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Paris A, Bodaghi B, Touhami S. Pan fibroblast growth factor receptor inhibitor associated retinopathy. Eur J Ophthalmol 2024; 34:NP66-NP71. [PMID: 38086757 DOI: 10.1177/11206721231220334] [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] [Indexed: 05/04/2024]
Abstract
PURPOSE To report a case of Fibroblast Growth Factor Receptor inhibitor (FGFRi) associated retinopathy in a patient treated with Erdafitinib. CASE REPORT A patient with a history of non-muscle invasive urothelial carcinoma treated with Erdafitinib developed symptomatic unifocal bilateral serous retinal detachments (SRD) eight weeks after starting this new treatment. Six months after discontinuing the drug, the SRDs resolved and visual acuity recovered to baseline. However, hyper and hypo auto fluorescent lesions were still visible on fundus autofluorescence, suggesting a still ongoing retinal pigment epithelium (RPE) impairment. CONCLUSIONS Cancer treatments using FGFRi are showing promising results but their ocular toxicity is not well reported nor fully understood. Oncologists should be aware of the potential risks associated with FGFRi and involve ophthalmologists for the follow-up of their patients. The toxicity of FGFRi seems to resolve after drug continuation, but a certain degree of infra clinical RPE impairment may persist. Longer term follow-ups are warranted to further understand the effects of FGFRi on the RPE.
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Affiliation(s)
- Arianna Paris
- Department of Ophthalmology, Pitié-Salpêtrière University Hospital, Sorbonne Université, Paris, France
- Clinic of Ophthalmology, Institute of Clinical Neurosciences of Southern Switzerland (INSI), Ente Ospedaliero Cantonale, Ospedale Regionale di Lugano, Lugano, Switzerland
| | - Bahram Bodaghi
- Department of Ophthalmology, Pitié-Salpêtrière University Hospital, Sorbonne Université, Paris, France
| | - Sara Touhami
- Department of Ophthalmology, Pitié-Salpêtrière University Hospital, Sorbonne Université, Paris, France
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Mhibik B, Kouadio D, Jung C, Bchir C, Toutée A, Maestri F, Gulic K, Miere A, Falcione A, Touati M, Monnet D, Bodaghi B, Touhami S. Automated detection of vitritis using ultrawide-field fundus photographs and deep learning. Retina 2024:00006982-990000000-00585. [PMID: 38261816 DOI: 10.1097/iae.0000000000004049] [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] [Indexed: 01/25/2024]
Abstract
PURPOSE Evaluate the performance of a deep learning (DL) algorithm for the automated detection and grading of vitritis on ultra-wide field (UWF) imaging. DESIGN Cross-sectional non-interventional study. METHOD UWF fundus retinophotographs of uveitis patients were used. Vitreous haze was defined according to the 6 steps of the SUN classification. The DL framework TensorFlow and the DenseNet121 convolutional neural network were used to perform the classification task. The best fitted model was tested in a validation study. RESULTS 1181 images were included. The performance of the model for the detection of vitritis was good with a sensitivity of 91%, a specificity of 89%, an accuracy of 0.90 and an area under the ROC curve of 0.97. When used on an external set of images, the accuracy for the detection of vitritis was 0.78. The accuracy to classify vitritis in one of the 6 SUN grades was limited (0.61), but improved to 0.75 when the grades were grouped in three categories. When accepting an error of one grade, the accuracy for the 6-class classification increased to 0.90, suggesting the need for a larger sample to improve the model performances. CONCLUSION We describe a new DL model based on UWF fundus imaging that produces an efficient tool for the detection of vitritis. The performance of the model for the grading into 3 categories of increasing vitritis severity was acceptable. The performance for the 6-class grading of vitritis was limited but can probably be improved with a larger set of images.
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Affiliation(s)
- Bayram Mhibik
- Sorbonne Université, Department of Ophthalmology, Pitié Salpêtrière University Hospital, Paris, France
| | - Desire Kouadio
- Department of Ophthalmology, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Camille Jung
- Department of Ophthalmology, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Chemsedine Bchir
- Sorbonne Université, Department of Mathematics and Engineering Applications, Paris, France
| | - Adelaide Toutée
- Sorbonne Université, Department of Ophthalmology, Pitié Salpêtrière University Hospital, Paris, France
| | - Federico Maestri
- Sorbonne Université, Department of Ophthalmology, Pitié Salpêtrière University Hospital, Paris, France
| | - Karmen Gulic
- Sorbonne Université, Department of Ophthalmology, Pitié Salpêtrière University Hospital, Paris, France
| | - Alexandra Miere
- Department of Ophthalmology, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Alessandro Falcione
- Sorbonne Université, Department of Ophthalmology, Pitié Salpêtrière University Hospital, Paris, France
| | - Myriam Touati
- Sorbonne Université, Department of Ophthalmology, Pitié Salpêtrière University Hospital, Paris, France
| | - Dominique Monnet
- Université de Paris, Department of Ophthalmology, Cochin University Hospital, Paris, France
| | - Bahram Bodaghi
- Sorbonne Université, Department of Ophthalmology, Pitié Salpêtrière University Hospital, Paris, France
| | - Sara Touhami
- Sorbonne Université, Department of Ophthalmology, Pitié Salpêtrière University Hospital, Paris, France
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Paris A, Hié M, Tadayoni R, Bodaghi B, Touhami S. Cerebro-Ocular Toxocariasis Revealed by Bilateral Cystoid Macular Edema. Ocul Immunol Inflamm 2024; 32:127-130. [PMID: 36622871 DOI: 10.1080/09273948.2022.2155844] [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: 11/14/2022] [Accepted: 12/01/2022] [Indexed: 01/10/2023]
Abstract
DESIGN Case Report Case description: This report describes the case of a female patient diagnosed with oculo-cerebral toxocariasis manifesting initially in the form of isolated bilateral cystoid macular edema. Diagnosis was made by means of positive anterior chamber and lumbar puncture western blots. The unusual presentation, ancillary findings and treatment are discussed. The control of intraocular inflammation that was only partially responsive to steroids was eventually achieved with pegylated interferon alfa-2a. CONCLUSION Isolated macular edema is a rare presentation of ocular toxocariasis. Interferon alfa-2a may prove useful in case of insufficient control of inflammation.
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Affiliation(s)
- Arianna Paris
- Department of Ophthalmology, Pitié-Salpêtrière University Hospital, Sorbonne Université, Paris, France
| | - Miguel Hié
- Department of Internal Medicine, Pitié-Salpêtrière University Hospital, Sorbonne Université, Paris, France
| | - Ramin Tadayoni
- Department of Ophthalmology, Lariboisière University Hospital, Université de Paris, Paris, France
| | - Bahram Bodaghi
- Department of Ophthalmology, Pitié-Salpêtrière University Hospital, Sorbonne Université, Paris, France
| | - Sara Touhami
- Department of Ophthalmology, Pitié-Salpêtrière University Hospital, Sorbonne Université, Paris, France
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Abramowicz S, Dentel A, Chouraqui M, Bodaghi B, Touhami S. Atypical retinopathy in ataxia with vitamin E deficiency: report of a sibship. Neurogenetics 2024; 25:33-38. [PMID: 38105315 DOI: 10.1007/s10048-023-00741-9] [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: 10/12/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023]
Abstract
Typical retinitis pigmentosa (RP) may not be the only retinal phenotype encountered in ataxia with vitamin E deficiency (AVED). The following short case series describes a novel form of retinopathy in AVED. We describe two patients with AVED belonging to the same consanguineous sibship. Both presented an unusual retinopathy consisting of scattered, multifocal, nummular, hyperautofluorescent atrophic retinal patches. The retinopathy remained stable under vitamin E supplementation. We hypothesize these changes to be the result of arrested AVED-related RP following early supplementation with α-tocopherol acetate.
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Affiliation(s)
- Stéphane Abramowicz
- Department of Ophthalmology, IHU FOReSIGHT, Hôpital Universitaire Pitié-Salpêtrière, Sorbonne Université, 47-83 Boulevard de l'Hôpital, 75013, Paris, France.
| | - Alexandre Dentel
- Department of Ophthalmology, IHU FOReSIGHT, Hôpital Universitaire Pitié-Salpêtrière, Sorbonne Université, 47-83 Boulevard de l'Hôpital, 75013, Paris, France
| | - Maxime Chouraqui
- Department of Ophthalmology, IHU FOReSIGHT, Hôpital Universitaire Pitié-Salpêtrière, Sorbonne Université, 47-83 Boulevard de l'Hôpital, 75013, Paris, France
| | - Bahram Bodaghi
- Department of Ophthalmology, IHU FOReSIGHT, Hôpital Universitaire Pitié-Salpêtrière, Sorbonne Université, 47-83 Boulevard de l'Hôpital, 75013, Paris, France
| | - Sara Touhami
- Department of Ophthalmology, IHU FOReSIGHT, Hôpital Universitaire Pitié-Salpêtrière, Sorbonne Université, 47-83 Boulevard de l'Hôpital, 75013, Paris, France
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Desurmont MG, Bourdin A, Paris L, Toutée A, Faudi E, Fardeau C, Bodaghi B, Touhami S. Ocular Toxocariasis in Adult Caucasian Patients: Clinical Presentations and Treatment Outcomes. Ocul Immunol Inflamm 2023:1-8. [PMID: 38133947 DOI: 10.1080/09273948.2023.2295530] [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: 07/06/2023] [Accepted: 12/11/2023] [Indexed: 12/24/2023]
Abstract
PURPOSE To report the clinical features and treatment outcomes in adult Caucasians with ocular toxocariasis (OT) and investigate their prognosis depending on their serological status. METHODS Retrospective observational cohort study (2016-2021) including consecutive adults with uveitis and positive western blot (WB) in the aqueous humor or vitreous. The presence of serum antibodies was not necessary for inclusion, allowing to compare the outcomes depending on the serological status. RESULTS Seventeen eyes of 15 patients were included. Mean age at diagnosis was 51.9 years. Vitreous inflammation was the most frequent sign (100%). Vitreoretinal tractions (41.2%) and chorioretinal granulomas (58.8%) were less prevalent. Atypical features were: spontaneous intravitreal hemorrhage (23.5%), exudative retinal detachment (11.8%), isolated macular edema (17.6%), papillitis (29.4%) and vasculitis (47.1%). Twenty percent of patients had a positive serum serology. Baseline clinical features did not differ statistically depending on the serological status; however, the degree of inflammation was numerically higher in patients with negative serology. Overall, macular thickness, anterior and posterior segment inflammation improved significantly after treatment with oral albendazole, systemic ± local corticosteroids. Vitrectomy (47.1%) was performed in case of persistent vitritis (62.5%), retinal detachment (12.5%) and intravitreous hemorrhage (25%). CONCLUSION OT has no pathognomonic sign and atypical presentations were not infrequent in this adult Caucasian cohort. Serum antibodies were rarely positive, stressing on the importance of ocular sample analysis, especially in case of atypical features. Serum antibodies may prove useful in forecasting the rapidity of inflammation clearance. Antiparasitic and anti-inflammatory treatment was safe and efficient in most cases.
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Affiliation(s)
- Marie-Gwenola Desurmont
- Department of Ophthalmology, Sorbonne Université, Pitié Salpêtrière University Hospital, Paris, France
| | - Alexandre Bourdin
- Department of Ophthalmology, Sorbonne Université, Pitié Salpêtrière University Hospital, Paris, France
| | - Luc Paris
- Department of Parasitology, Sorbonne Université, Paris, France
| | - Adélaide Toutée
- Department of Ophthalmology, Sorbonne Université, Pitié Salpêtrière University Hospital, Paris, France
| | - Emilien Faudi
- Department of Ophthalmology, Sorbonne Université, Pitié Salpêtrière University Hospital, Paris, France
| | - Christine Fardeau
- Department of Ophthalmology, Sorbonne Université, Pitié Salpêtrière University Hospital, Paris, France
| | - Bahram Bodaghi
- Department of Ophthalmology, Sorbonne Université, Pitié Salpêtrière University Hospital, Paris, France
| | - Sara Touhami
- Department of Ophthalmology, Sorbonne Université, Pitié Salpêtrière University Hospital, Paris, France
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Abramowicz S, Wassef M, Touhami S. Choroidal Nodules in Ocular Sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 2023; 40:e2023039. [PMID: 38126497 DOI: 10.36141/svdld.v40i4.15122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 08/20/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND AND AIM Ocular sarcoidosis is present in 30-60% of all sarcoidosis patients. Our purpose is to increase awareness of the various presentations of ocular sarcoidosis. METHODS Short image-based clinical case report. RESULTS We report on a case of ocular sarcoidosis presenting with unilateral choroidal nodules in a middle-aged man. Sarcoid uveitis is generally bilateral and rather symmetrical. However, choroidal nodules are an exception to this rule, as they generally arise unilaterally. Choroidal nodules are highly responsive to oral corticosteroids. When left untreated, they may evolve to chorioretinal atrophy and secondary choroidal neovascularization. CONCLUSIONS Knowledge of this presentation of ocular sarcoidosis can help clinicians optimize treatment outcomes for patients.
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Affiliation(s)
- Stéphane Abramowicz
- Department of Ophthalmology, Hôpital Universitaire Pitié-Salpêtrière, Sorbonne Université, 47-83 Boulevard de l'Hôpital, 75013, Paris, France.
| | - Michel Wassef
- Department of Pathology, Hôpital Lariboisière, Université Paris Diderot, 2 Rue Ambroise Paré, 75010, Paris, France.
| | - Sara Touhami
- Department of Ophthalmology, Hôpital Universitaire Pitié-Salpêtrière, Sorbonne Université, 47-83 Boulevard de l'Hôpital, 75013, Paris, France.
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Touitou V, Shor N, Mainguy A, Touhami S. When the Retina Reflects the Brain: An Unusual Presentation of a Carotid-Cavernous Fistula. J Neuroophthalmol 2023; 43:e197-e198. [PMID: 35234691 DOI: 10.1097/wno.0000000000001443] [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] [Indexed: 11/26/2022]
Affiliation(s)
- Valérie Touitou
- Departments of Ophthalmology (VT, AM, ST), and Neuro-Radiology (NS), Pitié Salpêtrière University Hospital, Sorbonne Université, Paris, France
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Dentel A, Touhami S, Bodaghi B. Sight Threat, Life Threat. Ophthalmol Retina 2023; 7:1122. [PMID: 37542499 DOI: 10.1016/j.oret.2023.07.011] [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: 04/05/2023] [Revised: 07/08/2023] [Accepted: 07/13/2023] [Indexed: 08/07/2023]
Affiliation(s)
- Alexandre Dentel
- Ophthalmology Department, Pitié-Salpêtrière University Hospital, Paris, France; Institut de la Vision, INSERM, CNRS, Sorbonne Université, Paris, France
| | - Sara Touhami
- Ophthalmology Department, Pitié-Salpêtrière University Hospital, Paris, France; Institut de la Vision, INSERM, CNRS, Sorbonne Université, Paris, France
| | - Bahram Bodaghi
- Ophthalmology Department, Pitié-Salpêtrière University Hospital, Paris, France
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Joubert M, Desbois AC, Domont F, Ghembaza A, Lejoncour A, Mirouse A, Maalouf G, Leclercq M, Touhami S, Cacoub P, Bodaghi B, Saadoun D. Behçet's disease uveitis. Rev Med Interne 2023; 44:546-554. [PMID: 37414674 DOI: 10.1016/j.revmed.2023.06.004] [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: 05/09/2023] [Accepted: 06/06/2023] [Indexed: 07/08/2023]
Abstract
Uveitis in Behçet's disease (BD) is frequent (40% of cases) and is a major cause of morbidity. The age of onset of uveitis is between 20 and 30 years. Ocular involvement includes anterior, posterior or panuveitis. It is non-granulomatous. Uveitis may be the first sign of the disease in 20% of cases or it may appear 2 or 3 years after the first symptoms. Panuveitis is the most common presentation and is more commonly found in men. Bilateralisation usually occurs on average 2 years after the first symptoms. The estimated risk of blindness at 5 years is 10-15%. BD uveitis has several ophthalmological features that distinguish it from other uveitis. The main goals in the management of patients are the rapid resolution of intraocular inflammation, prevention of recurrent attacks, achievement of complete remission, and preservation of vision. Biologic therapies have changed the management of intraocular inflammation. The aim of this review is to provide an update previous article by our team on pathogenesis, diagnostic approaches, identification of factors associated with relapse and the therapeutic strategy of BD uveitis.
