Incidence et caractéristiques des hémopathies malignes au cours de l’artérite à cellules géantes

Introduction L’arterite a cellules geantes (ACG) est une vascularite du sujet âge au cours de laquelle les cellules mononucleees jouent un role physiopathologique majeur. L’hematopoiese clonale est un phenomene dont la frequence augmente egalement avec l’âge et qui conduit a l’apparition de mutations responsables de la survenue d’hemopathies malignes (HM) ou de mutations des cellules effectrices de l’immunite responsables de pathologies inflammatoires. Notre hypothese est qu’il existe une association specifique entre certaines HM et l’ACG. Nous avons pu etudier cette hypothese en croisant les donnees du registre des hemopathies de Cote d’Or (RHEMCO) et celles de tous les laboratoires d’anat…

Association between the retinal vascular network, cardiovascular history and risk factors in the elderly

IF 3.157; International audience; PurposeTo identify patterns summarizing the retinal vascular network in the elderly and to investigate the relationship of these vascular patterns with cardiovascular history.MethodsWe conducted a population-based study, the Montrachet study (Maculopathy Optic Nerve nuTRition neurovAsCular and HEarT diseases), in participants older than 75 years. History of cardiovascular disease and a score-based estimation of their 10-year risk of cardiovascular mortality (Heart SCORE) were collected. Retinal vascular network analysis was performed by means of Singapore “I” Vessel Assessment (SIVA) software. Principal component analysis was used to condense the informatio…

Des données cliniques à la vie réelle : quelles preuves pour le devenir des patients DMLA ?

Macular edema: Miscellaneous.

International audience; Abstract. This article provides the reader with practical information to be applied to the various remaining causes of macular edema. Some macular edemas linked to ocular diseases like radiotherapy after ocular melanomas remained of poor functional prognosis due to the primary disease. On the contrary, macular edemas occurring after retinal detachment or after some systemic or local treatment use are often temporary. Macular edema associated with epiretinal membranes or vitreomacular traction is the main cause of poor functional recovery. However, the delay to observe a significant improvement of vision after surgery should be long, as usually observed in tractional …

The LDL receptor in the retina: the missing link in aging, the new target in dietary prevention

National audience; Purpose: The discovery of the LDL receptor (LDLR) in 1985 by Brown and Goldstein was awarded by a Nobel Prize. The LDLR has initially been identified for its role in mediating the endocytosis of LDL particles in the vascular endothelium. The deposition of lipids, including cholesterol and cholesteryl esters in Bruch’s Membrane in the one hand, and in the vessel intima in the other hand, is one of the common features of age related macular degeneration (AMD) and cardiovascular disease (CVD). Dietary habits with high intakes of omega 3 long chain fatty acids (LCFA) have been associated with AMD prevention. Similar effects have been demonstrated in CVD prevention. The mechan…

Predictive factors for good visual acuity recovery in diabetic macular oedema

Qu'est ce qui a changé dans le traitement des OVR rétine en pratique

Clinical spectrum of eye malformations in four patients with Mowat-Wilson syndrome

Mowat-Wilson syndrome (MWS) is a rare genetic syndrome characterized by a specific facial gestalt, intellectual deficiency, Hirschsprung disease and multiple congenital anomalies. Heterozygous mutations or deletions in the zinc finger E-box-binding homeobox2 gene (ZEB2) cause MWS. ZEB2 encodes for Smad-interacting protein 1, a transcriptional co-repressor involved in TGF-beta and BMP pathways and is strongly expressed in early stages of development in mice. Eye abnormalities have rarely been described in patients with this syndrome. Herein, we describe four patients (two males and two females; mean age 7 years) with MWS and eye malformations. Ocular anomalies included, iris/retinal coloboma…

Initiation thérapeutique et accompagnement du patient en 2018

Micronutrition : de la théorie à l'application en clinique

Revue de la tolérance au niveau systémique des patients diabétiques

Decreasing dietary linoleic acid promotes long chain omega-3 fatty acid incorporation into rat retina and modifies gene expression

