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Billerot E, Nguyen TH, Sedira N, Espinoza S, Vende B, Heron E, Habas C. Ocular motor nerve palsy in patients with diabetes: High-resolution MR imaging of nerve enhancement. J Fr Ophtalmol 2023; 46:726-736. [PMID: 37210294 DOI: 10.1016/j.jfo.2023.01.009] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 01/05/2023] [Accepted: 01/05/2023] [Indexed: 05/22/2023]
Abstract
OBJECTIVE To evaluate the extent of signal abnormality in impaired ocular motor nerves using high signal and spatial resolution MRI sequences and to discuss the involvement of inflammatory or microvascular impairment in patients with diabetic ophthalmoplegia. METHODS We conducted a retrospective study of 10 patients referred for acute ocular motor nerve palsy in the context of diabetes mellitus from September 15th, 2021 to April 24th, 2022. 3T MRI evaluation included diffusion, 3D TOF, FLAIR, coronal STIR and post-injection 3D T1 SPACE DANTE sequences. RESULTS Ten patients were included: 9 males and 1 female aged from 46 to 79 years. Five patients presented with cranial nerve (CN) III palsy, and 5 presented with CN VI palsy. Third nerve palsy was pupil-sparing in 4 patients and pupil-involved in 1 patient. Pain was associated in all patients with CN III deficiencies and in 2 patients CN VI deficiencies. In all patients, MRI sequences ruled out mass effect and vascular pathology, such as acute stroke or aneurysm. Eight patients presented with STIR hypersignals, some with enlargement of the involved nerve. The diagnosis was confirmed through a post-injection 3D T1 SPACE DANTE sequence, which showed extended enhancement along the abnormal portion of the nerve. CONCLUSION High-resolution MRI evaluation of diplopia in diabetic patients is used to rule out a diagnosis of acute stroke and contributes to the positive diagnosis of ocular motor nerve impairment, possibly combining the influences of inflammatory and microvascular phenomena. Dedicated MR imaging should be included in the initial diagnosis and longitudinal follow-up of patients with diabetic ophthalmoplegia.
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Affiliation(s)
- E Billerot
- Department of Neuroimaging, centre hospitalier national d'ophtalmologie des Quinze-Vingts, Paris, France
| | - T H Nguyen
- Department of Neuroimaging, centre hospitalier national d'ophtalmologie des Quinze-Vingts, Paris, France.
| | - N Sedira
- Department of Internal Medicine, centre hospitalier national d'ophtalmologie des Quinze-Vingts, Paris, France
| | - S Espinoza
- Department of Neuroimaging, centre hospitalier national d'ophtalmologie des Quinze-Vingts, Paris, France
| | - B Vende
- Department of Neuroimaging, centre hospitalier national d'ophtalmologie des Quinze-Vingts, Paris, France
| | - E Heron
- Department of Internal Medicine, centre hospitalier national d'ophtalmologie des Quinze-Vingts, Paris, France
| | - C Habas
- Department of Neuroimaging, centre hospitalier national d'ophtalmologie des Quinze-Vingts, Paris, France
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Denier M, Tick S, Dubois R, Dulery R, Eller AW, Suarez F, Burroni B, Maurage CA, Bories C, Konopacki J, Puech M, Bouscary D, Cantalloube A, Héron E, Marçais A, Habas C, Theillac V, Keilani C, Bonhomme GR, Gallagher DS, Boumendil J, Abarah W, Sedira N, Bertin S, Choquet S, Sahel JA, Merabet L, Brignole-Baudouin F, Putterman M, Errera MH. Hidden in the Eyes—Recurrence of Systemic Hemopathies Reportedly “In Remission”: Six Cases and Review of Literature. Medicina (B Aires) 2022; 58:medicina58030456. [PMID: 35334633 PMCID: PMC8950814 DOI: 10.3390/medicina58030456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 11/16/2022] Open
Abstract
Background and Objectives: Secondary ocular localizations of hematological malignancies are blinding conditions with a poor prognosis, and often result in a delay in the diagnosis. Materials and Methods: We describe a series of rare cases of ocular involvement in six patients with hematological malignancies, reportedly in remission, who presented secondary ocular localizations, challenging to diagnose. Two patients had an acute lymphoblastic leukemia (ALL) and developed either a posterior scleritis or a pseudo-panuveitis with ciliary process infiltration. One patient had iris plasmacytoma and developed an anterior uveitis as a secondary presentation. Two patients had a current systemic diffuse large B-cell lymphoma (DLBCL) and were referred either for intermediate uveitis or for papilledema and vitritis with secondary retinitis. Finally, one patient with an acute myeloid leukemia (AML) presented a conjunctival localization of a myeloid sarcoma. We herein summarize the current knowledge of ophthalmologic manifestations of extramedullary hematopathies. Results: Inflammatory signs were associated with symptomatic infiltrative lesions well displayed in either the iris, the retina, the choroid, or the cavernous sinus, from the admission of the patients in the ophthalmological department. These findings suggest that patients with ALL, AML, systemic DLBCL, and myeloma can present with ophthalmic involvement, even after having been reported as in remission following an effective systemic treatment and/or allograft. Conclusions: Early detection of hidden recurrence in the eyes may permit effective treatment. Furthermore, oncologists and ophthalmologists should be aware of those rare ocular malignant locations when monitoring patient’s progression after initial treatment, and close ophthalmologic examinations should be recommended when detecting patient’s ocular symptoms after treatment.
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Affiliation(s)
- Margot Denier
- Centre Hospitalier National des Quinze-Vingts, CIC 1423, DHU Sight Restore, 28 rue de Charenton, Sorbonne-Universités, Université Pierre et Marie Curie (UPMC), 75012 Paris, France; (M.D.); (S.T.); (A.C.); (E.H.); (C.H.); (V.T.); (C.K.); (J.B.); (N.S.); (S.B.); (J.-A.S.); (L.M.); (F.B.-B.); (M.P.)
| | - Sarah Tick
- Centre Hospitalier National des Quinze-Vingts, CIC 1423, DHU Sight Restore, 28 rue de Charenton, Sorbonne-Universités, Université Pierre et Marie Curie (UPMC), 75012 Paris, France; (M.D.); (S.T.); (A.C.); (E.H.); (C.H.); (V.T.); (C.K.); (J.B.); (N.S.); (S.B.); (J.-A.S.); (L.M.); (F.B.-B.); (M.P.)