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Affiliation(s)
- M Joubert
- Department of Internal Medicine and Clinical Immunology, centre de référence des maladies auto-immunes systémiques rares, centre de référence des maladies auto-inflammatoires et de l'amylose inflammatoire, Sorbonne universités, Pitié-Salpêtrière University Hospital, AP-HP, Inserm, UMR_S 959, 83, boulevard de l'Hôpital, 75013 Paris, France
| | - A-C Desbois
- Department of Internal Medicine and Clinical Immunology, centre de référence des maladies auto-immunes systémiques rares, centre de référence des maladies auto-inflammatoires et de l'amylose inflammatoire, Sorbonne universités, Pitié-Salpêtrière University Hospital, AP-HP, Inserm, UMR_S 959, 83, boulevard de l'Hôpital, 75013 Paris, France
| | - F Domont
- Department of Internal Medicine and Clinical Immunology, centre de référence des maladies auto-immunes systémiques rares, centre de référence des maladies auto-inflammatoires et de l'amylose inflammatoire, Sorbonne universités, Pitié-Salpêtrière University Hospital, AP-HP, Inserm, UMR_S 959, 83, boulevard de l'Hôpital, 75013 Paris, France
| | - A Ghembaza
- Department of Internal Medicine and Clinical Immunology, centre de référence des maladies auto-immunes systémiques rares, centre de référence des maladies auto-inflammatoires et de l'amylose inflammatoire, Sorbonne universités, Pitié-Salpêtrière University Hospital, AP-HP, Inserm, UMR_S 959, 83, boulevard de l'Hôpital, 75013 Paris, France
| | - A Lejoncour
- Department of Internal Medicine and Clinical Immunology, centre de référence des maladies auto-immunes systémiques rares, centre de référence des maladies auto-inflammatoires et de l'amylose inflammatoire, Sorbonne universités, Pitié-Salpêtrière University Hospital, AP-HP, Inserm, UMR_S 959, 83, boulevard de l'Hôpital, 75013 Paris, France
| | - A Mirouse
- Department of Internal Medicine and Clinical Immunology, centre de référence des maladies auto-immunes systémiques rares, centre de référence des maladies auto-inflammatoires et de l'amylose inflammatoire, Sorbonne universités, Pitié-Salpêtrière University Hospital, AP-HP, Inserm, UMR_S 959, 83, boulevard de l'Hôpital, 75013 Paris, France
| | - G Maalouf
- Department of Internal Medicine and Clinical Immunology, centre de référence des maladies auto-immunes systémiques rares, centre de référence des maladies auto-inflammatoires et de l'amylose inflammatoire, Sorbonne universités, Pitié-Salpêtrière University Hospital, AP-HP, Inserm, UMR_S 959, 83, boulevard de l'Hôpital, 75013 Paris, France
| | - M Leclercq
- Internal Medicine Department, CHU de Rouen, 76000 Rouen, France
| | - S Touhami
- Department of Ophtalmology, Sorbonne universités, Pitié-Salpêtrière University Hospital, Paris, France
| | - P Cacoub
- Department of Internal Medicine and Clinical Immunology, centre de référence des maladies auto-immunes systémiques rares, centre de référence des maladies auto-inflammatoires et de l'amylose inflammatoire, Sorbonne universités, Pitié-Salpêtrière University Hospital, AP-HP, Inserm, UMR_S 959, 83, boulevard de l'Hôpital, 75013 Paris, France
| | - B Bodaghi
- Department of Ophtalmology, Sorbonne universités, Pitié-Salpêtrière University Hospital, Paris, France
| | - D Saadoun
- Department of Internal Medicine and Clinical Immunology, centre de référence des maladies auto-immunes systémiques rares, centre de référence des maladies auto-inflammatoires et de l'amylose inflammatoire, Sorbonne universités, Pitié-Salpêtrière University Hospital, AP-HP, Inserm, UMR_S 959, 83, boulevard de l'Hôpital, 75013 Paris, France.
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Bourdin A, Ortoli M, Karadayi R, Przegralek L, Sennlaub F, Bodaghi B, Guillonneau X, Carpentier A, Touhami S. Efficacy and Safety of Low-Intensity Pulsed Ultrasound-Induced Blood-Retinal Barrier Opening in Mice. Pharmaceutics 2023; 15:1896. [PMID: 37514082 PMCID: PMC10384184 DOI: 10.3390/pharmaceutics15071896] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 06/22/2023] [Accepted: 07/04/2023] [Indexed: 07/30/2023] Open
Abstract
Systemic drugs can treat various retinal pathologies such as retinal cancers; however, their ocular diffusion may be limited by the blood-retina barrier (BRB). Sonication corresponds to the use of ultrasound (US) to increase the permeability of cell barriers including in the BRB. The objective was to study the efficacy and safety of sonication using microbubble-assisted low-intensity pulsed US in inducing a transient opening of the BRB. The eyes of C57/BL6J mice were sonicated at different acoustic pressures (0.10 to 0.50 MPa). Efficacy analyses consisted of fluorescein angiography (FA) performed at different timepoints and the size of the leaked molecules was assessed using FITC-marked dextrans. Tolerance was assessed by fundus photographs, optical coherence tomography, immunohistochemistry, RT-qPCR, and electroretinograms. Sonication at 0.15 MPa was the most suitable pressure for transient BRB permeabilization without altering the morphology or function of the retina. It did not increase the expression of inflammation or apoptosis markers in the retina, retinal pigment epithelium, or choroid. The dextran assay suggested that drugs up to 150 kDa in size can cross the BRB. Microbubble-assisted sonication at an optimized acoustic pressure of 0.15 MPa provides a non-invasive method to transiently open the BRB, increasing the retinal diffusion of systemic drugs without inducing any noticeable side-effect.
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Affiliation(s)
- Alexandre Bourdin
- Institut de la Vision, Sorbonne Université, INSERM, CNRS, 75012 Paris, France
| | - Manon Ortoli
- Institut de la Vision, Sorbonne Université, INSERM, CNRS, 75012 Paris, France
| | - Remi Karadayi
- Institut de la Vision, Sorbonne Université, INSERM, CNRS, 75012 Paris, France
| | - Lauriane Przegralek
- Institut de la Vision, Sorbonne Université, INSERM, CNRS, 75012 Paris, France
| | - Florian Sennlaub
- Institut de la Vision, Sorbonne Université, INSERM, CNRS, 75012 Paris, France
| | - Bahram Bodaghi
- Ophthalmology Department, Pitié Salpêtrière University Hospital, AP-HP, Sorbonne Université, 75013 Paris, France
| | - Xavier Guillonneau
- Institut de la Vision, Sorbonne Université, INSERM, CNRS, 75012 Paris, France
| | - Alexandre Carpentier
- Department of Neurosurgery, Pitié Salpêtrière University Hospital, AP-HP, Sorbonne Université, 75013 Paris, France
- NeurOn Brain Machine Interface Clinical Research Group, Pitié Salpêtrière University Hospital, AP-HP, Sorbonne Université, 75013 Paris, France
- ASTRL Advanced Surgical Technologies Research Laboratory, Sorbonne Université, 75013 Paris, France
| | - Sara Touhami
- Institut de la Vision, Sorbonne Université, INSERM, CNRS, 75012 Paris, France
- Ophthalmology Department, Pitié Salpêtrière University Hospital, AP-HP, Sorbonne Université, 75013 Paris, France
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Huang-Xu L, Bertret C, Bodaghi B, Maestri F, Touhami S. Anterior Chamber Cytology Confirms the Diagnosis of T-cell Prolymphocytic Leukemia Masquerading as Viral Retinal Necrosis. Ocul Immunol Inflamm 2023:1-4. [PMID: 36821712 DOI: 10.1080/09273948.2023.2180648] [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: 12/12/2022] [Revised: 02/10/2023] [Accepted: 02/10/2023] [Indexed: 02/25/2023]
Abstract
PURPOSE To describe a case of T-cell prolymphocytic leukemia (T-PLL) masquerading as viral retinal necrosis (VRN). CASE PRESENTATION A 75-year-old-man with a history of T-PLL in complete remission complained of an acute vision loss in his right and only eye. Ophthalmic examination demonstrated the presence of anterior chamber cells, mild vitritis, and peripheral retinal whitening with intraretinal hemorrhages evocative of VRN. While the anterior chamber tap came back negative for HSV, VZV, and CMV, cytology performed on the aqueous humor described the presence of leukemic cells. CONCLUSION T-PLL can rarely masquerade as a viral retinal necrosis. Diagnostic work-up should therefore always rule out the infectious causes of retinitis. Anterior chamber tap can sometimes prove useful in the diagnosis of T-PLL even in the absence of a hypopyon, avoiding the need for vitrectomy.
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Affiliation(s)
- Lydie Huang-Xu
- Department of Ophthalmology, Pitié Salpetrière University Hospital, Sorbonne Université, Paris, France
| | - Clara Bertret
- Department of Ophthalmology, Pitié Salpetrière University Hospital, Sorbonne Université, Paris, France
| | - Bahram Bodaghi
- Department of Ophthalmology, Pitié Salpetrière University Hospital, Sorbonne Université, Paris, France
| | - Federico Maestri
- Department of Ophthalmology, Pitié Salpetrière University Hospital, Sorbonne Université, Paris, France
| | - Sara Touhami
- Department of Ophthalmology, Pitié Salpetrière University Hospital, Sorbonne Université, Paris, France
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Touhami S. The eye and lymphoma: New concepts of an old acquaintance. Acta Ophthalmol 2022. [DOI: 10.1111/j.1755-3768.2022.15482] [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: 02/11/2023]
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13
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Chaudot F, Sève P, Rousseau A, Alexandre M, Fournie P, Lozac’h P, Keraen J, Servant M, Muller R, Gramont B, Touhami S, Mahmoud H, Quintart P, Dalle S, Lambotte O, Kodjikian L, Jamilloux Y. Inflammation oculaire induite par les inhibiteurs du checkpoint immunitaire. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.10.254] [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: 12/12/2022]
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14
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Tan ACS, Schwartz R, Anaya D, Chatziralli I, Yuan M, Cicinelli MV, Faes L, Mustapha M, Phasukkijwatana N, Pohlmann D, Reynolds R, Rosenblatt A, Savastano A, Touhami S, Vaezi K, Ventura CV, Vogt D, Ambati J, de Smet MD, Loewenstein A. Are intravitreal injections essential during the COVID-19 pandemic? Global preferred practice patterns and practical recommendations. Int J Retina Vitreous 2022; 8:33. [PMID: 35672810 PMCID: PMC9171474 DOI: 10.1186/s40942-022-00380-6] [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: 02/18/2021] [Accepted: 05/01/2022] [Indexed: 11/12/2022] Open
Abstract
Tertiary outpatient ophthalmology clinics are high-risk environments for COVID-19 transmission, especially retina clinics, where regular follow-up is needed for elderly patients with multiple comorbidities. Intravitreal injection therapy (IVT) for chronic macular diseases, is one of the most common procedures performed, associated with a significant burden of care because of the vigorous treatment regimen associated with multiple investigations. While minimizing the risk of COVID-19 infection transmission is a priority, this must be balanced against the continued provision of sight-saving ophthalmic care to patients at risk of permanent vision loss. This review aims to give evidence-based guidelines on managing IVT during the COVID-19 pandemic in common macular diseases such as age-related macular degeneration, diabetic macula edema and retinal vascular disease and to report on how the COVID-19 pandemic has affected IVT practices worldwide. To illustrate some real-world examples, 18 participants in the International Retina Collaborative, from 15 countries and across four continents, were surveyed regarding pre- and during- COVID-19 pandemic IVT practices in tertiary ophthalmic centers. The majority of centers reported a reduction in the number of appointments to reduce the risk of the spread of COVID-19 with varying changes to their IVT regimen to treat various macula diseases. Due to the constantly evolving nature of the COVID-19 pandemic, and the uncertainty about the normal resumption of health services, we suggest that new solutions for eye healthcare provision, like telemedicine, may be adopted in the future when we consider new long-term adaptations required to cope with the COVID-19 pandemic.
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Affiliation(s)
- A C S Tan
- Singapore National Eye Centre, Singapore, Singapore. .,Singapore Eye Research Institute, Singapore, Singapore. .,Duke-NUS Medical School, National University of Singapore, Singapore, Singapore.
| | - R Schwartz
- Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | - D Anaya
- Department of Retina, Clínica de Oftalmología de Cali, Valle del Cauca, Colombia
| | - I Chatziralli
- 2nd Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece
| | - M Yuan
- Department of Retina, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - M V Cicinelli
- School of Medicine, Vita-Salute San Raffaele University, Milan, Italy.,Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - L Faes
- Moorfields Eye Hospital NHS Foundation Trust, London, UK.,Cantonal Hospital Lucerne, Lucerne, Switzerland
| | - M Mustapha
- Department of Ophthalmology, Universiti Kebangsaan Malaysia, Kulala Lumpur, Malaysia
| | - N Phasukkijwatana
- Department of Ophthalmology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - D Pohlmann
- Charité - Universitätsmedizin Berlin, FreieUiversität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
| | - R Reynolds
- Department of Ophthalmology, Aneurin Bevan University Health Board, Wales, UK
| | - A Rosenblatt
- Department of Ophthalmology, Tel-Aviv Sourasky Medical Center Tel-Aviv, Israel Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - A Savastano
- Ophthalmology Department, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.,Università Cattolica del Sacro Cuore, Rome, Italy
| | - S Touhami
- Department of Ophthalmology, Reference Center in Rare diseases, DHU Sight Restore, Hôpital Pitié Salpêtrière, Sorbonne Université, 47-83 Boulevard de l'Hôpital, 75013, Paris, France
| | - K Vaezi
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, Canada
| | - C V Ventura
- Department of Ophthalmology, Altino Ventura Foundation (FAV), Recife, Brazil.,Department of Ophthalmology, HOPE Eye Hospital, Recife, Brazil
| | - D Vogt
- Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany
| | - J Ambati
- Center for Advanced Vision Science, Department of Ophthalmology, University of Virginia School of Medicine, Charlottesville, USA
| | - M D de Smet
- Department of Ophthalmology, Leiden University, Leiden, The Netherlands.,MIOS sa, Lausanne, Switzerland
| | - A Loewenstein
- Department of Ophthalmology, Tel-Aviv Sourasky Medical Center Tel-Aviv, Israel Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Maalouf G, Andrillon A, Leclercq M, Sève P, Bielefeld P, Gueudry J, Sené T, Titah C, Moulinet T, Rouvière B, Sène D, Desbois AC, Domont F, Touhami S, Thibault T, Chamieh CE, Cacoub P, Kodjikian L, Biard L, Bodaghi B, Saadoun D. Lower Relapses Rate With Infliximab Versus Adalimumab in Sight-Threatening Uveitis: A Multicenter Study of 330 Patients. Am J Ophthalmol 2022; 238:173-180. [PMID: 35172172 DOI: 10.1016/j.ajo.2022.02.002] [Citation(s) in RCA: 3] [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: 10/24/2021] [Revised: 01/21/2022] [Accepted: 02/02/2022] [Indexed: 12/01/2022]
Abstract
PURPOSE To compare the relapse rate of sight-threatening noninfectious uveitis (NIU) in patients treated with infliximab (IFX) or adalimumab (ADA). DESIGN Observational retrospective multicenter study. METHODS A total of 330 patients (median age, 36 years; interquartile range, 27-54), 45.2% men) with sight-threatening NIU (ie, retinal vasculitis and/or macular edema) treated with anti-tumor necrosis factor [TNF]-α agents (IFX intravenously at 5 mg/kg at weeks 0, 2, 6, and every 4 to 6 weeks or ADA subcutaneously at 80 mg, then 40 mg every 2 weeks). Data were obtained retrospectively from patients' medical records. Main outcome measures were relapse rate, complete response of NIU, corticosteroid sparing effect, and safety. RESULTS Main etiologies of uveitis included Behçet disease (27%), idiopathic juvenile arthritis (5.8%), and sarcoidosis (5.5%). The estimated relapse rate at 6 months after introduction of biological agents was 13% (95% CI = 0.009-0.16). IFX was associated with less relapse risk than ADA (hazard ratio [HR] = 0.52, 95% CI = 0.36- 0.77, P = .001). ADA and IFX were comparable in terms of complete response rate of NIU as well as corticosteroid-sparing effect. Behçet disease was associated with higher odds of complete response (HR = 2.04, 95% CI = 1.16 -3.60, P = .01] and lower relapse rate (HR = 0.53, 95% CI = 0.33-0.85, P = .009) than other causes of NIU with anti-TNF-α agents. CONCLUSIONS In sight-threatening NIU, IFX seems to be associated with a lower relapse rate than ADA.
