaisseaux choroïdiens du myope fort naïfs traités par injections intravitréennes de bévacizumab : résultats à plus de 12 mois. J Fr Ophtalmol 2013; 36:12-8. [DOI: 10.1016/j.jfo.2012.04.017] [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: 12/03/2011] [Revised: 03/31/2012] [Accepted: 04/10/2012] [Indexed: 11/28/2022]
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De Bats F, Grange JD, Cornut PL, Feldman A, Burillon C, Denis P, Kodjikian L. Bevacizumab versus ranibizumab in the treatment of exudative age-related macular degeneration: A retrospective study of 58 patients. J Fr Ophtalmol 2012; 35:661-6. [DOI: 10.1016/j.jfo.2012.01.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Revised: 01/07/2012] [Accepted: 01/27/2012] [Indexed: 11/27/2022]
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De Bats F, Gambrelle J, Feldman A, Mauget-Faysse M, Germain-Pastene M, Denis P. [Role of intolerance to hypoxia in the occurrence of anterior bilateral ischaemic optic neuropathy at high altitude]. J Fr Ophtalmol 2010; 33:724-7. [PMID: 21093103 DOI: 10.1016/j.jfo.2010.09.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2009] [Accepted: 09/05/2010] [Indexed: 10/18/2022]
Abstract
The pathophysiology of nonarteritic anterior ischemic optic neuropathy (NA-AION) is still imperfectly understood, but arterial hypertension seems to play a decisive role. Intolerance to hypoxia is defined as desaturation of hemoglobin more than 15% at rest and/or elevation of blood pressure at rest or after exercise over 20mmHg in hypoxia. We report the case of a 66-year-old woman who presented bilateral NA-AION during a trek at high altitude (>2500m). The etiological check up was negative. Due to the circumstances of occurrence, we requested a tolerance to hypoxia test, which was positive. In this case, the combined effects of altitude and effort probably led to prolonged desaturation of oxyhemoglobin associated with an excessive blood pressure increase upon exercise leading to ischemia of the optic nerve head. This case showed the value of a systematic search for hypoxia tolerance in patients with nonarteritic anterior ischemic optic neuropathy occurring during a situation of prolonged hypoxia (long-distance flight, high altitude).
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Affiliation(s)
- F De Bats
- Service d'ophtalmologie, hôpital de la Croix-Rousse, 103, Grande-Rue de la Croix-Rousse, 69004 Lyon, France. gonzalez
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