| | - Romain Dubois
- Institut de Pathologie, CHRU de Lille, 59000 Lille, France;
| | - Remy Dulery
- Service d’Hématologie Clinique et de Thérapie Cellulaire, Hôpital Saint Antoine, AP-HP, Sorbonne Université, INSERM UMRs938, 75012 Paris, France;
| | - Andrew W. Eller
- Ophthalmology Service, University of Pittsburgh School of Medicine, Pittsburgh, PA 75012, USA; (A.W.E.); (G.R.B.); (D.S.G.)
| | - Felipe Suarez
- Department of Hematology, Hôpital Necker-Enfants Malades, INSERM UMR 1163 et CNRS ERL 8254, Institut Imagine, Sorbonne Paris Cité, Université Paris Descartes, 149 rue de Sèvres, CEDEX 15, 75743 Paris, France; (F.S.); (A.M.)
| | - Barbara Burroni
- Centre de Recherche des Cordeliers, Sorbonne Université, Inserm, Université de Paris, 75006 Paris, France;
| | - Claude-Alain Maurage
- Centre de Recherche Jean-Pierre Aubert INSERM: U837, Université du Droit et de la Santé—Lille II, Faculté de Médecine 1, Place de Verdun, CEDEX, 59045 Lille, France;
- Institut de Pathologie—CHRU de Lille, 59000 Lille, France
| | - Claire Bories
- France Department of Hematology, CHRU, 59000 Lille, France;
| | - Johanna Konopacki
- Department of Hematology, Hôpital D’instruction des Armées Percy, 92140 Clamart, France;
| | | | - Didier Bouscary
- Department of Hematology, Faculté de Médecine Sorbonne Paris Cité, Université Paris Descartes, Hôpital Cochin, AP-HP, 75014 Paris, France;
| | - Alberte Cantalloube
- Centre Hospitalier National des Quinze-Vingts, CIC 1423, DHU Sight Restore, 28 rue de Charenton, Sorbonne-Universités, Université Pierre et Marie Curie (UPMC), 75012 Paris, France; (M.D.); (S.T.); (A.C.); (E.H.); (C.H.); (V.T.); (C.K.); (J.B.); (N.S.); (S.B.); (J.-A.S.); (L.M.); (F.B.-B.); (M.P.)
| | - Emmanuel Héron
- Centre Hospitalier National des Quinze-Vingts, CIC 1423, DHU Sight Restore, 28 rue de Charenton, Sorbonne-Universités, Université Pierre et Marie Curie (UPMC), 75012 Paris, France; (M.D.); (S.T.); (A.C.); (E.H.); (C.H.); (V.T.); (C.K.); (J.B.); (N.S.); (S.B.); (J.-A.S.); (L.M.); (F.B.-B.); (M.P.)
| | - Ambroise Marçais
- Department of Hematology, Hôpital Necker-Enfants Malades, INSERM UMR 1163 et CNRS ERL 8254, Institut Imagine, Sorbonne Paris Cité, Université Paris Descartes, 149 rue de Sèvres, CEDEX 15, 75743 Paris, France; (F.S.); (A.M.)
| | - Christophe Habas
- Centre Hospitalier National des Quinze-Vingts, CIC 1423, DHU Sight Restore, 28 rue de Charenton, Sorbonne-Universités, Université Pierre et Marie Curie (UPMC), 75012 Paris, France; (M.D.); (S.T.); (A.C.); (E.H.); (C.H.); (V.T.); (C.K.); (J.B.); (N.S.); (S.B.); (J.-A.S.); (L.M.); (F.B.-B.); (M.P.)
| | - Vincent Theillac
- Centre Hospitalier National des Quinze-Vingts, CIC 1423, DHU Sight Restore, 28 rue de Charenton, Sorbonne-Universités, Université Pierre et Marie Curie (UPMC), 75012 Paris, France; (M.D.); (S.T.); (A.C.); (E.H.); (C.H.); (V.T.); (C.K.); (J.B.); (N.S.); (S.B.); (J.-A.S.); (L.M.); (F.B.-B.); (M.P.)
| | - Chafik Keilani
- Centre Hospitalier National des Quinze-Vingts, CIC 1423, DHU Sight Restore, 28 rue de Charenton, Sorbonne-Universités, Université Pierre et Marie Curie (UPMC), 75012 Paris, France; (M.D.); (S.T.); (A.C.); (E.H.); (C.H.); (V.T.); (C.K.); (J.B.); (N.S.); (S.B.); (J.-A.S.); (L.M.); (F.B.-B.); (M.P.)
| | - Gabrielle R. Bonhomme
- Ophthalmology Service, University of Pittsburgh School of Medicine, Pittsburgh, PA 75012, USA; (A.W.E.); (G.R.B.); (D.S.G.)
| | - Denise S. Gallagher
- Ophthalmology Service, University of Pittsburgh School of Medicine, Pittsburgh, PA 75012, USA; (A.W.E.); (G.R.B.); (D.S.G.)
| | - Julien Boumendil
- Centre Hospitalier National des Quinze-Vingts, CIC 1423, DHU Sight Restore, 28 rue de Charenton, Sorbonne-Universités, Université Pierre et Marie Curie (UPMC), 75012 Paris, France; (M.D.); (S.T.); (A.C.); (E.H.); (C.H.); (V.T.); (C.K.); (J.B.); (N.S.); (S.B.); (J.-A.S.); (L.M.); (F.B.-B.); (M.P.)
| | - Wajed Abarah
- Department of Hematology, Hôpital de Meaux, 77100 Meaux, France;
| | - Neila Sedira
- Centre Hospitalier National des Quinze-Vingts, CIC 1423, DHU Sight Restore, 28 rue de Charenton, Sorbonne-Universités, Université Pierre et Marie Curie (UPMC), 75012 Paris, France; (M.D.); (S.T.); (A.C.); (E.H.); (C.H.); (V.T.); (C.K.); (J.B.); (N.S.); (S.B.); (J.-A.S.); (L.M.); (F.B.-B.); (M.P.)
| | - Stéphane Bertin
- Centre Hospitalier National des Quinze-Vingts, CIC 1423, DHU Sight Restore, 28 rue de Charenton, Sorbonne-Universités, Université Pierre et Marie Curie (UPMC), 75012 Paris, France; (M.D.); (S.T.); (A.C.); (E.H.); (C.H.); (V.T.); (C.K.); (J.B.); (N.S.); (S.B.); (J.-A.S.); (L.M.); (F.B.-B.); (M.P.)
| | - Sylvain Choquet
- Department of Hematology, Hôpital Pitié-Salpêtrière, 75013 Paris, France;
| | - José-Alain Sahel
- Centre Hospitalier National des Quinze-Vingts, CIC 1423, DHU Sight Restore, 28 rue de Charenton, Sorbonne-Universités, Université Pierre et Marie Curie (UPMC), 75012 Paris, France; (M.D.); (S.T.); (A.C.); (E.H.); (C.H.); (V.T.); (C.K.); (J.B.); (N.S.); (S.B.); (J.-A.S.); (L.M.); (F.B.-B.); (M.P.)