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Affiliation(s)
- Georgina Maalouf
- From the Department of Internal Medicine and Clinical Immunology, Sorbonne Universités, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Centre National de Références Maladies Autoimmunes et Systémiques Rares, Centre National de Références Maladies Autoinflammatoires Rares et Amylose Inflammatoire; INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), Paris, France
| | - Anaïs Andrillon
- Department of Biostatistics and Medical Information, CRESS UMR 1153, INSERM, ECSTRRA Team, Saint-Louis University Hospital, AP-HP, University of Paris, Paris, France
| | - Mathilde Leclercq
- From the Department of Internal Medicine and Clinical Immunology, Sorbonne Universités, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Centre National de Références Maladies Autoimmunes et Systémiques Rares, Centre National de Références Maladies Autoinflammatoires Rares et Amylose Inflammatoire; INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), Paris, France; Internal Medicine Department, CHU Rouen, Rouen, France
| | - Pascal Sève
- Internal Medicine Department, Hôpital de la Croix- Rousse, Hospices Civils de Lyon, Lyon Cedex, France; Faculté de Médecine Lyon-Sud, Université Claude Bernard-Lyon 1, Lyon, France
| | - Philip Bielefeld
- Internal Medicine and Systemic Diseases Department (Medicine Interne 2), Dijon University hospital, Dijon, France
| | - Julie Gueudry
- Ophthalmology Department, Hospital Charles Nicolle, CHU Rouen, Rouen, France; EA7510, UFR Santé, Rouen University, Rouen, France
| | - Thomas Sené
- Internal Medicine Department, Fondation Rothschild, Paris, France
| | - Cherif Titah
- Ophthalmology Department, Fondation Rothschild, Paris, France
| | - Thomas Moulinet
- Department of Internal Medicine, CHRU de Nancy, Nancy, France; Université de Lorraine, Inserm UMR_S 1116, Nancy, France
| | - Bénédicte Rouvière
- Internal Medicine and Pneumology Department, CHU de Brest, Hôpital La Cavale Blanche, Brest Cedex, France
| | - Damien Sène
- Internal Medicine Department, Lariboisière Hospital, Paris, France; INSERM UMR, Paris Diderot University, Paris, France
| | - Anne-Claire Desbois
- From the Department of Internal Medicine and Clinical Immunology, Sorbonne Universités, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Centre National de Références Maladies Autoimmunes et Systémiques Rares, Centre National de Références Maladies Autoinflammatoires Rares et Amylose Inflammatoire; INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), Paris, France
| | - Fanny Domont
- From the Department of Internal Medicine and Clinical Immunology, Sorbonne Universités, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Centre National de Références Maladies Autoimmunes et Systémiques Rares, Centre National de Références Maladies Autoinflammatoires Rares et Amylose Inflammatoire; INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), Paris, France
| | - Sara Touhami
- Ophthalmology Department, DHU View Restore, Pitié Salpêtrière Hospital, Paris, France
| | - Thomas Thibault
- From the Department of Internal Medicine and Clinical Immunology, Sorbonne Universités, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Centre National de Références Maladies Autoimmunes et Systémiques Rares, Centre National de Références Maladies Autoinflammatoires Rares et Amylose Inflammatoire; INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), Paris, France
| | - Carolla El Chamieh
- Department of Biostatistics and Medical Information, CRESS UMR 1153, INSERM, ECSTRRA Team, Saint-Louis University Hospital, AP-HP, University of Paris, Paris, France
| | - Patrice Cacoub
- From the Department of Internal Medicine and Clinical Immunology, Sorbonne Universités, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Centre National de Références Maladies Autoimmunes et Systémiques Rares, Centre National de Références Maladies Autoinflammatoires Rares et Amylose Inflammatoire; INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), Paris, France
| | - Laurent Kodjikian
- Ophthalmology Department, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon Cedex, France; Faculté de Médecine Lyon-Sud, Université Claude Bernard-Lyon 1, Lyon, France
| | - Lucie Biard
- Department of Biostatistics and Medical Information, CRESS UMR 1153, INSERM, ECSTRRA Team, Saint-Louis University Hospital, AP-HP, University of Paris, Paris, France
| | - Bahram Bodaghi
- Ophthalmology Department, DHU View Restore, Pitié Salpêtrière Hospital, Paris, France
| | - David Saadoun
- From the Department of Internal Medicine and Clinical Immunology, Sorbonne Universités, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Paris, France; Centre National de Références Maladies Autoimmunes et Systémiques Rares, Centre National de Références Maladies Autoinflammatoires Rares et Amylose Inflammatoire; INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), Paris, France.
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Leclercq M, Sève P, Biard L, Vautier M, Domont F, Maalouf G, Leroux G, Toutée A, Fardeau C, Touhami S, Bodaghi B, Kodjikian L, Cacoub P, Saadoun D, Desbois A. Effet bénéfique du traitement immunosuppresseur dans les uvéites non-antérieures de la sarcoïdose. Rev Med Interne 2022. [DOI: 10.1016/j.revmed.2022.03.285] [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: 11/15/2022]
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17
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Mainguy A, Marchal A, Touhami S. [Multimodal imaging in a case of congenital retinal macrovessel]. J Fr Ophtalmol 2022; 45:574-577. [PMID: 35459573 DOI: 10.1016/j.jfo.2021.04.021] [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: 03/12/2021] [Revised: 04/07/2021] [Accepted: 04/07/2021] [Indexed: 11/25/2022]
Affiliation(s)
- A Mainguy
- Service d'ophtalmologie, centre hospitalo-universitaire de Nantes, 1, place Alexis-Ricordeau, 44000 Nantes, France.
| | - A Marchal
- Service d'ophtalmologie, centre hospitalier du Mans, 194, avenue Rubillard, 72037 Le Mans, France
| | - S Touhami
- Service d'ophtalmologie, hôpital universitaire de la Pitié-Salpêtrière, 47-83, boulevard de l'Hôpital, 75013 Paris, France
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18
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Chatziralli I, Touhami S, Cicinelli MV, Agapitou C, Dimitriou E, Theodossiadis G, Theodossiadis P. Disentangling the association between retinal non-perfusion and anti-VEGF agents in diabetic retinopathy. Eye (Lond) 2022; 36:692-703. [PMID: 34408316 PMCID: PMC8956693 DOI: 10.1038/s41433-021-01750-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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: 01/31/2021] [Revised: 07/29/2021] [Accepted: 08/06/2021] [Indexed: 02/07/2023] Open
Abstract
Diabetic retinopathy (DR) is the most common microvascular complication of diabetes mellitus (DM) and the leading cause of blindness in patients with DM. In the pathogenesis of DR, chronic hyperglycemia leads to biochemical and structural alterations in retinal blood vessels' wall, resulting in hyperpermeability and non-perfusion. Since vascular endothelial growth factor (VEGF) has been found to play a significant role in the pathogenesis of DR, this review sheds light on the effect of intravitreal anti-VEGF agents on retinal non-perfusion in patients with DR. Based on the existing literature, anti-VEGF agents have been shown to improve DR severity, although they cannot reverse retinal ischemia. The results of the published studies are controversial and differ based on the location of retinal non-perfusion, as well as the imaging modality used to assess retinal non-perfusion. In cases of macular non-perfusion, most of studies showed no change in both fundus fluorescein angiography (FFA) and optical coherence tomography (OCTA) in patients with DR treated with intravitreal anti-VEGF agents, while few studies reported worsening of non-perfusion with enlargement of foveal avascular zone (FAZ). Regarding peripheral ischemia, studies using wide-field-FFA demonstrated an improvement or stability in non-perfusion areas after anti-VEGF treatment. However, the use of wide-field-OCTA revealed no signs of re-perfusion of retinal vessels post anti-VEGF treatment. Further prospective studies with long follow-up and large sample size are still needed to draw solid conclusions.
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Affiliation(s)
- Irini Chatziralli
- grid.5216.00000 0001 2155 08002nd Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece
| | - Sara Touhami
- grid.462844.80000 0001 2308 1657Department of Ophthalmology, Reference Center in Rare diseases, DHU Sight Restore, Hôpital Pitié Salpêtrière, Sorbonne Université, Paris, France
| | - Maria Vittoria Cicinelli
- grid.15496.3f0000 0001 0439 0892School of Medicine, Vita-Salute San Raffaele University, Milan, Italy ,grid.18887.3e0000000417581884Department of Ophthalmology, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Chrysa Agapitou
- grid.5216.00000 0001 2155 08002nd Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece
| | - Eleni Dimitriou
- grid.5216.00000 0001 2155 08002nd Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece
| | - George Theodossiadis
- grid.5216.00000 0001 2155 08002nd Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece
| | - Panagiotis Theodossiadis
- grid.5216.00000 0001 2155 08002nd Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece
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Touhami S, Marciniak A, Doyen A, Brisson G. Effect of alkalinization and ultra-high-pressure homogenization on casein micelles in raw and pasteurized skim milk. J Dairy Sci 2022; 105:2815-2827. [PMID: 35086710 DOI: 10.3168/jds.2021-20700] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 05/05/2021] [Accepted: 11/24/2021] [Indexed: 01/08/2023]
Abstract
Mechanical and physicochemical treatments of milk induce structural modifications of the casein (CN) micelles, affecting their techno-functional properties in dairy processing. Here, we studied the effect of alkalinization and ultra-high-pressure homogenization (UHPH) on CN micelles in raw skim milk (rSM) and pasteurized skim milk (pSM). The pH of both skim milks (approximately 6.7) was adjusted to 8.5 and 10.5 before UHPH at 100, 200, and 300 MPa. The structural changes of the CN micelles during the treatments were assessed using laser diffraction, transmission electron microscopy, and turbidity measurements. Finally, ultracentrifugation (70,000 × g for 1 h at 20°C) was carried out to evaluate the protein's distribution between the supernatant (serum phase) and the pellet (colloidal phase) by gel electrophoresis and protein concentration measurement. Alkalinization of both skim milks induced a significant reduction in turbidity, whereas an increase of the average particle size was observed, the effect being more severe in pSM than rSM. At alkaline pH, more proteins were recovered in the serum phase, which suggested that the CN underwent major rearrangements into nonsedimentable CN forms of various sizes, as confirmed by transmission electron microscopy. The amount of CN found in the serum phase at pH 8.5 also increased with the UHPH pressure. Although UHPH did not influence the average CN micelle size at pH 6.7 and 8.5, a pressure-dependent decrease was observed at pH 10.5 for both skim milks. The structural changes of the CN micelles observed in this study throughout the combination of alkalinization and UHPH could be of interest for developing new dairy ingredients with improved functionality.
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Affiliation(s)
- S Touhami
- Institute of Nutrition and Functional Foods (INAF), Dairy Science and Technology Research Centre (STELA), Department of Food Sciences, Université Laval, Quebec, Quebec, G1V 0A6, Canada
| | - A Marciniak
- Institute of Nutrition and Functional Foods (INAF), Dairy Science and Technology Research Centre (STELA), Department of Food Sciences, Université Laval, Quebec, Quebec, G1V 0A6, Canada
| | - A Doyen
- Institute of Nutrition and Functional Foods (INAF), Dairy Science and Technology Research Centre (STELA), Department of Food Sciences, Université Laval, Quebec, Quebec, G1V 0A6, Canada
| | - G Brisson
- Institute of Nutrition and Functional Foods (INAF), Dairy Science and Technology Research Centre (STELA), Department of Food Sciences, Université Laval, Quebec, Quebec, G1V 0A6, Canada.
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Touhami S, Béguier F, Yang T, Augustin S, Roubeix C, Blond F, Conart JB, Sahel JA, Bodaghi B, Delarasse C, Guillonneau X, Sennlaub F. Hypoxia Inhibits Subretinal Inflammation Resolution Thrombospondin-1 Dependently. Int J Mol Sci 2022; 23:681. [PMID: 35054863 PMCID: PMC8775350 DOI: 10.3390/ijms23020681] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 01/02/2022] [Accepted: 01/04/2022] [Indexed: 12/10/2022] Open
Abstract
Hypoxia is potentially one of the essential triggers in the pathogenesis of wet age-related macular degeneration (wetAMD), characterized by choroidal neovascularization (CNV) which is driven by the accumulation of subretinal mononuclear phagocytes (MP) that include monocyte-derived cells. Here we show that systemic hypoxia (10% O2) increased subretinal MP infiltration and inhibited inflammation resolution after laser-induced subretinal injury in vivo. Accordingly, hypoxic (2% O2) human monocytes (Mo) resisted elimination by RPE cells in co-culture. In Mos from hypoxic mice, Thrombospondin 1 mRNA (Thbs1) was most downregulated compared to normoxic animals and hypoxia repressed Thbs-1 expression in human monocytes in vitro. Hypoxic ambient air inhibited MP clearance during the resolution phase of laser-injury in wildtype animals, but had no effect on the exaggerated subretinal MP infiltration observed in normoxic Thbs1-/--mice. Recombinant Thrombospondin 1 protein (TSP-1) completely reversed the pathogenic effect of hypoxia in Thbs1-/--mice, and accelerated inflammation resolution and inhibited CNV in wildtype mice. Together, our results demonstrate that systemic hypoxia disturbs TSP-1-dependent subretinal immune suppression and promotes pathogenic subretinal inflammation and can be therapeutically countered by local recombinant TSP-1.
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Affiliation(s)
- Sara Touhami
- Institut de la Vision, Sorbonne Université, INSERM, CNRS, 75012 Paris, France; (S.T.); (F.B.); (T.Y.); (S.A.); (C.R.); (F.B.); (J.B.C.); (J.A.S.); (C.D.); (X.G.)
- Ophthalmology Department, Pitié Salpêtrière University Hospital, Sorbonne Université, AP-HP, 75013 Paris, France;
| | - Fanny Béguier
- Institut de la Vision, Sorbonne Université, INSERM, CNRS, 75012 Paris, France; (S.T.); (F.B.); (T.Y.); (S.A.); (C.R.); (F.B.); (J.B.C.); (J.A.S.); (C.D.); (X.G.)
| | - Tianxiang Yang
- Institut de la Vision, Sorbonne Université, INSERM, CNRS, 75012 Paris, France; (S.T.); (F.B.); (T.Y.); (S.A.); (C.R.); (F.B.); (J.B.C.); (J.A.S.); (C.D.); (X.G.)
| | - Sébastien Augustin
- Institut de la Vision, Sorbonne Université, INSERM, CNRS, 75012 Paris, France; (S.T.); (F.B.); (T.Y.); (S.A.); (C.R.); (F.B.); (J.B.C.); (J.A.S.); (C.D.); (X.G.)
| | - Christophe Roubeix
- Institut de la Vision, Sorbonne Université, INSERM, CNRS, 75012 Paris, France; (S.T.); (F.B.); (T.Y.); (S.A.); (C.R.); (F.B.); (J.B.C.); (J.A.S.); (C.D.); (X.G.)
| | - Frederic Blond
- Institut de la Vision, Sorbonne Université, INSERM, CNRS, 75012 Paris, France; (S.T.); (F.B.); (T.Y.); (S.A.); (C.R.); (F.B.); (J.B.C.); (J.A.S.); (C.D.); (X.G.)
| | - Jean Baptiste Conart
- Institut de la Vision, Sorbonne Université, INSERM, CNRS, 75012 Paris, France; (S.T.); (F.B.); (T.Y.); (S.A.); (C.R.); (F.B.); (J.B.C.); (J.A.S.); (C.D.); (X.G.)
- Department of Ophthalmology, University Hospital, 54000 Nancy, France
| | - José Alain Sahel
- Institut de la Vision, Sorbonne Université, INSERM, CNRS, 75012 Paris, France; (S.T.); (F.B.); (T.Y.); (S.A.); (C.R.); (F.B.); (J.B.C.); (J.A.S.); (C.D.); (X.G.)
- CHNO des Quinze-Vingts, INSERM-DGOS CIC 1423, 75012 Paris, France
| | - Bahram Bodaghi
- Ophthalmology Department, Pitié Salpêtrière University Hospital, Sorbonne Université, AP-HP, 75013 Paris, France;
| | - Cécile Delarasse
- Institut de la Vision, Sorbonne Université, INSERM, CNRS, 75012 Paris, France; (S.T.); (F.B.); (T.Y.); (S.A.); (C.R.); (F.B.); (J.B.C.); (J.A.S.); (C.D.); (X.G.)
| | - Xavier Guillonneau
- Institut de la Vision, Sorbonne Université, INSERM, CNRS, 75012 Paris, France; (S.T.); (F.B.); (T.Y.); (S.A.); (C.R.); (F.B.); (J.B.C.); (J.A.S.); (C.D.); (X.G.)
| | - Florian Sennlaub
- Institut de la Vision, Sorbonne Université, INSERM, CNRS, 75012 Paris, France; (S.T.); (F.B.); (T.Y.); (S.A.); (C.R.); (F.B.); (J.B.C.); (J.A.S.); (C.D.); (X.G.)
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Leclercq M, Andrillon A, Maalouf G, Sève P, Bielefeld P, Gueudry J, Sené T, Moulinet T, Rouvière B, Sène D, Desbois AC, Domont F, Touhami S, El Chamieh C, Cacoub P, Bodaghi B, Biard L, Saadoun D. Anti-Tumor Necrosis Factor α versus Tocilizumab in the Treatment of Refractory Uveitic Macular Edema: A Multicenter Study from the French Uveitis Network. Ophthalmology 2021; 129:520-529. [PMID: 34793830 DOI: 10.1016/j.ophtha.2021.11.013] [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: 06/18/2021] [Revised: 11/01/2021] [Accepted: 11/08/2021] [Indexed: 12/16/2022] Open
Abstract
PURPOSE To analyze the factors associated with response (control of ocular inflammation and corticosteroid-sparing effect) to biologics (anti-tumor necrosis factor [TNF]-α agents and tocilizumab) in patients with refractory uveitic macular edema (ME). DESIGN Multicenter, retrospective, observational study. PARTICIPANTS Adult patients with uveitic ME refractory to systemic corticosteroids, disease-modifying antirheumatic drugs, or both. METHODS Patients received anti-TNF-α agents (infliximab 5 mg/kg at week 0, 2, 6, and every 4-6 weeks [n = 69] and adalimumab 40 mg/2 weeks [n = 80]) and tocilizumab (8 mg/kg every 4 weeks intravenously [n = 39] and 162 mg/week subcutaneously [n = 16]). MAIN OUTCOME MEASURES Analysis of complete and partial response rates, relapse rate, low vision (visual acuity in at least 1 eye of ≥ 1 logarithm of the minimum angle of resolution), corticosteroid-sparing effect, and adverse events at 6 months. RESULTS Two hundred four patients (median age, 40 years [interquartile range, 28-58 years]; 42.2% men) were included. Main causes of uveitis included Behçet's disease (17.2%), birdshot chorioretinopathy (11.3%), and sarcoidosis (7.4%). The overall response rate at 6 months was 46.2% (21.8% of complete response) with anti-TNF-α agents and 58.5% (35.8% of complete response) with tocilizumab. In multivariate analysis, treatment with tocilizumab (odds ratio, 2.10; 95% confidence interval [CI], 1.06-4.06; P = 0.03) was associated independently with complete response of uveitic ME compared with anti-TNF-α agents. Anti-TNF-α agents and tocilizumab did not differ significantly in terms of relapse rate (hazard ratio, 1.00; 95% CI, 0.31-3.18; P = 0.99) or occurrence of low vision (odds ratio, 1.02; 95% CI, 0.51-2.07; P = 0.95) or corticosteroid-sparing effect (P = 0.29). Adverse events were reported in 20.6% of patients, including serious adverse events reported in 10.8% of patients. CONCLUSIONS Tocilizumab seems to improve complete response of uveitic ME compared with anti-TNF-α agents.
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Affiliation(s)
- Mathilde Leclercq
- Internal Medicine Department, CHU Rouen, Rouen, France; Department of Internal Medicine and Clinical Immunology, Sorbonne Universités, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Centre National de Références Maladies Autoimmunes et Systémiques Rares, Centre National de Références Maladies Autoinflammatoires Rares et Amylose Inflammatoire, and INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), Paris, France
| | - Anaïs Andrillon
- Department of Biostatistics and Medical Information, CRESS UMR 1153, INSERM, ECSTRRA Team, Saint-Louis University Hospital, AP-HP, University of Paris, Paris, France
| | - Georgina Maalouf
- Department of Internal Medicine and Clinical Immunology, Sorbonne Universités, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Centre National de Références Maladies Autoimmunes et Systémiques Rares, Centre National de Références Maladies Autoinflammatoires Rares et Amylose Inflammatoire, and INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), Paris, France
| | - Pascal Sève
- Internal Medicine Department, Hôpital de la Croix- Rousse, Hospices Civils de Lyon, and Faculté de Médecine Lyon-Sud, Université Claude Bernard-Lyon 1, Lyon, France
| | - Philip Bielefeld
- Internal Medicine and Systemic Diseases Department (Médecine Interne 2), Dijon University Hospital, Dijon, France
| | - Julie Gueudry
- Ophthalmology Department, Hospital Charles Nicolle, CHU Rouen, and EA7510, UFR Santé, Rouen University, Rouen, France
| | - Thomas Sené
- Internal Medicine Department, Fondation Rothschild, Paris, France
| | - Thomas Moulinet
- Department of Internal Medicine, CHRU de Nancy, and Université de Lorraine, Inserm UMR_S 1116, Nancy, France
| | - Bénédicte Rouvière
- Internal Medicine and Pneumology Department, CHU de Brest, Hôpital La Cavale Blanche, Brest, France
| | - Damien Sène
- Internal Medicine Department, Lariboisière Hospital, and INSERM UMR 969, University of Paris, Paris, France
| | - Anne-Claire Desbois
- Department of Internal Medicine and Clinical Immunology, Sorbonne Universités, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Centre National de Références Maladies Autoimmunes et Systémiques Rares, Centre National de Références Maladies Autoinflammatoires Rares et Amylose Inflammatoire, and INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), Paris, France
| | - Fanny Domont
- Department of Internal Medicine and Clinical Immunology, Sorbonne Universités, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Centre National de Références Maladies Autoimmunes et Systémiques Rares, Centre National de Références Maladies Autoinflammatoires Rares et Amylose Inflammatoire, and INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), Paris, France
| | - Sara Touhami
- Ophthalmology Department, DHU ViewRestore, Pitié Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Carolla El Chamieh
- Department of Biostatistics and Medical Information, CRESS UMR 1153, INSERM, ECSTRRA Team, Saint-Louis University Hospital, AP-HP, University of Paris, Paris, France
| | - Patrice Cacoub
- Department of Internal Medicine and Clinical Immunology, Sorbonne Universités, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Centre National de Références Maladies Autoimmunes et Systémiques Rares, Centre National de Références Maladies Autoinflammatoires Rares et Amylose Inflammatoire, and INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), Paris, France
| | - Bahram Bodaghi
- Ophthalmology Department, DHU ViewRestore, Pitié Salpêtrière Hospital, Sorbonne Université, Paris, France
| | - Lucie Biard
- Department of Biostatistics and Medical Information, CRESS UMR 1153, INSERM, ECSTRRA Team, Saint-Louis University Hospital, AP-HP, University of Paris, Paris, France
| | - David Saadoun
- Department of Internal Medicine and Clinical Immunology, Sorbonne Universités, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Centre National de Références Maladies Autoimmunes et Systémiques Rares, Centre National de Références Maladies Autoinflammatoires Rares et Amylose Inflammatoire, and INSERM, UMR S 959, Immunology-Immunopathology-Immunotherapy (I3), Paris, France.
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22
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Touhami S, Dupas B, Bertaud S, Tadayoni R, Couturier A. Intravitreal dexamethasone in diabetic macular edema: a way of enhancing the response to anti VEGF in non or poor responders? Ophthalmologica 2021; 245:350-357. [PMID: 34587614 DOI: 10.1159/000519235] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 08/12/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Sara Touhami
- Ophthalmology Department, Université de Paris, APHP, Hôpital Lariboisière, Paris, France
- Department of Ophthalmology, Reference Center in Rare Diseases, DHU Sight Restore, Hôpital Pitié Salpêtrière, Sorbonne Université, Paris, France
| | - Bénédicte Dupas
- Ophthalmology Department, Université de Paris, APHP, Hôpital Lariboisière, Paris, France
| | - Samuel Bertaud
- Ophthalmology Department, Université de Paris, APHP, Hôpital Lariboisière, Paris, France
| | - Ramin Tadayoni
- Ophthalmology Department, Université de Paris, APHP, Hôpital Lariboisière, Paris, France
| | - Aude Couturier
- Ophthalmology Department, Université de Paris, APHP, Hôpital Lariboisière, Paris, France
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23
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Touhami S, Gueudry J, Leclercq M, Touitou V, Ghembaza A, Errera MH, Saadoun D, Bodaghi B. Perspectives for immunotherapy in noninfectious immune mediated uveitis. Expert Rev Clin Immunol 2021; 17:977-989. [PMID: 34264142 DOI: 10.1080/1744666x.2021.1956313] [Citation(s) in RCA: 4] [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: 01/01/2023]
Abstract
Introduction: Noninfectious uveitis (NIU) is one of the leading causes of blindness worldwide. In adult patients, anterior NIU is usually managed with topical corticosteroids. In intermediate, posterior uveitis. and panuveitis, systemic corticosteroids are used especially in case of bilaterality or association with systemic disease. Biotherapies are recommended in case of inefficacy or intolerance to corticosteroids or conventional immunosuppressive drugs. Anti-TNF-α agents are by far the most widely used biotherapies. In case of failure or poor tolerance to anti-TNF-α, new targeted therapies can be proposed.Areas covered: We present and discuss an updated overview on biologics and biotherapies in NIU.Expert opinion: In case of dependency to systemic or intravitreal steroids, sight-threatening disease, and/or failure of conventional immunosuppressive drugs, anti-TNF-α are used as first-line biologics to achieve quiescence of inflammation. Anti-interleukin-6 is another option that may be proposed as first-line biologic or in case of poor efficacy of anti-TNF-α. Interferon can be directly proposed in specific indications (e.g. refractory macular edema, sight-threatening Behçet's uveitis). In the rare cases that remain unresponsive to traditional biotherapies, novel molecules, such as Janus-associated-kinase and anti-phosphodiesterase-4-inhibitors can be used. Therapeutic response must always be evaluated by clinical and appropriate ancillary investigations.
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Affiliation(s)
- Sara Touhami
- Department of Ophthalmology, DHU ViewRestore, Sorbonne Université, Paris, France
| | - Julie Gueudry
- Department of Ophthalmology Charles Nicolle University Hospital, Rouen, France
| | - Mathilde Leclercq
- Sorbonne Université, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Département De Médecine Interne Et Immunologie Clinique, Paris, France, Centre National De Références Maladies Autoimmunes Systémiques Rares, Centre National De Références Maladies Autoinflammatoires Et Amylose Inflammatoire; Inflammation-Immunopathology-Biotherapy Department (DMU 3iD); INSERM 959, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France.,CHU Rouen, Department of Internal Medicine, Rouen, France
| | - Valérie Touitou
- Department of Ophthalmology, DHU ViewRestore, Sorbonne Université, Paris, France
| | - Amine Ghembaza
- Sorbonne Université, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Département De Médecine Interne Et Immunologie Clinique, Paris, France, Centre National De Références Maladies Autoimmunes Systémiques Rares, Centre National De Références Maladies Autoinflammatoires Et Amylose Inflammatoire; Inflammation-Immunopathology-Biotherapy Department (DMU 3iD); INSERM 959, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France
| | - Marie Hélène Errera
- Ophthalmology Department and Laboratory and DHU Sight Restore, Centre Hospitalier National d'Ophtalmologie Des Quinze-Vingts, Sorbonne Université, Paris, France.,Department of Ophthalmology, Pittsburgh University Hospital, Pittsburgh, PA, USA
| | - David Saadoun
- Sorbonne Université, AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Département De Médecine Interne Et Immunologie Clinique, Paris, France, Centre National De Références Maladies Autoimmunes Systémiques Rares, Centre National De Références Maladies Autoinflammatoires Et Amylose Inflammatoire; Inflammation-Immunopathology-Biotherapy Department (DMU 3iD); INSERM 959, Groupe Hospitalier Pitié-Salpêtrière, AP-HP, Paris, France
| | - Bahram Bodaghi
- Department of Ophthalmology, DHU ViewRestore, Sorbonne Université, Paris, France
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24
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Negrier P, Couturier A, Gaucher D, Touhami S, Le Guern G, Tadayoni R, Gaudric A, Philippakis E. Choroidal thickness and vessel pattern in myopic eyes with dome-shaped macula. Br J Ophthalmol 2021; 106:1730-1735. [PMID: 34183323 DOI: 10.1136/bjophthalmol-2021-319066] [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: 02/09/2021] [Accepted: 06/05/2021] [Indexed: 11/03/2022]
Abstract
AIM To analyse the choroidal thickness (CT) and vessel pattern of myopic patients with dome-shaped macula (DSM) and their association with the DSM axis and serous retinal detachment (SRD). METHODS Retrospective study. The CT and vessel pattern were assessed on optical coherence tomography (OCT), OCT-angiography and ultra-wide-field photography. RESULTS 27 eyes of 18 subjects (mean age: 65 years) were included. Compared with the 11 eyes (41%) with horizontal DSM, the 16 eyes (59%) with vertical DSM had a shorter axial length (25.8±2 mm vs 28.3±2.5 mm; p=0.01), a higher mean macular bulge height (624.4±207 µm vs 255.4±160.3 µm; p=0.0001) and a thicker CT (183.1±91.1 µm vs 72±38.3 µm; p<0.001). Large choroidal vessels crossed the macular area in 75% of eyes with vertical DSM vs 27% of eyes with horizontal DSM (p=0.02), whereas a watershed zone framing the macula was more often seen in horizontal DSM (72% vs 25%, p=0.02). Thirteen eyes (48%) had an SRD that was not associated with the DSM axis, the mean bulge height, the CT or the vessel pattern. CONCLUSION The presence of an SRD did not correlate with the DSM axis, the CT or the vessel pattern. However, the rate of large choroidal vessels crossing the macula was higher in vertical DSM than in horizontal DSM.
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Affiliation(s)
- Pierre Negrier
- Université de Paris, Ophthalmology Department, APHP, Hôpital Lariboisière, Paris, France
| | - Aude Couturier
- Université de Paris, Ophthalmology Department, APHP, Hôpital Lariboisière, Paris, France
| | - David Gaucher
- Ophtalmology, University Hospitals Strasbourg, Strasbourg, Alsace, France
| | - Sara Touhami
- Université de Paris, Ophthalmology Department, APHP, Hôpital Lariboisière, Paris, France
| | - Guillaume Le Guern
- Université de Paris, Ophthalmology Department, APHP, Hôpital Lariboisière, Paris, France
| | - Ramin Tadayoni
- Université de Paris, Ophthalmology Department, APHP, Hôpital Lariboisière, Paris, France
| | - Alain Gaudric
- Université de Paris, Ophthalmology Department, APHP, Hôpital Lariboisière, Paris, France
| | - Elise Philippakis
- Université de Paris, Ophthalmology Department, APHP, Hôpital Lariboisière, Paris, France
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25
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Abstract
Uveitis maybe induced by the use of various medications known as drug-induced uveitis (DIU), though rare it is an important cause of uveitis which one needs to be aware of. The drugs may be administered through any route including systemic, topical, and intravitreal. Ocular inflammation can be in the form of anterior, intermediate, posterior or pan uveitis, and rarely may present as episcleritis and scleritis. Identification of drug as the offending agent of uveitis is important as many a times stopping the drug may help recover the uveitis or the concomitant use of corticosteroids. An extensive literature review was done using the Pubmed. An overview of DIU is provided as it is important for us to be aware of this clinical entity.
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Affiliation(s)
- Manisha Agarwal
- Vitreoretina and Uveitis Services, Dr. Shroff's Charity Eye Hospital, New Delhi, India
| | | | - Kalpana Babu
- Department of Uveitis and Ocular Inflammation, Vittala International Institute of Ophthalmology, Prabha Eye Clinic and Research Centre, Bangalore, Karnataka, India
| | | | - Mallika Goyal
- Department of Ophthalmology, IHU FOReSIGHT, Pitie-Salpetriere Universtiy Hospital, Paris, France
| | - Sara Touhami
- Department of Ophthalmology, IHU FOReSIGHT, Pitie-Salpetriere Universtiy Hospital, Paris, France
| | - Dinu Stanescu-Segall
- Department of Ophthalmology, IHU FOReSIGHT, Pitie-Salpetriere Universtiy Hospital, Paris, France
| | - Bahram Bodaghi
- Department of Ophthalmology, IHU FOReSIGHT, Pitie-Salpetriere Universtiy Hospital, Paris, France
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26
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Chatziralli I, Ventura CV, Touhami S, Reynolds R, Nassisi M, Weinberg T, Pakzad-Vaezi K, Anaya D, Mustapha M, Plant A, Yuan M, Loewenstein A. Transforming ophthalmic education into virtual learning during COVID-19 pandemic: a global perspective. Eye (Lond) 2021; 35:1459-1466. [PMID: 32651545 PMCID: PMC7348577 DOI: 10.1038/s41433-020-1080-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 06/27/2020] [Accepted: 06/30/2020] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE The coronavirus disease 2019 (COVID-19) pandemic has imposed measures of social distancing and barriers in delivery of "in person" education. Institutions, involved in training the next generation of ophthalmologists, are using alternative teaching methods to maintain the standard of education. METHODS We conducted a worldwide survey among physicians, who are actively involved in Ophthalmology-related education, between 3 and 14 April 2020. The expert survey, developed on the basis of literature search and focus group discussions, comprised 23 questions addressing the use of e-learning in Ophthalmology during the COVID-19 pandemic. RESULTS A total of 321 participants from both academic and non-academic institutions worldwide, with variable practice experience and expertise, completed the survey. Before the pandemic, the majority of participants used traditional training modalities, including lectures, grand rounds and journal clubs, and 48% did not use any e-learning. There was a statistically significant increase in the use of all e-learning alternatives during the pandemic (p < 0.001), associated mainly with the availability of e-learning facilities (p < 0.001) and the academic character of institutions (p < 0.001). Zoom® was recognized as the mostly used platform for virtual teaching. Although theoretical teaching may take place, the surgical training of residents/fellows was dramatically reduced. The latter was significantly associated with participants' perspectives about teaching practices (p < 0.001). CONCLUSION COVID-19 pandemic imposed great challenges in the educational field of Ophthalmology. The experience related to virtual training in Ophthalmology, gained during the pandemic, may change the traditional teaching practices in the world and provide new educational opportunities.