- Ophthalmology Service, University of Pittsburgh School of Medicine, Pittsburgh, PA 75012, USA; (A.W.E.); (G.R.B.); (D.S.G.)
| | - Lilia Merabet
- Centre Hospitalier National des Quinze-Vingts, CIC 1423, DHU Sight Restore, 28 rue de Charenton, Sorbonne-Universités, Université Pierre et Marie Curie (UPMC), 75012 Paris, France; (M.D.); (S.T.); (A.C.); (E.H.); (C.H.); (V.T.); (C.K.); (J.B.); (N.S.); (S.B.); (J.-A.S.); (L.M.); (F.B.-B.); (M.P.)
| | - Françoise Brignole-Baudouin
- Centre Hospitalier National des Quinze-Vingts, CIC 1423, DHU Sight Restore, 28 rue de Charenton, Sorbonne-Universités, Université Pierre et Marie Curie (UPMC), 75012 Paris, France; (M.D.); (S.T.); (A.C.); (E.H.); (C.H.); (V.T.); (C.K.); (J.B.); (N.S.); (S.B.); (J.-A.S.); (L.M.); (F.B.-B.); (M.P.)
- Sorbonne Universités, 75006 Paris, France
| | - Marc Putterman
- Centre Hospitalier National des Quinze-Vingts, CIC 1423, DHU Sight Restore, 28 rue de Charenton, Sorbonne-Universités, Université Pierre et Marie Curie (UPMC), 75012 Paris, France; (M.D.); (S.T.); (A.C.); (E.H.); (C.H.); (V.T.); (C.K.); (J.B.); (N.S.); (S.B.); (J.-A.S.); (L.M.); (F.B.-B.); (M.P.)
| | - Marie-Hélène Errera
- Centre Hospitalier National des Quinze-Vingts, CIC 1423, DHU Sight Restore, 28 rue de Charenton, Sorbonne-Universités, Université Pierre et Marie Curie (UPMC), 75012 Paris, France; (M.D.); (S.T.); (A.C.); (E.H.); (C.H.); (V.T.); (C.K.); (J.B.); (N.S.); (S.B.); (J.-A.S.); (L.M.); (F.B.-B.); (M.P.)
- Ophthalmology Service, University of Pittsburgh School of Medicine, Pittsburgh, PA 75012, USA; (A.W.E.); (G.R.B.); (D.S.G.)
- Correspondence:
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Errera MH, Pratas A, Fisson S, Manicom T, Boubaya M, Sedira N, Héron E, Merabet L, Kobal A, Levy V, Warnet JM, Chaumeil C, Brignole-Baudouin F, Sahel JA, Goldschmidt P, Bodaghi B, Bloch-Queyrat C. Cytokines, chemokines and growth factors profile in human aqueous humor in idiopathic uveitis. PLoS One 2022; 17:e0254972. [PMID: 35061677 PMCID: PMC8782285 DOI: 10.1371/journal.pone.0254972] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 11/10/2021] [Indexed: 12/14/2022] Open
Abstract
To investigate which cytokines, chemokines and growth factors are involved in the immunopathogenesis of idiopathic uveitis, and whether cytokine profiles are associated with. Serum and aqueous humor (AH) samples of 75 patients with idiopathic uveitis were analyzed by multiplex immunoassay. Infectious controls consisted of 16 patients with ocular toxoplasmosis all confirmed by intraocular fluid analyses. Noninfectious controls consisted of 7 patients with Behçet disease related uveitis and 15 patients with sarcoidosis related uveitis. The control group consisted of AH and serum samples from 47 noninflammatory control patients with age-related cataract. In each sample, 27 immune mediators ± IL-21 and IL-23 were measured. In idiopathic uveitis, 13 of the 29 mediators, including most proinflammatory and vascular mediators such as IL-6, IL-8, IL-12, G-CSF, GM-CSF, MCP-1, IP-10, TNF-α and VEGF, were significantly elevated in the aqueous humor when compared to all controls. Moreover, IL-17, IP-10, and IL-21, were significantly elevated in the serum when compared to all controls. We clustered 4 subgroups of idiopathic uveitis using a statistical analysis of hierarchical unsupervised classification, characterized by the order of magnitude of concentrations of intraocular cytokines. The pathogenesis of idiopathic uveitis is characterized by the presence of predominantly proinflammatory cytokines and chemokines and vascular endothelial growth factor with high expression levels as compared to other causes of uveitis. There are indications for obvious Th-1/ IL21-Th17 pathways but also IL9-Th9 and increased IFN-γ-inducing cytokine (IL12) and IFN-γ-inducible CXC chemokine (IP-10). The combined data suggest that immune mediator expression is different among idiopathic uveitis. This study suggests various clusters among the idiopathic uveitis group rather than one specific uveitis entity.
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Affiliation(s)
- Marie-Hélène Errera
- Departments of Ophthalmology and Internal Medicine at Quinze-Vingts National Eye Hospital and DHU Sight Restore, Laboratory, Paris, France
- Sorbonne Universités, UPMC Univ Paris, Paris, France
- Department of Ophthalmology, UPMC Eye Center, University of Pittsburgh School of Medicine, Pennsylvania, United States of America
| | - Ana Pratas
- Departments of Ophthalmology and Internal Medicine at Quinze-Vingts National Eye Hospital and DHU Sight Restore, Laboratory, Paris, France
| | - Sylvain Fisson
- Généthon, Inserm UMR_S951, Univ Evry, Université Paris-Saclay, EPHE, Evry, France
| | - Thomas Manicom
- Departments of Ophthalmology and Internal Medicine at Quinze-Vingts National Eye Hospital and DHU Sight Restore, Laboratory, Paris, France
- Sorbonne Universités, UPMC Univ Paris, Paris, France
| | - Marouane Boubaya
- Université Paris 13, Sorbonne Paris cité, INSERM U1163/CNRS ERL 8254, AP-HP, Hôpital Avicenne, URC-CRC GHPSS, Bobigny, France
| | - Neila Sedira
- Departments of Ophthalmology and Internal Medicine at Quinze-Vingts National Eye Hospital and DHU Sight Restore, Laboratory, Paris, France
| | - Emmanuel Héron
- Departments of Ophthalmology and Internal Medicine at Quinze-Vingts National Eye Hospital and DHU Sight Restore, Laboratory, Paris, France
| | - Lilia Merabet
- Departments of Ophthalmology and Internal Medicine at Quinze-Vingts National Eye Hospital and DHU Sight Restore, Laboratory, Paris, France
| | - Alfred Kobal
- Departments of Ophthalmology and Internal Medicine at Quinze-Vingts National Eye Hospital and DHU Sight Restore, Laboratory, Paris, France
| | - Vincent Levy
- Université Paris 13, Sorbonne Paris cité, INSERM U1163/CNRS ERL 8254, AP-HP, Hôpital Avicenne, URC-CRC GHPSS, Bobigny, France
| | | | - Christine Chaumeil
- Departments of Ophthalmology and Internal Medicine at Quinze-Vingts National Eye Hospital and DHU Sight Restore, Laboratory, Paris, France
| | - Françoise Brignole-Baudouin
- Departments of Ophthalmology and Internal Medicine at Quinze-Vingts National Eye Hospital and DHU Sight Restore, Laboratory, Paris, France
- Faculty Pharmacy, Sorbonne Universities, Paris, France
| | - José-Alain Sahel
- Departments of Ophthalmology and Internal Medicine at Quinze-Vingts National Eye Hospital and DHU Sight Restore, Laboratory, Paris, France
- Sorbonne Universités, UPMC Univ Paris, Paris, France
- Department of Ophthalmology, UPMC Eye Center, University of Pittsburgh School of Medicine, Pennsylvania, United States of America
| | - Pablo Goldschmidt
- Departments of Ophthalmology and Internal Medicine at Quinze-Vingts National Eye Hospital and DHU Sight Restore, Laboratory, Paris, France
| | - Bahram Bodaghi
- Sorbonne Universités, UPMC Univ Paris, Paris, France
- Pitié-Salpêtrière Hospital, DHU Sight Restore, Paris, France
| | - Coralie Bloch-Queyrat
- Université Paris 13, Sorbonne Paris cité, INSERM U1163/CNRS ERL 8254, AP-HP, Hôpital Avicenne, URC-CRC GHPSS, Bobigny, France
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Mebsout-Pallado C, Orès R, Terrada C, Dansingani KK, Chhablani J, Eller AW, Martel JN, Anetakis A, Harwick JC, Waxman EL, Gallagher DS, Prensky C, Indermill C, Sedira N, Héron E, Paques M, Brignole-Baudouin F, Bodaghi B, Sahel JA, Gaudric A, Mrejen S, Errera MH. Review of the Current Literature and Our Experience on the Value of OCT-angiography in White Dot Syndromes. Ocul Immunol Inflamm 2021; 30:364-378. [PMID: 33617412 DOI: 10.1080/09273948.2020.1837185] [Citation(s) in RCA: 7] [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] [Indexed: 10/22/2022]
Abstract
PURPOSE To describe the application of OCT-A in various posterior uveitis disorders in our experience and to compare it with the available literature. METHODS Eighteen eyes with the diagnoses of multifocal choroiditis (MFC), multifocal placoid pigment epitheliopathy (APMPPE), multiple evanescent white dot syndrome (MEWDS), tuberculous serpiginous-like choroiditis (SLC), serpiginous choroiditis (SC), and birdshot chorioretinopathy (BSCR) were studied. RESULTS We found flow void of the choriocapillaris in patients with APMPPE, SC, MFC, BSCR, and in SLC. In contrast, perfusion of the choriocapillaris seemed normal in patients with MEWDS. CONCLUSIONS We confirmed that OCT-A contributes new information on the physiopathology of white dot syndromes and inflammatory chorioretinopathies, notably on whether or not the choriocapillaris is involved. Comparing the OCT-A features allowed us to suggest that both APMPPE and SLC might be part of the same spectrum of inflammatory disease with primary involvement at the level of the choriocapillaris and secondary RPE damage.
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Affiliation(s)
| | - Raphaëlle Orès
- DHU Sight Restore, Centre Hospitalier National Des Quinze-Vingts, Paris, France
| | - Céline Terrada
- Department of Ophthalmology, Lariboisière Hospital, Université Paris Diderot, Paris, France.,Centre Ophtalmologique Roule Peretti, Neuilly Sur Seine, France
| | - Kunal K Dansingani
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jay Chhablani
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Andrew W Eller
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Joseph N Martel
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Alexander Anetakis
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Jean C Harwick
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Evan L Waxman
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Denise S Gallagher
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Colin Prensky
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Chad Indermill
- Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Neila Sedira
- DHU Sight Restore, Centre Hospitalier National Des Quinze-Vingts, Paris, France
| | - Emmanuel Héron
- DHU Sight Restore, Centre Hospitalier National Des Quinze-Vingts, Paris, France
| | - Michel Paques
- DHU Sight Restore, Centre Hospitalier National Des Quinze-Vingts, Paris, France.,INSERM-DHOS CIC, Sorbonne Universités, France
| | - Françoise Brignole-Baudouin
- DHU Sight Restore, Centre Hospitalier National Des Quinze-Vingts, Paris, France.,Université Paris Descartes (Sorbonne Paris Cité), Paris V, France