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Affiliation(s)
- Irini Chatziralli
- 2nd Department of Ophthalmology, National and Kapodistrian University of Athens, Athens, Greece.
| | - Camila V Ventura
- Department of Ophthalmology, Altino Ventura Foundation, Recife, Brazil
- Department of Ophthalmology, HOPE Eye Hospital, Recife, Brazil
| | - Sara Touhami
- Department of Ophthalmology, Reference Center in Rare diseases, DHU Sight Restore, Hôpital Pitié Salpêtrière, Sorbonne Université, Paris, France
| | - Rhianon Reynolds
- Department of Ophthalmology, Aneurin Bevan University Health Board, Wales, UK
| | - Marco Nassisi
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | - Tamir Weinberg
- Department of Ophthalmology, Kaplan Medical Center, Rehovot, Israel
- Hadassah School of Medicine, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Kaivon Pakzad-Vaezi
- Department of Ophthalmology and Visual Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Denis Anaya
- Department of Retina and Vitreous, Clínica de Oftalmología de Cali, Cali, Colombia
| | - Mushawiahti Mustapha
- Department of Ophthalmology, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Adam Plant
- Westmead and Central (Save Sight Institute) Clinical Schools, Discipline of Clinical Ophthalmology and Eye Health, University of Sydney, Sydney, NSW, Australia
| | - Miner Yuan
- State Key Laboratory of Ophthalmology, Retina Division, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Anat Loewenstein
- Division of Ophthalmology, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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27
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Troumani Y, Touhami S, Jackson TL, Ventura CV, Stanescu-Segall DM, Errera MH, Rousset D, Bodaghi B, Cartry G, David T, Beral L. Association of Anterior Uveitis With Acute Zika Virus Infection in Adults. JAMA Ophthalmol 2021; 139:95-102. [PMID: 33237306 DOI: 10.1001/jamaophthalmol.2020.5131] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Importance Acute anterior uveitis has been reported to be associated with Zika virus (ZIKV) infection in case reports and retrospective studies based on systemic clinical signs of ZIKV and positive serologic tests. Objective To describe the ophthalmic findings associated with systemic ZIKV infection during the 2016 ZIKV outbreak in Guadeloupe in the French West Indies. Design, Setting, and Participants This cohort study assessed adult patients with red eye and virologic or serologic confirmation of acute ZIKV infection who were admitted to the Pointe-à-Pitre University Hospital from January 1, 2016, to January 1, 2017, for a systematic ophthalmologic examination. All patients with anterior uveitis also underwent a complete uveitis workup to rule out other causes of uveitis. Patients were excluded from the study if they had active uveitis and a history of uveitis or positive serology for other infectious diseases including dengue fever virus and chikungunya virus. Data were analyzed from January 1, 2016, to January 1, 2017. Exposures Patients with confirmed ZIKV infection underwent full ophthalmic examination at study inception and 3, 6, and 12 months. Main Outcomes and Measures Description of the presenting ocular characteristics, management, and outcome. Results Of 62 total patients with a red eye, 32 (51.6%) had no uveitis (mean [SD] age, 27.8 [3.7] years; 26 women [81.3%]) and 30 (48.4%) had anterior uveitis (mean [SD] age, 27.5 [3.8] years; 26 women [86.7%]), which was bilateral in all cases. Acute anterior uveitis was nongranulomatous and without synechiae, exhibiting mild anterior chamber reaction with small keratic precipitates. Ocular hypertension occurred in 25 patients (83.3%) with uveitis at presentation and persisted in 15 patients (50%) at 1 year despite antiglaucoma therapy and control of uveitis. Uveitis responded to topical steroids in all cases. Intraocular pressure was within normal limits for all patients without uveitis throughout the follow-up period. Conclusions and Relevance Anterior uveitis was present in almost half of patients with a red eye and acute systemic ZIKV infection; the uveitis was usually bilateral and often associated with increased intraocular pressure. These results suggest that ophthalmic evaluation should be performed in patients with red eye and acute ZIKV infection to potentially detect and manage hypertensive anterior uveitis.
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Affiliation(s)
- Yacine Troumani
- Department of Ophthalmology, Centre Hospitalier de Perpignan, Perpignan, France.,Department of Ophthalmology, Centre Hospitalier Universitaire, Guadeloupe, French West Indies
| | - Sara Touhami
- Department of Ophthalmology, Reference Center in Rare Diseases, DHU Sight Restore, Hôpital Pitié Salpêtrière, Sorbonne Université, Paris, France
| | - Timothy L Jackson
- Faculty of Life Science and Medicine, King's College London, London, United Kingdom
| | - Camila V Ventura
- Department of Ophthalmology, Altino Ventura Foundation, Recife, Brazil.,Department of Ophthalmology, HOPE Eye Hospital, Recife, Brazil
| | - Dinu Michel Stanescu-Segall
- Department of Ophthalmology, Reference Center in Rare Diseases, DHU Sight Restore, Hôpital Pitié Salpêtrière, Sorbonne Université, Paris, France
| | - Marie-Helene Errera
- Department of Ophthalmology, Centre Hospitalier National des Quinze Vingts, Paris, France
| | - Dominique Rousset
- Virology Laboratory, National Reference Center of Arboviruses, Pastor Institute of Guyana, Cayenne, French Guiana
| | - Bahram Bodaghi
- Department of Ophthalmology, Reference Center in Rare Diseases, DHU Sight Restore, Hôpital Pitié Salpêtrière, Sorbonne Université, Paris, France
| | - Guilhem Cartry
- Department of Ophthalmology, Centre Hospitalier de Perpignan, Perpignan, France
| | - Thierry David
- Department of Ophthalmology, Centre Hospitalier Universitaire, Guadeloupe, French West Indies
| | - Laurence Beral
- Department of Ophthalmology, Centre Hospitalier Universitaire, Guadeloupe, French West Indies
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28
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Stanescu-Segall D, Zarka J, Pedinielli A, Gaudric A, Bodaghi B, Touhami S. Bilateral cystoid maculopathy as first manifestation of SARS-CoV-2 infection. J Fr Ophtalmol 2021; 44:e249-e251. [PMID: 33840494 PMCID: PMC7997302 DOI: 10.1016/j.jfo.2021.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/22/2021] [Accepted: 03/01/2021] [Indexed: 11/24/2022]
Affiliation(s)
- D Stanescu-Segall
- Hôpital Pitié-Salpêtrière: hopital universitaire Pitié-Salpetrière, 47-83, boulevard de l'hôpital, 75013 Paris, France.
| | - J Zarka
- CHIC: Centre hospitalier intercommunal de Creteil, 40, avenue de Verdun, 94000 Créteil, France
| | - A Pedinielli
- Hôpital Pitié-Salpêtrière: hopital universitaire Pitié-Salpetrière, 47-83, boulevard de l'hôpital, 75013 Paris, France
| | - A Gaudric
- CIL, 11, rue Antoine-Bourdelle, 75015 Paris, France
| | - B Bodaghi
- Hôpital Pitié-Salpêtrière: hopital universitaire Pitié-Salpetrière, 47-83, boulevard de l'hôpital, 75013 Paris, France
| | - S Touhami
- Hôpital Pitié-Salpêtrière: hopital universitaire Pitié-Salpetrière, 47-83, boulevard de l'hôpital, 75013 Paris, France
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Conart JB, Blot G, Augustin S, Millet-Puel G, Roubeix C, Beguier F, Charles-Messance H, Touhami S, Sahel JA, Berrod JP, Léveillard T, Guillonneau X, Delarasse C, Sennlaub F. Insulin inhibits inflammation-induced cone death in retinal detachment. J Neuroinflammation 2020; 17:358. [PMID: 33243251 PMCID: PMC7694924 DOI: 10.1186/s12974-020-02039-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 05/22/2020] [Accepted: 11/17/2020] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Rhegmatogenous retinal detachment (RD) involving the macula is a major cause of visual impairment despite high surgical success rate, mainly because of cone death. RD causes the infiltration of activated immune cells, but it is not clear whether and how infiltrating inflammatory cells contribute to cone cell loss. METHODS Vitreous samples from patients with RD and from control patients with macular hole were analyzed to characterize the inflammatory response to RD. A mouse model of RD and retinal explants culture were then used to explore the mechanisms leading to cone death. RESULTS Analysis of vitreous samples confirms that RD induces a marked inflammatory response with increased cytokine and chemokine expression in humans, which is closely mimicked by experimental murine RD. In this model, we corroborate that myeloid cells and T-lymphocytes contribute to cone loss, as the inhibition of their accumulation by Thrombospondin 1 (TSP1) increased cone survival. Using monocyte/retinal co-cultures and TSP1 treatment in RD, we demonstrate that immune cell infiltration downregulates rod-derived cone viability factor (RdCVF), which physiologically regulates glucose uptake in cones. Insulin and the insulin sensitizers rosiglitazone and metformin prevent in part the RD-induced cone loss in vivo, despite the persistence of inflammation CONCLUSION: Our results describe a new mechanism by which inflammation induces cone death in RD, likely through cone starvation due to the downregulation of RdCVF that could be reversed by insulin. Therapeutic inhibition of inflammation and stimulation of glucose availability in cones by insulin signaling might prevent RD-associated cone death until the RD can be surgically repaired and improve visual outcome after RD. TRIAL REGISTRATION ClinicalTrials.gov NCT03318588.
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Affiliation(s)
- Jean-Baptiste Conart
- Institut de la Vision, INSERM, UMR_S 968, CNRS, Sorbonne Université, 17 rue Moreau, F-75012, Paris, France.,Département d'Ophtalmologie, CHRU Nancy, Allée du Morvan, Vandoeuvre-lès-Nancy, France
| | - Guillaume Blot
- Institut de la Vision, INSERM, UMR_S 968, CNRS, Sorbonne Université, 17 rue Moreau, F-75012, Paris, France
| | - Sébastien Augustin
- Institut de la Vision, INSERM, UMR_S 968, CNRS, Sorbonne Université, 17 rue Moreau, F-75012, Paris, France
| | - Géraldine Millet-Puel
- Institut de la Vision, INSERM, UMR_S 968, CNRS, Sorbonne Université, 17 rue Moreau, F-75012, Paris, France
| | - Christophe Roubeix
- Institut de la Vision, INSERM, UMR_S 968, CNRS, Sorbonne Université, 17 rue Moreau, F-75012, Paris, France
| | - Fanny Beguier
- Institut de la Vision, INSERM, UMR_S 968, CNRS, Sorbonne Université, 17 rue Moreau, F-75012, Paris, France
| | - Hugo Charles-Messance
- Institut de la Vision, INSERM, UMR_S 968, CNRS, Sorbonne Université, 17 rue Moreau, F-75012, Paris, France
| | - Sara Touhami
- Institut de la Vision, INSERM, UMR_S 968, CNRS, Sorbonne Université, 17 rue Moreau, F-75012, Paris, France
| | - José-Alain Sahel
- Institut de la Vision, INSERM, UMR_S 968, CNRS, Sorbonne Université, 17 rue Moreau, F-75012, Paris, France
| | - Jean-Paul Berrod
- Département d'Ophtalmologie, CHRU Nancy, Allée du Morvan, Vandoeuvre-lès-Nancy, France
| | - Thierry Léveillard
- Institut de la Vision, INSERM, UMR_S 968, CNRS, Sorbonne Université, 17 rue Moreau, F-75012, Paris, France
| | - Xavier Guillonneau
- Institut de la Vision, INSERM, UMR_S 968, CNRS, Sorbonne Université, 17 rue Moreau, F-75012, Paris, France.
| | - Cécile Delarasse
- Institut de la Vision, INSERM, UMR_S 968, CNRS, Sorbonne Université, 17 rue Moreau, F-75012, Paris, France.
| | - Florian Sennlaub
- Institut de la Vision, INSERM, UMR_S 968, CNRS, Sorbonne Université, 17 rue Moreau, F-75012, Paris, France.
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Affiliation(s)
- Dinu Stanescu-Segall
- Département d'Ophtlalmologie, Centre Hospitalier Universitaire Piite Salpétrière, Paris 75013, France.
| | - Sara Touhami
- Département d'Ophtlalmologie, Centre Hospitalier Universitaire Piite Salpétrière, Paris 75013, France
| | - Bahram Bodaghi
- Département d'Ophtlalmologie, Centre Hospitalier Universitaire Piite Salpétrière, Paris 75013, France
| | - Phuc LeHoang
- Département d'Ophtlalmologie, Centre Hospitalier Universitaire Piite Salpétrière, Paris 75013, France
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Faes L, Rosenblatt A, Schwartz R, Touhami S, Ventura CV, Chatziralli IP, Ruiz-Medrano J, Vogt D, Savastano A, Ruiz-Garcia H, Pohlmann D, Loewenstein A. Overcoming barriers of retinal care delivery during a pandemic—attitudes and drivers for the implementation of digital health: a global expert survey. Br J Ophthalmol 2020; 105:1738-1743. [DOI: 10.1136/bjophthalmol-2020-316882] [Citation(s) in RCA: 6] [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: 05/10/2020] [Revised: 07/11/2020] [Accepted: 09/04/2020] [Indexed: 01/02/2023]
Abstract
Background/AimsThe SARS-CoV-2 pandemic has imposed barriers to retinal care delivery worldwide. In this context, retinal services are exploring novel ways to ensure access to healthcare.MethodsWe conducted a worldwide survey among retinal specialists between March 31, 2020 and April 12, 2020. The expert survey was developed on the basis of focus group discussions involving retinal specialists and literature searches. It included 44 questions on alternative ways of care provision including digital health domains such as teleophthalmology, home monitoring or decentralised patient care.Results214 retinal experts participated in the survey, of which 120 (56.1%) had more than 15 years of experience in ophthalmology. Most participants were clinicians (n=158, 73.9%) practising in Western Europe (n=159, 74%). In the majority of institutions, teleophthalmology, home monitoring and decentralised patient care have not been implemented before the pandemic (n=46, 21.8.1%; n=64, 29.9%; n=38, 19.1%). During the pandemic, the use of teleophthalmology and home monitoring increased significantly (n=105, p<0.001; n=90, p<0.001). In the subgroup of institutions reporting no teleophthalmology service before and implementing a service during the pandemic (34/70, 48.6%), reimbursement was the sole significant parameter (OR 9.62 (95% CI 2.42 to 38.16); p<0.001).ConclusionDigital health is taking the centre stage tackling unpreceded challenges of retinal care delivery during the SARS-CoV-2 pandemic and may sustainably change the way we practice ophthalmology.
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Beguier F, Housset M, Roubeix C, Augustin S, Zagar Y, Nous C, Mathis T, Eandi C, Benchaboune M, Drame-Maigné A, Carpentier W, Chardonnet S, Touhami S, Blot G, Conart JB, Charles-Messance H, Potey A, Girmens JF, Paques M, Blond F, Leveillard T, Koertvely E, Roger JE, Sahel JA, Sapieha P, Delarasse C, Guillonneau X, Sennlaub F. The 10q26 Risk Haplotype of Age-Related Macular Degeneration Aggravates Subretinal Inflammation by Impairing Monocyte Elimination. Immunity 2020; 53:429-441.e8. [PMID: 32814029 DOI: 10.1016/j.immuni.2020.07.021] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [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: 03/12/2019] [Revised: 03/06/2020] [Accepted: 07/24/2020] [Indexed: 02/08/2023]
Abstract
A minor haplotype of the 10q26 locus conveys the strongest genetic risk for age-related macular degeneration (AMD). Here, we examined the mechanisms underlying this susceptibility. We found that monocytes from homozygous carriers of the 10q26 AMD-risk haplotype expressed high amounts of the serine peptidase HTRA1, and HTRA1 located to mononuclear phagocytes (MPs) in eyes of non-carriers with AMD. HTRA1 induced the persistence of monocytes in the subretinal space and exacerbated pathogenic inflammation by hydrolyzing thrombospondin 1 (TSP1), which separated the two CD47-binding sites within TSP1 that are necessary for efficient CD47 activation. This HTRA1-induced inhibition of CD47 signaling induced the expression of pro-inflammatory osteopontin (OPN). OPN expression increased in early monocyte-derived macrophages in 10q26 risk carriers. In models of subretinal inflammation and AMD, OPN deletion or pharmacological inhibition reversed HTRA1-induced pathogenic MP persistence. Our findings argue for the therapeutic potential of CD47 agonists and OPN inhibitors for the treatment of AMD.
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Affiliation(s)
- Fanny Beguier
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012 Paris, France
| | - Michael Housset
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012 Paris, France
| | - Christophe Roubeix
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012 Paris, France
| | - Sebastien Augustin
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012 Paris, France
| | - Yvrick Zagar
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012 Paris, France
| | - Caroline Nous
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012 Paris, France
| | - Thibaud Mathis
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012 Paris, France
| | - Chiara Eandi
- University of Torino, Department of Surgical Science, Torino, Italy
| | - Mustapha Benchaboune
- CHNO des Quinze-Vingts, DHU Sight Restore, INSERM-DGOS CIC 1423, 28 rue de Charenton, F-75012 Paris, France
| | - Adèle Drame-Maigné
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012 Paris, France
| | - Wassila Carpentier
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012 Paris, France
| | - Solenne Chardonnet
- Sorbonne Université, INSERM, UMS 37 PASS, Plateforme Post-génomique de la Pitié-Salpêtrière, P3S, F-75013 Paris, France
| | - Sara Touhami
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012 Paris, France
| | - Guillaume Blot
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012 Paris, France
| | - Jean Baptiste Conart
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012 Paris, France
| | - Hugo Charles-Messance
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012 Paris, France
| | - Anaïs Potey
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012 Paris, France
| | - Jean-François Girmens
- CHNO des Quinze-Vingts, DHU Sight Restore, INSERM-DGOS CIC 1423, 28 rue de Charenton, F-75012 Paris, France
| | - Michel Paques
- CHNO des Quinze-Vingts, DHU Sight Restore, INSERM-DGOS CIC 1423, 28 rue de Charenton, F-75012 Paris, France
| | - Fréderic Blond
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012 Paris, France
| | - Thierry Leveillard
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012 Paris, France
| | - Elod Koertvely
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, 124 Grenzacherstrasse, 4070, Basel, Switzerland
| | - Jerome E Roger
- Paris-Saclay Institute of Neuroscience, CERTO-Retina France, CNRS, Univ Paris Sud, Université Paris-Saclay, F-91405 Orsay
| | - José-Alain Sahel
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012 Paris, France; CHNO des Quinze-Vingts, DHU Sight Restore, INSERM-DGOS CIC 1423, 28 rue de Charenton, F-75012 Paris, France
| | - Przemyslaw Sapieha
- Department of Ophthalmology, Maisonneuve-Rosemont Hospital Research Centre, University of Montreal, Quebec, Canada
| | - Cécile Delarasse
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012 Paris, France
| | - Xavier Guillonneau
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012 Paris, France
| | - Florian Sennlaub
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012 Paris, France.