| | - Bahram Bodaghi
- Department of Ophthalmology, Hopital Pitié-Salpêtrière, DHU Sight Restore, Sorbonne Universités, Paris, France
| | - José-Alain Sahel
- DHU Sight Restore, Centre Hospitalier National Des Quinze-Vingts, Paris, France.,Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,INSERM-DHOS CIC, Sorbonne Universités, France
| | - Alain Gaudric
- Department of Ophthalmology, Lariboisière Hospital, Université Paris Diderot, Paris, France
| | - Sarah Mrejen
- DHU Sight Restore, Centre Hospitalier National Des Quinze-Vingts, Paris, France
| | - Marie-Hélène Errera
- DHU Sight Restore, Centre Hospitalier National Des Quinze-Vingts, Paris, France.,Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA.,INSERM-DHOS CIC, Sorbonne Universités, France
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5
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de Parisot A, Jamilloux Y, Kodjikian L, Errera MH, Sedira N, Heron E, Pérard L, Cornut PL, Schneider C, Rivière S, Ollé P, Pugnet G, Cathébras P, Manoli P, Bodaghi B, Saadoun D, Baillif S, Tieulie N, André M, Chiambaretta F, Bonin N, Bielefeld P, Bron A, Mouriaux F, Bienvenu B, Amamra N, Guerre P, Decullier E, Sève P. Evaluating the cost-consequence of a standardized strategy for the etiological diagnosis of uveitis (ULISSE study). PLoS One 2020; 15:e0228918. [PMID: 32059021 PMCID: PMC7021300 DOI: 10.1371/journal.pone.0228918] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Accepted: 01/25/2020] [Indexed: 12/02/2022] Open
Abstract
MAIN OBJECTIVE To prospectively assess the cost-consequence of a standardized diagnostic strategy as to compared to an open one for the etiological diagnosis of uveitis. DESIGN This was a prospective, non-inferiority, multicentre, randomized controlled trial. METHODS We included all consecutive patients with uveitis who had visited at least one of the Departments of Ophthalmology. In the standardized group, patients had a minimal work-up regardless of the type of uveitis (including evaluation of the CBC, ESR, C-reactive protein, tuberculin skin test, syphilis serology and chest X-ray). Depending on ophthalmological findings, further investigations could be performed. In the open strategy, ophthalmologists were free to order any kind of investigation. The main outcome was the mean cost per patient of each strategy. RESULTS 903 uveitis patients were included from January, 2010 to May, 2013. The mean cost per patient of the standardized strategy was 182.97 euros [CI 95% (173.14; 192.80)], and the mean cost per patient of the open strategy was 251.75 euros [CI 95% (229.24; 274.25)]. Therefore, the mean cost per patient of the standardized strategy was significantly lower than the mean cost per patient of the open strategy (p<0.001). There were significantly fewer visits (p<0.001), fewer radiological procedures (p<0.004) and fewer laboratory investigations (p<0.001) in the standardized group. CONCLUSION A standardized strategy is a cost-saving approach for the etiological diagnosis of uveitis.
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Affiliation(s)
- Audrey de Parisot
- Department of Internal Medicine, Hospices Civils de Lyon, Croix-Rousse Hospital, Lyon, France
| | - Yvan Jamilloux
- Department of Internal Medicine, Hospices Civils de Lyon, Croix-Rousse Hospital, Lyon, France
| | - Laurent Kodjikian
- Department of Ophthalmology, Hospices Civils de Lyon, Croix-Rousse Hospital, Lyon, France
| | | | - Neila Sedira
- Department of Internal Medicine, Quinze-Vingts Hospital, Paris, France
| | - Emmanuel Heron
- Department of Internal Medicine, Quinze-Vingts Hospital, Paris, France
| | - Laurent Pérard
- Department of Internal Medicine, Edouard-Herriot Hospital, Lyon, France
| | | | - Christelle Schneider
- Department of Ophthalmology, Centre Hospitalier Regional Universitaire de Montpellier, Montpellier, France
| | - Sophie Rivière
- Department of Internal Medicine, Centre Hospitalier Regional Universitaire de Montpellier, Montpellier, France
| | - Priscille Ollé
- Department of Ophthalmology, Pierre-Paul Riquet Hospital, Toulouse, France
| | - Grégory Pugnet
- Department of Internal Medicine, Purpan University Hospital, Toulouse, France
| | - Pascal Cathébras
- Department of Internal Medicine, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Étienne, France
| | - Pierre Manoli
- Department of Ophthalmology, Centre Hospitalier Universitaire de Saint-Etienne, Saint-Étienne, France
| | - Bahram Bodaghi
- Department of Ophthalmology, Pitié-Salpêtrière Hospital, Paris, France
| | - David Saadoun
- Department of Internal Medicine, Pitié-Salpêtrière Hospital, Paris, France
| | - Stéphanie Baillif
- Department of Ophthalmology, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Nathalie Tieulie
- Department of Internal Medicine, Centre Hospitalier Universitaire de Nice, Nice, France
| | - Marc André
- Department of Internal Medicine, Gabriel-Montpied Hospital, Clermont-Ferrand, France
| | | | - Nicolas Bonin
- Department of Ophthalmology, Gabriel-Montpied Hospital, Clermont-Ferrand, France
| | - Philip Bielefeld
- Department of Internal Medicine, Centre Hospitalier Universitaire de Dijon, Dijon, France
| | - Alain Bron
- Department of Ophthalmology, Centre Hospitalier Universitaire de Dijon, Dijon, France
| | - Frédéric Mouriaux
- Department of Ophthalmology, Centre Hospitalier Universitaire de Caen, Caen, France
| | - Boris Bienvenu
- Department of Internal Medicine, Centre Hospitalier Universitaire de Caen, Caen, France
| | | | | | | | - Pascal Sève
- Department of Internal Medicine, Hospices Civils de Lyon, Croix-Rousse Hospital, Lyon, France
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Jamilloux Y, De Parisot A, Kodjikian L, Sedira N, Héron E, Rivière S, Pugnet G, Cathébras P, Bodaghi B, David S, Tieulie N, Andre M, Bielefeld P, Bienvenu B, Guerre P, Sève P. Évaluation médico-économique d’une stratégie standardisée pour le diagnostic étiologique des uvéites : résultats de l’étude ULISSE. Rev Med Interne 2019. [DOI: 10.1016/j.revmed.2019.10.118] [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: 11/28/2022]
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Errera MH, Westcott M, Benesty J, Falah S, Smadja J, Orès R, Pratas AC, Sedira N, Bensemlali A, Héron E, Goldschmidt P, Bodaghi B, Sahel JA. A Comparison of the Dexamethasone Implant (Ozurdex®) and Inferior Fornix-Based Sub-Tenon Triamcinolone Acetonide for Treatment of Inflammatory Ocular Diseases. Ocul Immunol Inflamm 2018; 27:319-329. [DOI: 10.1080/09273948.2018.1501492] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- Marie-Hélène Errera
- DHU Sight Restore, INSERM-DHOS CIC, Quinze-Vingts Hospital, Paris, France
- UPMC Univ Paris VI, Sorbonne Université, Paris, France
| | - Mark Westcott
- Department of Medical Retina, Moorfields Eye Hospital, NHS Foundation Trust, London, UK
- Biomedical Research Centre, UCL Institute of Ophthalmology, London, UK
- Internal Medicine, DHU Sight Restore, Quinze-Vingts Hospital, Paris, France
| | - Jonathan Benesty
- DHU Sight Restore, INSERM-DHOS CIC, Quinze-Vingts Hospital, Paris, France
- UPMC Univ Paris VI, Sorbonne Université, Paris, France
| | - Sabrina Falah
- DHU Sight Restore, INSERM-DHOS CIC, Quinze-Vingts Hospital, Paris, France
| | - Jérôme Smadja
- DHU Sight Restore, INSERM-DHOS CIC, Quinze-Vingts Hospital, Paris, France
| | - Raphaëlle Orès
- DHU Sight Restore, INSERM-DHOS CIC, Quinze-Vingts Hospital, Paris, France
| | | | - Neila Sedira
- Internal Medicine, DHU Sight Restore, Quinze-Vingts Hospital, Paris, France
| | - Amine Bensemlali
- DHU Sight Restore, INSERM-DHOS CIC, Quinze-Vingts Hospital, Paris, France
| | - Emmanuel Héron
- Internal Medicine, DHU Sight Restore, Quinze-Vingts Hospital, Paris, France
| | | | - Bahram Bodaghi
- DHU Sight Restore, Pitié-Salpêtrière Hospital, UPMC Univ Paris VI, Sorbonne Universités, Paris, France
| | - José-Alain Sahel
- DHU Sight Restore, INSERM-DHOS CIC, Quinze-Vingts Hospital, Paris, France
- UPMC Univ Paris VI, Sorbonne Université, Paris, France
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Grumet P, Kodjikian L, de Parisot A, Errera MH, Sedira N, Heron E, Pérard L, Cornut PL, Schneider C, Rivière S, Ollé P, Pugnet G, Cathébras P, Manoli P, Bodaghi B, Saadoun D, Baillif S, Tieulie N, Andre M, Chiambaretta F, Bonin N, Bielefeld P, Bron A, Mouriaux F, Bienvenu B, Vicente S, Bin S, Labetoulle M, Broussolle C, Jamilloux Y, Decullier E, Sève P. Contribution of diagnostic tests for the etiological assessment of uveitis, data from the ULISSE study (Uveitis: Clinical and medicoeconomic evaluation of a standardized strategy of the etiological diagnosis). Autoimmun Rev 2018; 17:331-343. [DOI: 10.1016/j.autrev.2017.10.018] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 10/28/2017] [Indexed: 12/19/2022]
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Pratas AC, Goldschmidt P, Lebeaux D, Aguilar C, Ermak N, Benesty J, Charlier C, Benveniste E, Merabet L, Sedira N, Hope-Rapp E, Chaumeil C, Bodaghi B, Héron E, Sahel JA, Lortholary O, Errera MH. Increase in Ocular Syphilis Cases at Ophthalmologic Reference Center, France, 2012-2015. Emerg Infect Dis 2018; 24:193-200. [PMID: 29350138 PMCID: PMC5782877 DOI: 10.3201/eid2402.171167] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
We describe the frequency, demographic and clinical features, and visual outcomes of ocular syphilis infections observed during 2012-2015 at a tertiary reference center in Paris, France. Twenty-one cases (29 eyes) were identified. The occurrence of ocular syphilis increased from 1 case in 2012 to 5 cases in 2013, 6 cases in 2014, and 9 cases in 2015 (2.22-25.21/1,000 individual patients/year for the period). Among case-patients, an annual 20%-33% were co-infected with HIV. Seventy-six percent of ocular syphilis infections occurred in men who have sex with men. Seventy-five percent of case-patients had a good final visual outcome (best-corrected visual acuity >0.3 logMAR score). Visual outcome was worse for HIV-positive patients than for HIV-negative patients (p = 0.0139). At follow-up, the best visual outcomes were observed in patients whose mean time from first ocular symptom to consultation was 15 days (SD +19 days).
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Sedira N, Feldman-Billard S, Rossignol I, Mantout F, Héron E. Fréquence de l’aggravation des neuropathies optiques ischémiques antérieures aiguës artéritiques après instauration du traitement corticoïde. Rev Med Interne 2017. [DOI: 10.1016/j.revmed.2017.10.037] [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: 10/18/2022]
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Hoogewoud F, Frumholtz L, Loubet P, Charlier C, Blanche P, Lebeaux D, Benhaddou N, Sedira N, Coutte L, Vanhaecke C, Launay O, Le Jeunne C, Héron E, Monnet D, Lortholary O, Sahel JA, Dupin N, Brézin A, Errera MH, Salah S, Groh M. Prognostic Factors in Syphilitic Uveitis. Ophthalmology 2017; 124:1808-1816. [PMID: 28779905 DOI: 10.1016/j.ophtha.2017.06.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 06/02/2017] [Accepted: 06/02/2017] [Indexed: 01/20/2023] Open
Abstract
PURPOSE To identify predictors of treatment success in syphilitic uveitis (SU). DESIGN Retrospective multicentric analysis of patients treated for SU. PARTICIPANTS A total of 95 eyes (66 patients, mean [standard deviation] aged 49 [12.5] years, 31 [47%] of whom were human immunodeficiency virus [HIV]+) were analyzed. METHODS Activity of SU was assessed at 1 week and 1 month after treatment onset, and at last follow-up. Improvement was defined by a ≥2-step decrease of both anterior chamber and vitreous haze inflammation levels, and by the size reduction in chorioretinal lesions. MAIN OUTCOME MEASURES Recovery was defined as the resolution of inflammation in all anatomic structures at 1 month. RESULTS Panuveitis and posterior uveitis were the most frequent findings. Inflammatory parameters were higher in HIV+ patients. Recovery was reported in 65% and 85% of eyes at 1 month and at last follow-up, respectively. In multivariate analysis, after adjusting for initial best-corrected visual acuity and the antimicrobial treatment regimen, clinical improvement at 1 week (corrected risk ratios [cRR], 3.5 [2.3-3.8]; P = 0.001) was predictive of recovery at 1 month, whereas the use of periocular dexamethasone injections (cRR, 0.05 [0.02-0.6]; P = 0.01) and methylprednisolone pulses negatively affected the outcomes of eyes. CONCLUSIONS Early improvement is the strongest predictor of ophthalmological recovery in SU.