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Stanescu-Segall D, Sales de Gauzy T, Reynolds R, Faes L, Pohlmann D, Pakzad-Vaezi K, Ting D, Saadoun D, Ambati J, Loewenstein A, Bodaghi B, de Smet MD, Touhami S. Expert opinion on the management and follow-up of uveitis patients during SARS-CoV-2 outbreak. Expert Rev Clin Immunol 2020; 16:651-657. [PMID: 32615046 DOI: 10.1080/1744666x.2020.1791086] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Routine medical and ophthalmic care is being drastically curtailed in the context of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. Uveitis patients require particular attention because of their theoretical risk of viral infection, in the context of therapeutic immunosuppression. AREAS COVERED This collaborative work proposes practical management and follow-up criteria for uveitis patients in the context of the ongoing SARS-CoV-2 pandemic. EXPERT OPINION Management should proceed as usual when access to health care possible in patients who do not belong to a group at high risk of severe SARS-CoV-2 infection, and in uncontrolled uveitis cases. In case of reduced access to eye clinics or high risk of SARS-CoV-2 infection, patients' management should be stratified based on their clinical presentation. In non-severe uveitis cases, the use of systemic steroids should be avoided, and local steroids preferred whenever possible. In uncontrolled situations where there is real risk of permanent visual loss, high-dose intravenous steroids and/or systemic immunosuppressants and/or biotherapies can be administered depending on the severity of eye disease. Immunosuppressive therapy should not be withheld, unless the patient develops SARS-CoV2 infection.
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Affiliation(s)
- Dinu Stanescu-Segall
- Department of Ophthalmology, IHU FOReSIGHT, Sorbonne University-APHP , Paris, France
| | - Thomas Sales de Gauzy
- Department of Ophthalmology, IHU FOReSIGHT, Sorbonne University-APHP , Paris, France
| | - Rhianon Reynolds
- Department of Ophthalmology, Aneurin Bevan University Health Board , Newport, UK
| | - Livia Faes
- Department of Ophthalmology, Cantonal Hospital Lucerne , Lucerne, Switzerland
| | - Dominika Pohlmann
- Department of Ophthalmology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität Zu Berlin, and Berlin Institute of Health , Berlin, Germany
| | - Kaivon Pakzad-Vaezi
- Department of Ophthalmology and Visual Sciences, University of British Columbia , Vancouver, Canada
| | - Daniel Ting
- Singapore National Eye Center , Singapore, Singapore
| | - David Saadoun
- Department of Internal Medicine, Pitié Salpétrière University Hospital, Sorbonne University-APHP , Paris, France
| | - Jayakrishna Ambati
- Center for Advanced Vision Science, Department of Ophthalmology, Department of Pathology, Department of Microbiology, Immunology, and Cancer Biology, University of Virginia School of Medicine , Charlottesville, VA, USA
| | - Anat Loewenstein
- Division of Ophthalmology, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University , Tel Aviv, Israel
| | - Bahram Bodaghi
- Department of Ophthalmology, IHU FOReSIGHT, Sorbonne University-APHP , Paris, France
| | - Marc D de Smet
- Department of Ophthalmology, University of Leiden, the Netherlands; MIOS - Retina and Ocular Inflammation Center , Lausanne, Switzerland
| | - Sara Touhami
- Department of Ophthalmology, IHU FOReSIGHT, Sorbonne University-APHP , Paris, France
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Touhami S, Philippakis E, Mrejen S, Couturier A, Casteran C, Levent P, Tadayoni R, Gaudric A. Topographic Variations of Choroidal Thickness in Healthy Eyes on Swept-Source Optical Coherence Tomography. Invest Ophthalmol Vis Sci 2020; 61:38. [PMID: 32196096 PMCID: PMC7401446 DOI: 10.1167/iovs.61.3.38] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [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] [Indexed: 12/26/2022] Open
Abstract
Purpose To assess topographic variations of choroidal thickness (CT) in the fovea and beyond in healthy eyes. Methods This cross-sectional study included healthy subjects ≤ 55 years of age with axial lengths (22-26 mm) and refractive error margins (-4D, +4D) in normal ranges. Images were acquired using swept-source optical coherence tomography angiography (OCT-A). Corneal thickness (CT) maps from 12 × 12-mm radial scans and 9 × 9-mm OCT-A B-scans were analyzed. Results The study included 64 eyes of 33 subjects (mean age, 37 years). Mean CT was >300 µm in all locations except the nasal outer macula. The subfoveal CT was >395 µm in 30% of cases; in 38.7% of cases, >50% of the CT map was thicker than 395 µm. The mean thickest choroidal point was 395.2 µm (range, 164-548 µm), located superior and temporal to the macula in 72.2% of cases and subfoveally in 1.8% of cases. The CT pattern was symmetrical (58%) or asymmetrical (42%) along a horizontal axis correlating with choroidal vein distribution. Half of the asymmetrical patterns were thicker in the inferior quadrants, with an oblique temporal watershed of venous drainage, and the other half were thicker superiorly. The mean vascularity index was ∼75% regardless of the mean CT. Conclusions One-third of healthy eyes of patients younger than age 55 had a thick choroid (>395 µm). In these normal eyes, the thickest choroidal point was not subfoveal, CT symmetry above and below the fovea depended on choroidal vein distribution, and choroidal vascularity index was independent from CT. No patients demonstrated fundus autofluorescence abnormalities, and the choriocapillaris remained visible even in thick choroids. These features could be interesting when differentiating normal versus pathological states.
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Arndt C, Audrun F, Bodaghi B, Caujolle JP, Cassoux N, Defoort S, Delyfer MN, Denis P, Doan S, Fenolland JR, Giraud JM, Kodjikian L, Labetoulle M, Lasudry J, Leveziel N, Rousseau A, Saadoun D, Speeg-Schatz C, Touhami S, Touitou V, Vignal C, Zech C. [Categorization of the degree of urgency according to ophthalmology procedures or situations]. J Fr Ophtalmol 2020; 43:525-528. [PMID: 32409227 DOI: 10.1016/j.jfo.2020.04.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 04/27/2020] [Indexed: 11/19/2022]
Affiliation(s)
- C Arndt
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - F Audrun
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - B Bodaghi
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - J-P Caujolle
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - N Cassoux
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - S Defoort
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - M-N Delyfer
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - P Denis
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - S Doan
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - J-R Fenolland
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - J-M Giraud
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - L Kodjikian
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France.
| | - M Labetoulle
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - J Lasudry
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - N Leveziel
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - A Rousseau
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - D Saadoun
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - C Speeg-Schatz
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - S Touhami
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - V Touitou
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - C Vignal
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
| | - C Zech
- Société française d'ophtalmologie, 17, VLA d'Alésia, 75014 Paris, France
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Anquetil C, Salem JE, Lebrun-Vignes B, Touhami S, Desbois AC, Maalouf G, Domont F, Allenbach Y, Cacoub P, Bodaghi B, Saadoun D. Evolving spectrum of drug-induced uveitis at the era of immune checkpoint inhibitors results from the WHO's pharmacovigilance database. J Autoimmun 2020; 111:102454. [PMID: 32303423 DOI: 10.1016/j.jaut.2020.102454] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 01/23/2020] [Revised: 03/31/2020] [Accepted: 03/31/2020] [Indexed: 01/06/2023]
Abstract
PURPOSE Drug-induced uveitis is a rare but sight-threatening condition. We seek to determine the spectrum of drug-induced uveitis at the era of immune checkpoint inhibitors (ICI). METHODS Retrospective pharmacovigilance study based on adverse drug reactions reported within VigiBase, the WHO international pharmacovigilance database. We included deduplicated individual case safety reports (ICSRs) reported as 'uveitis' at Preferred Term level according to the Medical Dictionary for Drug Regulatory Activities between 1967 and 04/28/2019. We performed a case/non-case analysis to study if suspected drug-induced uveitis were differentially reported for each suspected treatment compared to the full database. We excluded drugs with potential indication bias. RESULTS 1404 ICSRs corresponding to 37 drugs had a significant over-reporting signal with a median age of 57 [42-68] years and 45.7% of males. We identified five major groups of treatments: bisphosphonates (26.9%), non-antiviral anti-infectious drugs (25.4%), protein kinase inhibitors (15.5%), ICI (15.0%), and antiviral drugs (11.1%). Severe visual loss was reported in 12.1% of cases. ICI and protein kinase inhibitors were the most recently emerging signals. The time to onset between first infusion and uveitis was significantly different between groups ranging from 5 days [2-19] in the bisphosphonate group to 138.5 [47.25-263.75] in protein kinase inhibitors group (p < 0.0001). Anti-Programmed Cell death 1 represented more than 70% of ICI-induced uveitis. We identified Vogt-Koyanagi-Harada (VKH)-like syndrome as being associated with ICI use. CONCLUSIONS The spectrum of drug-induced uveitis has changed with the evolution of pharmacopeia and the recent emergence of ICIs. VKH-like syndrome has been reported with ICI and protein kinase inhibitors therapy.
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Affiliation(s)
- Céline Anquetil
- Department of Internal Medicine and Clinical Immunlogy, Sorbonne Université, Pitié-Salpêtrière University Hospital, Paris, France; Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Association Institut de Myologie, Centre de Recherche en Myologie, UMRS974, Paris, France
| | - Joe-Elie Salem
- Regional Pharmacovigilance Centre, Department of Pharmacology, Sorbonne Université, INSERM CIC Paris-Est, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France
| | - Bénédicte Lebrun-Vignes
- Regional Pharmacovigilance Centre, Department of Pharmacology, Sorbonne Université, INSERM CIC Paris-Est, Assistance Publique Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Paris, France
| | - Sara Touhami
- Department of Ophtalmology, Sorbonne Université, Pitié-Salpêtrière University Hospital, Paris, France
| | - Anne-Claire Desbois
- Department of Internal Medicine and Clinical Immunlogy, Sorbonne Université, Pitié-Salpêtrière University Hospital, Paris, France
| | - Georgina Maalouf
- Department of Internal Medicine and Clinical Immunlogy, Sorbonne Université, Pitié-Salpêtrière University Hospital, Paris, France; AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Centre national de référence maladies auto-immunes systémiques rares, Centre national de référence maladies auto-inflammatoires et amylose, INSERM UMR_S 959, Immunologie-Immunopathologie-Immunothérapie, i3, France
| | - Fanny Domont
- Department of Internal Medicine and Clinical Immunlogy, Sorbonne Université, Pitié-Salpêtrière University Hospital, Paris, France
| | - Yves Allenbach
- Department of Internal Medicine and Clinical Immunlogy, Sorbonne Université, Pitié-Salpêtrière University Hospital, Paris, France; Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Association Institut de Myologie, Centre de Recherche en Myologie, UMRS974, Paris, France
| | - Patrice Cacoub
- Department of Internal Medicine and Clinical Immunlogy, Sorbonne Université, Pitié-Salpêtrière University Hospital, Paris, France; AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Centre national de référence maladies auto-immunes systémiques rares, Centre national de référence maladies auto-inflammatoires et amylose, INSERM UMR_S 959, Immunologie-Immunopathologie-Immunothérapie, i3, France
| | - Bahram Bodaghi
- Department of Ophtalmology, Sorbonne Université, Pitié-Salpêtrière University Hospital, Paris, France
| | - David Saadoun
- Department of Internal Medicine and Clinical Immunlogy, Sorbonne Université, Pitié-Salpêtrière University Hospital, Paris, France; AP-HP, Groupe Hospitalier Pitié-Salpêtrière, Centre national de référence maladies auto-immunes systémiques rares, Centre national de référence maladies auto-inflammatoires et amylose, INSERM UMR_S 959, Immunologie-Immunopathologie-Immunothérapie, i3, France.
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Lavalette S, Conart JB, Touhami S, Roubeix C, Houssier M, Augustin S, Raoul W, Combadière C, Febbraio M, Ong H, Chemtob S, Sahel JA, Delarasse C, Guillonneau X, Sennlaub F. CD36 Deficiency Inhibits Retinal Inflammation and Retinal Degeneration in Cx3cr1 Knockout Mice. Front Immunol 2020; 10:3032. [PMID: 31969887 PMCID: PMC6960398 DOI: 10.3389/fimmu.2019.03032] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 10/24/2019] [Accepted: 12/10/2019] [Indexed: 12/22/2022] Open
Abstract
Background: CD36, a member of the class B scavenger receptor family, participates in Toll-like receptor signaling on mononuclear phagocytes (MP) and can promote sterile pathogenic inflammation. We here analyzed the effect of CD36 deficiency on retinal inflammation and photoreceptor degeneration, the hallmarks of age-related macular degeneration (AMD), that characterize Cx3cr1−/−mice. Methods: We analyzed subretinal MP accumulation, and cone- and rod-degeneration in light-challenged and aged, CD36 competent or deficient, hyper-inflammatory Cx3cr1−/− mice, using histology and immune-stained retinal flatmounts. Monocytes (Mo) were subretinally adoptively transferred to evaluate their elimination rate from the subretinal space and Interleukin 6 (IL-6) secretion from cultured Mo-derived cells (MdCs) of the different mouse strains were analyzed. Results: CD36 deficient Cx3cr1−/− mice were protected against age- and light-induced subretinal inflammation and associated cone and rod degeneration. CD36 deficiency in Cx3cr1−/− MPs inhibited their prolonged survival in the immune-suppressive subretinal space and reduced the exaggerated IL-6 secretion observed in Cx3cr1−/− MPs that we previously showed leads to increased subretinal MP survival. Conclusion:Cd36 deficiency significantly protected hyperinflammatory Cx3cr1−/− mice against subretinal MP accumulation and associated photoreceptor degeneration. The observed CD36-dependent induction of pro-inflammatory IL-6 might be at least partially responsible for the prolonged MP survival in the immune-suppressive environment and its pathological consequences on photoreceptor homeostasis.
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Affiliation(s)
- Sophie Lavalette
- Institut de la Vision, Sorbonne Université, INSERM, CNRS, Paris, France
| | | | - Sara Touhami
- Institut de la Vision, Sorbonne Université, INSERM, CNRS, Paris, France
| | | | - Marianne Houssier
- Institut de la Vision, Sorbonne Université, INSERM, CNRS, Paris, France
| | | | - William Raoul
- Institut de la Vision, Sorbonne Université, INSERM, CNRS, Paris, France.,Université de Tours, Inserm, N2C UMR 1069, Faculté de Médecine, Tours, France
| | - Christophe Combadière
- Sorbonne Université, Inserm, CNRS, Centre d'Immunologie et des Maladies Infectieuses, Cimi-Paris, Paris, France
| | - Maria Febbraio
- Department of Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Huy Ong
- Faculty of Pharmacy, Université de Montréal, Montreal, QC, Canada
| | - Sylvain Chemtob
- Departments of Pediatrics, Ophthalmology and Pharmacology, Université de Montréal, Montreal, QC, Canada
| | - José-Alain Sahel
- Institut de la Vision, Sorbonne Université, INSERM, CNRS, Paris, France
| | - Cécile Delarasse
- Institut de la Vision, Sorbonne Université, INSERM, CNRS, Paris, France
| | | | - Florian Sennlaub
- Institut de la Vision, Sorbonne Université, INSERM, CNRS, Paris, France
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38
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Charles-Messance H, Blot G, Couturier A, Vignaud L, Touhami S, Beguier F, Siqueiros L, Forster V, Barmo N, Augustin S, Picaud S, Sahel JA, Rendon A, Grosche A, Tadayoni R, Sennlaub F, Guillonneau X. IL-1β induces rod degeneration through the disruption of retinal glutamate homeostasis. J Neuroinflammation 2020; 17:1. [PMID: 31900165 PMCID: PMC6942287 DOI: 10.1186/s12974-019-1655-5] [Citation(s) in RCA: 89] [Impact Index Per Article: 22.3] [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: 08/14/2019] [Accepted: 11/21/2019] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Age-related macular degeneration is characterized by the accumulation of subretinal macrophages and the degeneration of cones, but mainly of rods. We have previously shown that Mononuclear Phagocytes-derived IL-1β induces rod photoreceptor cell death during experimental subretinal inflammation and in retinal explants exposed to IL-1β but the mechanism is unknown. METHODS Retinal explants were culture in the presence of human monocytes or IL-1β and photoreceptor cell survival was analyzed by TUNEL labeling. Glutamate concentration and transcription levels of gene involved in the homeostasis of glutamate were analyzed in cell fractions of explant cultured or not in the presence of IL-1β. Glutamate receptor antagonists were evaluated for their ability to reduce photoreceptor cell death in the presence of IL1-β or monocytes. RESULTS We here show that IL-1β does not induce death in isolated photoreceptors, suggesting an indirect effect. We demonstrate that IL-1β leads to glutamate-induced rod photoreceptor cell death as it increases the extracellular glutamate concentrations in the retina through the inhibition of its conversion to glutamine in Müller cells, increased release from Müller cells, and diminished reuptake. The inhibition of non-NMDA receptors completely and efficiently prevented rod apoptosis in retinal explants cultured in the presence of IL-1β or, more importantly, in vivo, in a model of subretinal inflammation. CONCLUSIONS Our study emphasizes the importance of inflammation in the deregulation of glutamate homeostasis and provides a comprehensive mechanism of action for IL-1β-induced rod degeneration.