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Affiliation(s)
- Florence Hoogewoud
- Department of Ophthalmology, National Referral Center for Rare Ocular Diseases, Hôpital Cochin, Paris, France
| | - Laure Frumholtz
- Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Hôpital Cochin, Paris, France
| | - Paul Loubet
- IAME, UMR 1137, INSERM, Hôpital Bichat, Paris, France; Department of Infectious Diseases, Hôpital Bichat-Claude Bernard, Paris, France
| | - Caroline Charlier
- Necker-Pasteur Center for Infectious Diseases and Tropical Medicine, Hôpital Necker Enfants Malades, Paris, France
| | - Philippe Blanche
- Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Hôpital Cochin, Paris, France; Department of Infectious Diseases, Hôpital Cochin, Paris, France
| | - David Lebeaux
- Necker-Pasteur Center for Infectious Diseases and Tropical Medicine, Hôpital Necker Enfants Malades, Paris, France
| | - Nadjet Benhaddou
- National Referral Center for Syphilis, Hôpital Cochin, APHP, Paris, France
| | - Neila Sedira
- Department of Internal Medicine, Centre Hospitalier National des Quinze-Vingt, Paris, France; DHU ViewMaintain, Sorbonne-Pierre et Marie Curie University, Paris, France
| | - Laetitia Coutte
- Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Hôpital Cochin, Paris, France; Department of Infectious Diseases, Hôpital Cochin, Paris, France
| | | | - Odile Launay
- Department of Infectious Diseases, Hôpital Cochin, Paris, France
| | - Claire Le Jeunne
- Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Hôpital Cochin, Paris, France
| | - Emmanuel Héron
- Department of Internal Medicine, Centre Hospitalier National des Quinze-Vingt, Paris, France; DHU ViewMaintain, Sorbonne-Pierre et Marie Curie University, Paris, France
| | - Dominique Monnet
- Department of Ophthalmology, National Referral Center for Rare Ocular Diseases, Hôpital Cochin, Paris, France
| | - Olivier Lortholary
- Necker-Pasteur Center for Infectious Diseases and Tropical Medicine, Hôpital Necker Enfants Malades, Paris, France
| | - José-Alain Sahel
- Department of Ophthalmology IV, Centre Hospitalier National des Quinze-Vingt, Paris, France; DHU ViewMaintain, Sorbonne-Pierre et Marie Curie University, Paris, France
| | - Nicolas Dupin
- National Referral Center for Syphilis, Hôpital Cochin, APHP, Paris, France; Department of Dermatology, Hôpital Cochin, Paris, France
| | - Antoine Brézin
- Department of Ophthalmology, National Referral Center for Rare Ocular Diseases, Hôpital Cochin, Paris, France
| | - Marie-Hélène Errera
- Department of Ophthalmology IV, Centre Hospitalier National des Quinze-Vingt, Paris, France; DHU ViewMaintain, Sorbonne-Pierre et Marie Curie University, Paris, France
| | - Sawsen Salah
- Department of Ophthalmology, National Referral Center for Rare Ocular Diseases, Hôpital Cochin, Paris, France
| | - Matthieu Groh
- Department of Internal Medicine, National Referral Center for Rare Systemic Autoimmune Diseases, Hôpital Cochin, Paris, France; Present address: Department of Internal Medicine, Hôpital St. Louis, Paris, France.
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de Parisot A, Jamilloux Y, Kodjikian L, Errera MH, Sedira N, Heron E, Pérard L, Cornut PL, Schneider C, Rivière S, Ollé P, Pugnet G, Cathébras P, Manoli P, Bodaghi B, Saadoun D, Baillif S, Tieulie N, Andre M, Chiambaretta F, Bonin N, Bielefeld P, Bron A, Mouriaux F, Bienvenu B, Vicente S, Bin S, Broussolle C, Decullier E, Sève P. Reply. Am J Ophthalmol 2017; 179:208-209. [PMID: 28528083 DOI: 10.1016/j.ajo.2017.04.023] [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: 04/23/2017] [Accepted: 04/27/2017] [Indexed: 10/19/2022]
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de Parisot A, Kodjikian L, Errera MH, Sedira N, Heron E, Pérard L, Cornut PL, Schneider C, Rivière S, Ollé P, Pugnet G, Cathébras P, Manoli P, Bodaghi B, Saadoun D, Baillif S, Tieulie N, Andre M, Chiambaretta F, Bonin N, Bielefeld P, Bron A, Mouriaux F, Bienvenu B, Vicente S, Bin S, Broussolle C, Decullier E, Sève P. Randomized Controlled Trial Evaluating a Standardized Strategy for Uveitis Etiologic Diagnosis (ULISSE). Am J Ophthalmol 2017; 178:176-185. [PMID: 28366648 DOI: 10.1016/j.ajo.2017.03.029] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 03/17/2017] [Accepted: 03/22/2017] [Indexed: 10/19/2022]
Abstract
PURPOSE To prospectively assess the efficiency of a standardized diagnostic approach, compared to an open strategy, for the etiologic diagnosis of uveitis. DESIGN Noninferiority, prospective, multicenter, clustered randomized controlled trial. METHODS Consecutive patients with uveitis, who visited 1 of the participating departments of ophthalmology, were included. In the standardized group, all patients had a minimal evaluation regardless of the type of uveitis (complete blood count, erythrocyte sedimentation rate, C-reactive protein, tuberculin skin test, syphilis serology, and chest radiograph) followed by more complex investigations according to ophthalmologic findings. In the open group, the ophthalmologist could order any type of investigation. Main outcome was the percentage of etiologic diagnoses at 6 months. RESULTS Nine hundred and three patients with uveitis were included from January 2010 to May 2013 and the per-protocol population comprised 676 patients (open 373; standardized 303). Mean age at diagnosis was 46 years. Anatomic distribution of uveitis was as follows: anterior (60.8% and 72.3%, P = .0017), intermediate (11.7% and 12.3%, P = .8028), posterior (17.8% and 8.2%, P = .0004), and panuveitis (15.3% and 15.2%, P = .9596). An etiologic diagnosis was established in 54.4% of cases in the open group and 49.5% in the standardized group (P = .2029). The difference between both strategies (standardized minus open) was -4.9% (95% CI [-12.5%; 2.6%]). There were more investigations in the open group than in the standardized group (5371 vs 3759, P < .0001). CONCLUSION The standardized strategy appears to be an efficient diagnostic approach for the etiologic diagnosis of uveitis, although its noninferiority cannot be proved.