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Affiliation(s)
- Hugo Charles-Messance
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012, Paris, France
| | - Guillaume Blot
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012, Paris, France
| | - Aude Couturier
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012, Paris, France.,Department of Ophthalmology, Hôpital Lariboisière, Paris, France
| | - Lucile Vignaud
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012, Paris, France
| | - Sara Touhami
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012, Paris, France.,Department of Ophthalmology, Hôpital Lariboisière, Paris, France
| | - Fanny Beguier
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012, Paris, France
| | - Lourdes Siqueiros
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012, Paris, France
| | - Valérie Forster
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012, Paris, France
| | - Nour Barmo
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012, Paris, France
| | - Sébastien Augustin
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012, Paris, France
| | - Serge Picaud
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012, Paris, France
| | - José-Alain Sahel
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012, Paris, France.,CHNO des Quinze-Vingts, DHU Sight Restore, INSERM-DGOS CIC 1423, 28 rue de Charenton, F-75012, Paris, France.,Department of Ophthalmology, The University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA
| | - Alvaro Rendon
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012, Paris, France
| | - Antje Grosche
- Department of Physiological Genomics, Ludwig-Maximilians-Universität München, Grosshaderner Str. 9, D-82152, Planegg-Martinsried, Germany
| | - Ramin Tadayoni
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012, Paris, France.,Department of Ophthalmology, Hôpital Lariboisière, Paris, France
| | - Florian Sennlaub
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012, Paris, France
| | - Xavier Guillonneau
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, F-75012, Paris, France.
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Touhami S, Vanier A, Rosati A, Bojanova M, Benromdhane B, Lehoang P, Rozenberg F, Bodaghi B. Predictive Factors of Intraocular Pressure Level Evolution Over Time and Glaucoma Severity in Fuchs' Heterochromic Iridocyclitis. Invest Ophthalmol Vis Sci 2019; 60:2399-2405. [PMID: 31157832 DOI: 10.1167/iovs.18-24597] [Citation(s) in RCA: 4] [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] [Indexed: 11/24/2022] Open
Abstract
Purpose To investigate the clinical and virologic-associated and predictive factors of intraocular pressure (IOP) evolution over time and its severity in Fuchs' heterochromic iridocyclitis (FHC). Methods Consecutive patients with both clinical FHC and intraocular synthesis of rubella virus (RV)-specific antibodies were included in this study. Specific ocular production of RV antibodies was confirmed using the quotient of serum/aqueous humor ratio of RV IgGs (Crv) and control antiviral IgGs (Cctl), using quantitative serology methods. Epidemiologic, clinical, biological, and virologic data at referral were collected and correlated with IOP values over time, occurrence, and severity of glaucoma. Results Sixty-eight eyes of 68 patients were included. Mean age at diagnosis was 40.7 ± 11.1 years. Mean follow-up was 4.3 ± 4.3 years. Mean baseline Crv and Cctl values were 12.34 ± 14.67 and 216.70 ± 98.4, respectively. Mean baseline IOP was 17.2 ± 7.2 mm Hg (range, 9-40) and 15.6 ± 5.6 (range, 3-30) 5 years after referral. The predictive factors for pejorative IOP evolution over time and glaucoma severity were male sex (P = 0.03) and decreased Crv (P = 0.04) and presence of iris nodules (P < 0.001) and decreased Cctl (P = 0.02), respectively. Diagnostic delay was associated with increased likelihood of undergoing glaucoma surgery (P = 0.02). Conclusions Time to diagnosis, male sex, presence of iris nodules at baseline, and decreased Crv and Cctl ratios were associated with increased likelihood of pejorative IOP evolution over time. Given the aggressiveness of glaucoma in FHC, these results provide interesting insight into what category of patients should need the closest screening.
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Affiliation(s)
- Sara Touhami
- Ophthalmology Department, Reference Center in Rare Diseases, Département Hospitalo Universitaire Sight Restore, Hôpital Pitié Salpêtrière, University Paris VI, Paris, France
| | - Antoine Vanier
- Inserm, University Bretagne Loire, University of Nantes, University of Tours, Unité Mixte de Recherche, U1246 Sciences Philosophie Histoire, Nantes, France
| | - Alessandra Rosati
- Ophthalmology Unit, Dipartimento di Neuroscienze Salute Mentale e Organi di Senso, S. Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Magdalena Bojanova
- Virology Department, Hôpital Cochin, Paris Descartes University, Paris, France
| | - Bouchra Benromdhane
- Ophthalmology Department, Reference Center in Rare Diseases, Département Hospitalo Universitaire Sight Restore, Hôpital Pitié Salpêtrière, University Paris VI, Paris, France
| | - Phuc Lehoang
- Ophthalmology Department, Reference Center in Rare Diseases, Département Hospitalo Universitaire Sight Restore, Hôpital Pitié Salpêtrière, University Paris VI, Paris, France
| | - Flore Rozenberg
- Virology Department, Hôpital Cochin, Paris Descartes University, Paris, France
| | - Bahram Bodaghi
- Ophthalmology Department, Reference Center in Rare Diseases, Département Hospitalo Universitaire Sight Restore, Hôpital Pitié Salpêtrière, University Paris VI, Paris, France
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Leleu I, Jhanji V, Touhami S, Westcott M, Angi M, Titah C, Rousseau A, Hamard P, Brasnu E, Manicom T, Blumen-Ohana E, Rozenberg F, Vauloup-Fellous C, Deback C, Labetoulle M, Sahel JA, Bodaghi B, Merabet L, Kobal A, Brignole-Baudouin F, Errera MH. Clinical Features and Diagnosis of Anterior Segment Inflammation Related to Cytomegalovirus in Immunocompetent African, Asian, and Caucasian Patients. Ocul Immunol Inflamm 2019; 29:160-168. [PMID: 31642720 DOI: 10.1080/09273948.2019.1662059] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 12/11/2022]
Abstract
Objective: To report the clinical features and treatment outcomes in immunocompetent patients with anterior segment inflammation (ASI) related to human cytomegalovirus (HCMV) depending on their ethnic origin.Material and Methods: Multicenter retrospective study of 38 patients with at least one test, either HCMV-positive PCR or GWc.Results: Features of Posner-Schlossman syndrome were observed in 50% of the eyes, Fuchs heterochromic iridocyclitis in 13% of the eyes, chronic nonspecific anterior uveitis in 21% of the eyes, and corneal endotheliitis in 18% of the eyes. PCR and GWc were positive for HCMV in 50% and 96.2% of the eyes, respectively. Glaucoma was diagnosed in 50% of eyes. Treatment was oral valganciclovir in about half of the patients. Other treatments were intravenous ganciclovir and/or ganciclovir topical ointment and/or intravitreal ganciclovir.Conclusions: No obvious association of specific clinical features with individual ethnicity could be identified. We found a high rate of glaucoma in all ethnic groups. There was a delay in diagnosis and specific treatment of HCMV in most patients.
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Affiliation(s)
- Igor Leleu
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Ophthalmology Department and Laboratory and DHU Sight Restore, Paris, France
| | | | - Sara Touhami
- Department of Ophthalmology, Hôpital de la Pitié-Salpêtrière, Paris, France.,Department of Ophthalmology, Hôpital de Lariboisière, 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
| | - Martina Angi
- Department of Ophthalmology, Hôpital de la Pitié-Salpêtrière, Paris, France
| | - Cherif Titah
- Department of Ophthalmology, Fondation Ophthalmologique de Rothschild, Paris, France
| | - Antoine Rousseau
- Department of Ophthalmology, Hôpital Bicêtre, Université Paris Sud, APHP, Paris, France
| | - Pascale Hamard
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Ophthalmology Department and Laboratory and DHU Sight Restore, Paris, France
| | - Emmanuelle Brasnu
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Ophthalmology Department and Laboratory and DHU Sight Restore, Paris, France
| | - Thomas Manicom
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Ophthalmology Department and Laboratory and DHU Sight Restore, Paris, France
| | - Esther Blumen-Ohana
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Ophthalmology Department and Laboratory and DHU Sight Restore, Paris, France
| | - Flore Rozenberg
- Université Paris Descartes, Paris, France.,Virology Department, Hôpital Cochin, Université Paris V, Paris, France
| | | | - Claire Deback
- Virology Department, Université Paris Sud, APHP, Villejuif, France
| | - Marc Labetoulle
- Department of Ophthalmology, Hôpital Bicêtre, Université Paris Sud, APHP, Paris, France
| | - Jose-Alain Sahel
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Ophthalmology Department and Laboratory and DHU Sight Restore, Paris, France.,Sorbonne Universités, UPMC Univ Paris VI, Paris, France
| | - Bahram Bodaghi
- Department of Ophthalmology, Hôpital de la Pitié-Salpêtrière, Paris, France.,Sorbonne Universités, UPMC Univ Paris VI, Paris, France
| | - Lilia Merabet
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Ophthalmology Department and Laboratory and DHU Sight Restore, Paris, France
| | - Alfred Kobal
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Ophthalmology Department and Laboratory and DHU Sight Restore, Paris, France
| | - Françoise Brignole-Baudouin
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Ophthalmology Department and Laboratory and DHU Sight Restore, Paris, France.,Virology Department, Hôpital Cochin, Université Paris V, Paris, France
| | - Marie-Hélène Errera
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Ophthalmology Department and Laboratory and DHU Sight Restore, Paris, France.,Pittsburgh University Hospital, Pittsburgh, PA, USA.,Sorbonne Universités, UPMC Univ Paris VI, Paris, France
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Touhami S, Audo I, Terrada C, Gaudric A, LeHoang P, Touitou V, Bodaghi B. Neoplasia and intraocular inflammation: From masquerade syndromes to immunotherapy-induced uveitis. Prog Retin Eye Res 2019; 72:100761. [DOI: 10.1016/j.preteyeres.2019.05.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2018] [Revised: 04/16/2019] [Accepted: 05/01/2019] [Indexed: 12/18/2022]
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Barugel R, Touhami S, Samama S, Landre C, Busquet G, Vera L, Bui Quoc E. Evaluation of the Spot Vision Screener for children with limited access to ocular health care. J AAPOS 2019; 23:153.e1-153.e5. [PMID: 31028870 DOI: 10.1016/j.jaapos.2018.09.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2017] [Revised: 06/30/2018] [Accepted: 09/17/2018] [Indexed: 10/27/2022]
Abstract
PURPOSE To compare the sensitivity, specificity, and referral rate of the Spot Vision Screener (Welch Allyn Inc, Skaneateles Falls, NY) with the gold standard cycloplegic measurements acquired using the Retinomax in a population of underprivileged children and teenagers with limited access to medical care. METHODS Children were recruited for the study by social workers in the vicinity of Robert Debre Hospital, Paris, France. Refractive errors (hyperopia of ≥ +2.00 D spherical equivalent [SE]; myopia of ≤ -0.50 D SE; astigmatism of ≥1.00 D between the two main meridians; anisometropia of ≥1.00 D SE difference between eyes) were assessed using the Spot Vision Screener and the Retinomax. Sensitivity (true positive rate), specificity (true negative rate), and referral rate of this Spot Vision screening program were evaluated. RESULTS A total of 82 eyes of 41 subjects (19 males) were included; mean age was 126 months of age (range, 48-246). The sensitivity of the Spot Vision Screener for the detection of refractive errors was 82.35%; specificity was 91.67%. The sensitivity of the Spot Vision Screener to detect hyperopia, myopia, astigmatism, and anisometropia was 27.27%, 84.61%, 78.57%, and 66.67%, respectively. Its specificity to detect hyperopia, myopia, astigmatism, and anisometropia was 100%, 98.55%, 89.71% and 94.29%, respectively. CONCLUSIONS The specificity of the Spot Vision Screener to detect refractive errors was found to be relatively high (>90%). However, its low sensitivity for hyperopia seems to remain a major limitation of the device, because hyperopia is particularly important to detect in children given its high prevalence and possible adverse consequences. Global programs using cycloplegic measurements should be considered an alternative.
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Affiliation(s)
- Raphaël Barugel
- Ophthalmology Department, Robert Debré University Hospital (Assistance Publique Hôpitaux de Paris), Paris, France.
| | - Sara Touhami
- Ophthalmology Department, Robert Debré University Hospital (Assistance Publique Hôpitaux de Paris), Paris, France
| | - Sacha Samama
- Ophthalmology Department, Robert Debré University Hospital (Assistance Publique Hôpitaux de Paris), Paris, France
| | - Céline Landre
- Ophthalmology Department, Robert Debré University Hospital (Assistance Publique Hôpitaux de Paris), Paris, France
| | - Gauthier Busquet
- Ophthalmology Department, Robert Debré University Hospital (Assistance Publique Hôpitaux de Paris), Paris, France
| | - Liza Vera
- Ophthalmology Department, Robert Debré University Hospital (Assistance Publique Hôpitaux de Paris), Paris, France
| | - Emmanuel Bui Quoc
- Ophthalmology Department, Robert Debré University Hospital (Assistance Publique Hôpitaux de Paris), Paris, France
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Touhami S, Diwo E, Sève P, Trad S, Bielefeld P, Sène D, Abad S, Brézin A, Quartier P, Koné Paut I, Weber M, Chiquet C, Errera MH, Sellam J, Cacoub P, Kaplanski G, Kodjikian L, Bodaghi B, Saadoun D. Expert opinion on the use of biological therapy in non-infectious uveitis. Expert Opin Biol Ther 2019; 19:477-490. [PMID: 30888881 DOI: 10.1080/14712598.2019.1595578] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [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: 12/14/2022]
Abstract
INTRODUCTION Conventional immunosuppressive drugs, anti-TNF alpha treatments and biotherapies are increasingly being used in non-infectious uveitis. AREAS COVERED The present work was led by a multidisciplinary panel of experts, including internal medicine specialists, rheumatologists and ophthalmologists, and proposes an extensive review on the use of biological agents in non-infectious uveitis. EXPERT OPINION In case of dependency to steroids or sight-threatening disease, conventional immunosuppressive drugs (methotrexate, azathioprine and mycophenolate mofetil) and/or biological therapies such as anti-TNF alpha treatments (adalimumab, infliximab) can be used to achieve and maintain disease quiescence. Interferon is an efficient immunomodulatory drug that can be proposed as second-line therapy in specific indications (eg. refractory macular edema, sight-threatening Behçet's uveitis). Other biologics, especially tocilizumab, are showing promising results. Local treatments (steroids, sirolimus etc.) can be used as adjuvant therapies in case of unilateral relapse. Therapeutic response must always be evaluated by clinical examination and appropriate ancillary investigations.