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Mora P, Ghirardini S, Héron E, Sedira N, Olcelli F, Gandolfi S, Sahel JA, Errera MH. Ocular tuberculosis: experience of an Italian and French cohort. Acta Ophthalmol 2015; 93:e403-e404. [PMID: 25488026 DOI: 10.1111/aos.12602] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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)
- Paolo Mora
- Ophthalmology Unit; Department of Biological, Biotechnological, and Translational Sciences; University of Parma; Parma Italy
| | - Stella Ghirardini
- Ophthalmology Unit; Department of Biological, Biotechnological, and Translational Sciences; University of Parma; Parma Italy
| | - Emmanuel Héron
- Internal Medicine Department; Centre Hospitalier National des Quinze-Vingts; Paris France
| | - Neila Sedira
- Internal Medicine Department; Centre Hospitalier National des Quinze-Vingts; Paris France
| | - Federico Olcelli
- Ophthalmology Unit; Department of Biological, Biotechnological, and Translational Sciences; University of Parma; Parma Italy
| | - Stefano Gandolfi
- Ophthalmology Unit; Department of Biological, Biotechnological, and Translational Sciences; University of Parma; Parma Italy
| | - José-Alain Sahel
- Sorbonne Universités; DHU ViewMaintain; UPMC Univ Paris; Paris France
- INSERM; CIC; Paris France
- Centre Hospitalier National des Quinze-Vingts, Ophthalmology IV; Paris France
| | - Marie-Hélène Errera
- Sorbonne Universités; DHU ViewMaintain; UPMC Univ Paris; Paris France
- INSERM; CIC; Paris France
- Centre Hospitalier National des Quinze-Vingts, Ophthalmology IV; Paris France
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Sedira N, Errera MH, Rossignol I, Parize P, Charlier-Woerther C, Lortholary O, Héron E. Syphilis oculaire : huit cas en huitans ! Rev Med Interne 2013. [DOI: 10.1016/j.revmed.2013.03.263] [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: 11/26/2022]
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Feldman-Billard S, Sedira N, Boelle PY, Poisson F, Héron E. High prevalence of undiagnosed diabetes and high risk for diabetes using HbA1c criteria in middle-aged patients undergoing cataract surgery. Diabetes & Metabolism 2013; 39:271-5. [PMID: 23628550 DOI: 10.1016/j.diabet.2012.10.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2012] [Accepted: 10/29/2012] [Indexed: 11/18/2022]
Affiliation(s)
- S Feldman-Billard
- Service de médecine interne, CHNO des Quinze-Vingts, 28, rue de Charenton, 75571 Paris cedex 12, France.
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Feldman-Billard S, Dupas B, Sedira N, Bitu J, Erginay A, Guillausseau PJ, Massin P. Hypoglycaemia is associated with the absence of a decrease in diurnal macular thickness in patients with diabetic macular oedema. Diabetes Metab 2013; 39:169-73. [PMID: 23337517 DOI: 10.1016/j.diabet.2012.12.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2012] [Revised: 12/06/2012] [Accepted: 12/10/2012] [Indexed: 12/25/2022]
Abstract
AIM Spontaneous diurnal variations measured by optical coherence tomography (OCT) have been reported in diabetic macular oedema (DME) together with a daytime decrease in central macular thickness (CMT). For this reason, this study aimed to investigate the influence of acute glucose and blood pressure changes on daytime variations in CMT in patients with DME. METHODS In this prospective observational study of type 1 (n=4) and type 2 (n=18) diabetic patients with DME, OCT scans, capillary blood glucose, and systolic and diastolic blood pressure measurements were performed at 9 a.m., 12 a.m., 3 p.m., 6 p.m. and again at 9 a.m. the day after. At the same time, the study protocol included simultaneous ambulatory blood pressure and glucose monitoring over a 24-h period. Hypoglycaemic episodes, defined as glucose values<60mg/dL, were also recorded. RESULTS CMT decreased consistently between 9 a.m. and 6 p.m. in 10 patients (from 374±82μm to 337±72μm; P=0.01) and increased or remained steady in 12 others (from 383±136μm to 390±149μm; P=0.58), with a significant difference in CMT absolute change between the two groups (P<0.001). In the study population as a whole, the lower the mean diurnal blood glucose, the smaller the decrease in CMT during the day (P=0.027). Also, eight (67%) of the 12 patients with a flat CMT profile experienced a diurnal hypoglycaemic event whereas none of those with a CMT decrease had hypoglycaemia (P=0.002). CONCLUSION Hypoglycaemic events may explain the lack of diurnal CMT decrease in diabetic patients with DME. However, further studies need to be conducted to evaluate whether having no diurnal CMT decrease is associated with a poorer visual prognosis and whether it can be modified by better glucose control.
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Maalouly G, Mantout F, Feldman-Billard S, Sedira N, Abanou A, Chaumeil C, Benrabah R. Oligoclonal band and multiple sclerosis risk in monosymptomatic optic neuritis patients: a retrospective study of 84 patients. Mult Scler 2012; 18:1804. [PMID: 22513521 DOI: 10.1177/1352458512443918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Maalouly G, Sedira N, Mantout F, Rossignol I, Feldman S, Benrabah R, Heron E. Atteinte oculaire bilatérale au cours de la maladie de Horton : une série de 27 cas consécutifs. Rev Med Interne 2010. [DOI: 10.1016/j.revmed.2010.03.449] [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: 11/26/2022]
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Heron E, Sedira N, Affortit-Demoge A, Rossignol I, Mihoubi-Mantout F, Feldman-Billard S. Neuropathie optique ischémique antérieure aiguë (NOIAA) : série prospective de 311 patients. Rev Med Interne 2009. [DOI: 10.1016/j.revmed.2009.03.105] [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: 10/20/2022]
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Sedira N, Lanternier F, Rossignol I, Benrabah R, Lortholary O, Héron E. Tuberculome cérébral révélé par une uvéite. Rev Med Interne 2008. [DOI: 10.1016/j.revmed.2008.10.238] [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: 11/30/2022]
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Trijau S, Rivière S, Toledano C, Sedira N, Cabane J, Tiev KP. [A temporal mass]. Rev Med Interne 2007; 29:240-1. [PMID: 17574709 DOI: 10.1016/j.revmed.2007.05.022] [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: 04/26/2007] [Accepted: 05/04/2007] [Indexed: 10/23/2022]
Affiliation(s)
- S Trijau
- Service de médecine interne, hôpital Saint-Antoine, 184, rue Faubourg-Saint-Antoine, 75571 Paris cedex 12, France
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