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Affiliation(s)
- Sara Touhami
- a Ophthalmology Department , DHU ViewRestore, Pitié Salpêtrière Hospital , Paris , France
| | - Eléonore Diwo
- a Ophthalmology Department , DHU ViewRestore, Pitié Salpêtrière Hospital , Paris , France
| | - Pascal Sève
- b Internal Medicine Department , Hôpital de la Croix-Rousse, Hospices Civils de Lyon , Lyon Cedex 04 , France.,c Faculté de Médecine Lyon-Sud , Université Claude Bernard-Lyon 1 , Lyon , France
| | - Salim Trad
- d Internal Medicine Department , Hôpital Ambroise Paré , Boulogne-Billancourt , France
| | - Philip Bielefeld
- e Internal Medicine and systemic diseases department (Médecine Interne 2) , Dijon University hospital , Dijon , France
| | - Damien Sène
- f Internal Medicine Department , Lariboisière Hospital , Paris , France.,g INSERM UMR , Paris Diderot University , Paris , France
| | - Sebastien Abad
- h Internal Medicine Department , Hopital Avicenne , Bobigny , France.,i Sorbonne Paris Cité, Faculté de Médecine SMBH , Université Paris 13 , Bobigny , France.,j Faculté de médecine , Université Paris 13, Sorbonne Paris Cité , Bobigny , France
| | - Antoine Brézin
- k Ophthalmology Department, Hôpital Cochin , Paris Descartes University , Paris , France
| | - Pierre Quartier
- l Unité d'Immunologie-Hématologie et Rhumatologie Pédiatriques, Hôpital Necker-Enfants Malades , Paris-Descartes University, Institut IMAGINE, Centre de référence des maladies rhumatologiques inflammatoires et auto-immunes systémiques rares de l'enfant (RAISE) , Paris , France
| | - Isabelle Koné Paut
- m Paediatric Rheumatology Department , centre de référence des maladies autoinflammatoires et de l'amylose inflammatoire, CEREMAIA, Bicêtre Hospital , Le Kremlin-Bicêtre , France
| | - Michel Weber
- n Ophthalmology Department , Nantes University Hospital , Nantes , France
| | - Christophe Chiquet
- o Ophthalmology Department , Grenoble Alpes University Hospital , La Tronche , France
| | - Marie-Hélène Errera
- p Ophthalmology Department , Quinze-Vingts National Eye Hospital , Paris , France
| | - Jérémie Sellam
- q Rheumatology Department, Saint-Antoine Hospital, AP-HP, CRSA Inserm UMRS_938, DHU i2B , Sorbonne Université , Paris , France
| | - Patrice Cacoub
- r Inflammation-Immunopathology-Biotherapy Department (DHU i2B) , Sorbonne Universités, UPMC Univ Paris 06, UMR 7211 , Paris , France.,s Inflammation-Immunopathology-BiotherapyDepartment , INSERM, UMR_S 959 , Paris , France.,t Inflammation-Immunopathology-BiotherapyDepartment , CNRS, FRE3632 , Paris , France.,u Department of Internal Medicine and Clinical Immunology, Centre national de référence des maladies autoimmunes systémiques rares, Centre national de référence des maladies autoinflammatoires et de l'amylose , AP-HP, Groupe Hospitalier Pitié-Salpêtrière , Paris , France
| | - Gilles Kaplanski
- v Internal Medicine and Clinical immunology Department, Hôpital de la Conception , Aix-Marseille Université , Marseille , France
| | - Laurent Kodjikian
- w Department of Ophthalmology , Croix-Rousse University Hospital, Hospices Civils de Lyon, University of Lyon I , Lyon , France.,x CNRS UMR 5510 Mateis , France
| | - Bahram Bodaghi
- a Ophthalmology Department , DHU ViewRestore, Pitié Salpêtrière Hospital , Paris , France
| | - David Saadoun
- r Inflammation-Immunopathology-Biotherapy Department (DHU i2B) , Sorbonne Universités, UPMC Univ Paris 06, UMR 7211 , Paris , France
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Touhami S, Qu L, Angi M, Bojanova M, Touitou V, Lehoang P, Rozenberg F, Bodaghi B. Cytomegalovirus Anterior Uveitis: Clinical Characteristics and Long-term Outcomes in a French Series. Am J Ophthalmol 2018; 194:134-142. [PMID: 30055154 DOI: 10.1016/j.ajo.2018.07.021] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 07/17/2018] [Accepted: 07/18/2018] [Indexed: 10/28/2022]
Abstract
PURPOSE To report the characteristics of cytomegalovirus anterior uveitis (CMV AU) and the comparative response to 2 types of antiviral induction treatments. DESIGN Retrospective, consecutive case series. METHODS Consecutive immunocompetent patients with polymerase chain reaction-positive CMV AU were included. For each patient, best-corrected visual acuity (BCVA), intraocular pressure (IOP), clinical characteristics at baseline and latest visit, and number of relapses were recorded. All patients received an induction dose of intravenous (IV) ganciclovir or oral valganciclovir and a maintenance dose of oral valganciclovir. RESULTS Thirty-six eyes of 35 patients were included. Mean age at diagnosis was 55.5 years. Mean follow-up was 4.13 years. Posner-Schlossman and chronic nonspecific AU were observed in 69.4% and 30.6% of cases, respectively. We did not observe any case of Fuchs uveitis or endotheliitis. At baseline, mean BCVA was 20/25 and mean IOP was 29.19 mm Hg. Keratic precipitates and iris atrophy were seen in 91.4% and 25.7% of cases. Induction therapy consisted of oral valganciclovir and IV ganciclovir in 40% and 60% of cases. A total of 94.2% of patients responded to the first line of therapy. Recurrence was reported in 73.5% of cases. Glaucoma surgery was necessary in 25.7% of cases. Early initiation of antiviral therapy (≤700 days) seemed to decrease the recourse to glaucoma surgery. Both IV and oral induction treatments seemed similar in terms of BCVA changes and occurrence of relapses. CONCLUSIONS Characteristics of CMV AU seem to show specificities in this French cohort. Early initiation of antiviral therapy seems to reduce the severity of glaucoma.
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Rousseau A, Terrada C, Touhami S, Barreau E, Rothschild PR, Valleix S, Benoudiba F, Errera MH, Cauquil C, Guiochon-Mantel A, Adams D, Labetoulle M. Angiographic Signatures of the Predominant Form of Familial Transthyretin Amyloidosis (Val30Met Mutation). Am J Ophthalmol 2018; 192:169-177. [PMID: 29859145 DOI: 10.1016/j.ajo.2018.05.023] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Revised: 05/23/2018] [Accepted: 05/24/2018] [Indexed: 01/08/2023]
Abstract
PURPOSE To describe abnormalities in choroidal and retinal vasculature associated with Val30Met familial transthyretin amyloidosis (V30M-FTA) using fluorescein and indocyanine green (ICG) angiography. DESIGN Prospective, cross-sectional study. METHODS This study was conducted at the French National Reference Center for FTA. We included 18 consecutive genetically confirmed V30M-FTA patients (36 eyes) who underwent complete neurologic examination, including staging with polyneuropathy disability (PND) score, and complete ophthalmic evaluation, including staging of intraocular amyloid deposits and fluorescein and ICG angiograms (ICG-A). The grading of choroidal and retinal angiopathy, and their association with neurologic functional impairment, were the main outcome measures. RESULTS Eleven men and 7 women, mean age 61.6 ± 12.1 years, were included. Retinal amyloid angiopathy (RAA) was detected in 24 eyes (92%) of 13 patients, with microaneurysms, retinal hemorrhages, and retinal ischemia of variable extent. Three patients (5 eyes) had neovascular glaucoma and 2 (2 eyes) had preretinal neovascularization. ICG-A indicated choroidal amyloid angiopathy (CAA) in all patients, with 3 distinct patterns-diffuse (9/18 patients), focal (5/18 patients), or punctiform (4/18 patients)-based on the extent of late hypercyanescence along the choroidal arteries. PND scores were significantly higher in patients with diffuse CAA (firework pattern) compared to those with limited CAA (focal and punctiform patterns) (2.89 vs 1.78, P = .045). CONCLUSION RAA is a frequent and severe complication of V30M-FTA that may lead to anterior and posterior segment neovascularization. CAA was detected in all patients, with a late hypercyanescent delineation of the choroidal arterial vasculature, which was more extensive with increased disease severity.
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Touhami S, Jouve L, Atia R, Georgeon C, Laroche L, Borderie V, Bouheraoua N. Optical coherence tomography and confocal microscopy aspects of a Schnyder's corneal dystrophy case. J Fr Ophtalmol 2018; 41:e207-e209. [PMID: 29778283 DOI: 10.1016/j.jfo.2018.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Revised: 02/15/2018] [Accepted: 02/16/2018] [Indexed: 10/16/2022]
Affiliation(s)
- S Touhami
- Service d'ophtalmologie 5, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Inserm UMR S 968, institut de la vision, Sorbonne Université, 75012 Paris, France
| | - L Jouve
- Service d'ophtalmologie 5, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - R Atia
- Service d'ophtalmologie 5, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - C Georgeon
- Service d'ophtalmologie 5, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France
| | - L Laroche
- Service d'ophtalmologie 5, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Inserm UMR S 968, institut de la vision, Sorbonne Université, 75012 Paris, France
| | - V Borderie
- Service d'ophtalmologie 5, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Inserm UMR S 968, institut de la vision, Sorbonne Université, 75012 Paris, France
| | - N Bouheraoua
- Service d'ophtalmologie 5, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Inserm UMR S 968, institut de la vision, Sorbonne Université, 75012 Paris, France.
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Touhami S, Beguier F, Augustin S, Reichman S, Goureau O, Nandrot E, Guillonneau X, Bodaghi B, Sennlaub F. Chronic exposure to TNF α
impairs RPE barrier and immunosuppressive functions. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.02332] [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)
- S. Touhami
- Therapeutics; Institut de la Vision; Paris France
| | - F. Beguier
- Therapeutics; Institut de la Vision; Paris France
| | - S. Augustin
- Therapeutics; Institut de la Vision; Paris France
| | - S. Reichman
- Therapeutics; Institut de la Vision; Paris France
| | - O. Goureau
- Therapeutics; Institut de la Vision; Paris France
| | - E. Nandrot
- Therapeutics; Institut de la Vision; Paris France
| | | | - B. Bodaghi
- Ophthalmology; Pitié Salpétrière; Paris France
| | - F. Sennlaub
- Therapeutics; Institut de la Vision; Paris France
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Mathis T, Housset M, Eandi C, Beguier F, Touhami S, Reichman S, Augustin S, Gondouin P, Sahel JA, Kodjikian L, Goureau O, Guillonneau X, Sennlaub F. Activated monocytes resist elimination by retinal pigment epithelium and downregulate their OTX2 expression via TNF-α. Aging Cell 2017; 16:173-182. [PMID: 27660103 PMCID: PMC5242302 DOI: 10.1111/acel.12540] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [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] [Accepted: 08/25/2016] [Indexed: 12/31/2022] Open
Abstract
Orthodenticle homeobox 2 (OTX2) controls essential, homeostatic retinal pigment epithelial (RPE) genes in the adult. Using cocultures of human CD14+ blood monocytes (Mos) and primary porcine RPE cells and a fully humanized system using human-induced pluripotent stem cell-derived RPE cells, we show that activated Mos markedly inhibit RPEOTX2 expression and resist elimination in contact with the immunosuppressive RPE. Mechanistically, we demonstrate that TNF-α, secreted from activated Mos, mediates the downregulation of OTX2 and essential RPE genes of the visual cycle among others. Our data show how subretinal, chronic inflammation and in particular TNF-α can affect RPE function, which might contribute to the visual dysfunctions in diseases such as age-related macular degeneration (AMD) where subretinal macrophages are observed. Our findings provide important mechanistic insights into the regulation of OTX2 under inflammatory conditions. Therapeutic restoration of OTX2 expression might help revive RPE and visual function in retinal diseases such as AMD.
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Affiliation(s)
- Thibaud Mathis
- Institut de la Vision; 17 rue Moreau 75012 Paris France
- UPMC University of Paris 06; INSERM; CNRS; Sorbonne Universités; Paris France
- Department of Ophthalmology; Croix-Rousse University Hospital; Hospices Civils de Lyon; University of medicine Lyon 1; 103 Grande rue de la Croix Rousse 69317 Lyon Cedex 04 France
| | - Michael Housset
- Institut de la Vision; 17 rue Moreau 75012 Paris France
- UPMC University of Paris 06; INSERM; CNRS; Sorbonne Universités; Paris France
| | - Chiara Eandi
- Institut de la Vision; 17 rue Moreau 75012 Paris France
- UPMC University of Paris 06; INSERM; CNRS; Sorbonne Universités; Paris France
- Department of Clinical Science; Eye Clinic; University of Torino; Torino Italy
| | - Fanny Beguier
- Institut de la Vision; 17 rue Moreau 75012 Paris France
- UPMC University of Paris 06; INSERM; CNRS; Sorbonne Universités; Paris France
| | - Sara Touhami
- Institut de la Vision; 17 rue Moreau 75012 Paris France
- UPMC University of Paris 06; INSERM; CNRS; Sorbonne Universités; Paris France
| | - Sacha Reichman
- Institut de la Vision; 17 rue Moreau 75012 Paris France
- UPMC University of Paris 06; INSERM; CNRS; Sorbonne Universités; Paris France
| | - Sebastien Augustin
- Institut de la Vision; 17 rue Moreau 75012 Paris France
- UPMC University of Paris 06; INSERM; CNRS; Sorbonne Universités; Paris France
| | - Pauline Gondouin
- Institut de la Vision; 17 rue Moreau 75012 Paris France
- UPMC University of Paris 06; INSERM; CNRS; Sorbonne Universités; Paris France
| | - José-Alain Sahel
- Institut de la Vision; 17 rue Moreau 75012 Paris France
- UPMC University of Paris 06; INSERM; CNRS; Sorbonne Universités; Paris France
| | - Laurent Kodjikian
- Department of Ophthalmology; Croix-Rousse University Hospital; Hospices Civils de Lyon; University of medicine Lyon 1; 103 Grande rue de la Croix Rousse 69317 Lyon Cedex 04 France
| | - Olivier Goureau
- Institut de la Vision; 17 rue Moreau 75012 Paris France
- UPMC University of Paris 06; INSERM; CNRS; Sorbonne Universités; Paris France
| | - Xavier Guillonneau
- Institut de la Vision; 17 rue Moreau 75012 Paris France
- UPMC University of Paris 06; INSERM; CNRS; Sorbonne Universités; Paris France
| | - Florian Sennlaub
- Institut de la Vision; 17 rue Moreau 75012 Paris France
- UPMC University of Paris 06; INSERM; CNRS; Sorbonne Universités; Paris France
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Touhami S, Fardeau C, Vanier A, Zambrowski O, Steinborn R, Simon C, Tezenas du Montcel S, Bodaghi B, Lehoang P. Birdshot Retinochoroidopathy: Prognostic Factors of Long-term Visual Outcome. Am J Ophthalmol 2016; 170:190-196. [PMID: 27523490 DOI: 10.1016/j.ajo.2016.08.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2016] [Revised: 08/03/2016] [Accepted: 08/03/2016] [Indexed: 11/18/2022]
Abstract
PURPOSE To determine the prognostic factors of long-term visual outcome in birdshot retinochoroidopathy (BRC). METHODS Design: Retrospective case series. Study Population: Successive HLA-A29+ BRC patients whose latest visit was between May and August 2013 at a single tertiary center (Pitié-Salpétrière Hospital, Paris). OBSERVATION PROCEDURE Endpoint visual status (remission or deterioration) was determined for each patient based on clinical and ancillary data from the latest visit including optical coherence tomography (OCT), automated visual field (AVF), and angiograms. Main Outcome Measure: Epidemiologic, clinical, OCT, AVF, angiographic, and electrophysiological data at baseline were correlated to final visual status. RESULTS Fifty-five patients were included. Mean observation period was 8 years (range: 0.6-23 years). Mean disease duration was 9.8 years (range: 1.2-32.7 years). Female-to-male sex ratio was 1.6:1. Factors of good visual prognosis (remission vs deterioration) included at baseline: late age of disease onset (49.5 vs 45 years, P = .05), presence of vitreous inflammatory reactions >2+ (35.9% vs 6.2%, P = .04), vascular leakage on fluorescein angiograms (FA) (44.4% vs 12.5%, P = .03), absence of macular pigment epithelium atrophy on FA (88.9% vs 62.5%, P = .05), and presence of macular edema on OCT (33.3% vs 6.2%, P = .04). Preserved electrooculography light peak and Arden ratio (P = .06) and presence of choroidal spots on infracyanine green angiograms (80.0% vs 53.3%, P = .08) seemed associated with the best prognoses. CONCLUSION This study suggests a series of prognostic factors of long-term visual outcome in BRC. Keeping in mind the insidious evolution of the disease, knowledge of such prognostic factors should help tailor the treatment and monitoring of birdshot patients.
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Affiliation(s)
- Sara Touhami
- Ophthalmology Department, Reference Center in Rare Diseases, DHU Sight Restore, Hôpital Pitié Salpêtrière, University Paris VI, Paris, France.
| | - Christine Fardeau
- Ophthalmology Department, Reference Center in Rare Diseases, DHU Sight Restore, Hôpital Pitié Salpêtrière, University Paris VI, Paris, France
| | - Antoine Vanier
- UPMC Univ. Paris 6, Department of Public Health; AP-HP, University Hospital Pitié-Salpêtrière Charles-Foix, Department of Biostatistics Public Health and Medical Informatics, Paris, France
| | - Olivia Zambrowski
- Ophthalmology Department, Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Rafaela Steinborn
- Ophthalmology Department, Reference Center in Rare Diseases, DHU Sight Restore, Hôpital Pitié Salpêtrière, University Paris VI, Paris, France
| | - Claude Simon
- Ophthalmology Department, Reference Center in Rare Diseases, DHU Sight Restore, Hôpital Pitié Salpêtrière, University Paris VI, Paris, France
| | - Sophie Tezenas du Montcel
- UPMC Univ. Paris 6, Department of Public Health; AP-HP, University Hospital Pitié-Salpêtrière Charles-Foix, Department of Biostatistics Public Health and Medical Informatics, Paris, France; Sorbonne Universités, UPMC University Paris 06 UMR_S1136, and INSERM UMR_S 1136, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | - Bahram Bodaghi
- Ophthalmology Department, Reference Center in Rare Diseases, DHU Sight Restore, Hôpital Pitié Salpêtrière, University Paris VI, Paris, France
| | - Phuc Lehoang
- Ophthalmology Department, Reference Center in Rare Diseases, DHU Sight Restore, Hôpital Pitié Salpêtrière, University Paris VI, Paris, France
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Touhami S, Fardeau C, Zambrowski O, Bonnet C, Bodaghi B, Touitou V, Lehoang P. Rétinochoroïdopathie de type Birdshot : les éléments clés. J Fr Ophtalmol 2016; 39:560-70. [DOI: 10.1016/j.jfo.2016.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 05/09/2016] [Accepted: 05/25/2016] [Indexed: 11/30/2022]
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