International audience; Age-related macular degeneration (AMD) may be partially prevented by dietary habits privileging the consumption of ω3 long chain polyunsaturated fatty acids (ω3s) while lowering linoleic acid (LA) intake. The present study aimed to document whether following these epidemiological guidelines would enrich the neurosensory retina and RPE with ω3s and modulate gene expression in the neurosensory retina. Rat progenitors and pups were fed with diets containing low or high LA, and low or high ω3s. After scotopic single flash and 8-Hz-Flicker electroretinography, rat pups were euthanized at adulthood. The fatty acid profile of the neurosensory retina, RPE, liver, adipose tis…

AntiVEGF and diabetic retinopathy

Cholestérol et pathologies oculaires : focus sur le rôle de la cholestérol 24S-hydroxylase (CYP46A1) dans l’homéostasie du cholestérol

Resume La retine est le tissu neurosensoriel de l’œil qui assure la transduction visuelle, c’est-a-dire le codage de l’information lumineuse en influx nerveux. Le terme « retine » regroupe l’association de la retine neurale et de l’epithelium pigmentaire retinien qui repose sur la membrane de Bruch. L’association physique de ces deux partenaires et leurs interactions metaboliques sont des elements indispensables au bon fonctionnement de la retine, a la fois en termes d’apport en nutriments et de maintien de l’homeostasie. Des dereglements de ces equilibres sont associes au vieillissement et a des pathologies comme la degenerescence maculaire liee a l’âge, premiere cause de malvoyance apres …

Serum omega-3 fatty acids are not associated with age-related macular degeneration

Revue non indexée dans le JCR.; International audience; Evaluation of: Kabasawa S, Mori K, Horie-Inoue K et al. Associations of cigarette smoking but. not serum fatty acids with age-related macular degeneration in a Japanese population. Ophthalmology 118(6), 1082–1088 (2011). Age-related macular degeneration (AMD) is the leading cause of visual impairment in the elderly. in developed countries. Risk factors for AMD are classified into endogenous nonmodifiable. factors, including genetics and environmental factors such as smoking and dietary habits. Both. epidemiological and experimental studies suggest that dietary omega-3 long-chain fatty acids. would participate to prevent from the develo…

Chirurgie combinée de la cataracte et endophtalmie postopératoire aiguë en France de 2005 à 2014

Introduction : L’objectif de cette étude était d’analyser l’association entre chirurgie de la cataracte combinée avec des interventions chirurgicales de traitement du glaucome, vitréorétiniennes ou cornéennes et la survenue d’une (EPOA), de 2005 à 2014 en France. Méthodes : Les procédures de chirurgie de la cataracte par phacoémulsification et/ou de traitement du glaucome, vitréorétiniennes ou cornéennes ont été repérées par les codes correspondant de la classification commune des actes médicaux (CCAM) dans le programme de médicalisation des systèmes d’information (PMSI) du 1er janvier 2005 au 31 décembre 2014. L’EPOA était définie par la présence d’un diagnostic d’endophtalmie lors d’une h…

Œdèmes maculaires : stratégies thérapeutiques en 2016

New insight into the genetics of age-related macular degeneration in connection with lipid metabolism

Evaluation of: Zerbib J, Seddon JM, Richard F et al. rs5888 variant of SCARB1 gene is a possible susceptibility factor for age-related macular degeneration. PLoS ONE 4(10), e7341 (2009).Age-related macular degeneration (AMD) is the leading cause of visual loss in elderly populations of Western countries. According to demographic forecasts, and owing to the improvement in life expectancy, the number of people suffering from this pathology is expected to dramatically increase in the near future, thereby becoming a significant socioeconomic burden. There has been great progress in defining risk factors for AMD over the last few decades. Beyond advanced age, environmental and genetic factors ha…

Plasmalogens and cell‐cell communication between retinal glial cells

National audience; Purpose Plasmalogens are glycerophospholipids containing a vinyl‐ether bond at sn‐1 position of their glycerol backbone and polyunsaturated fatty acids (PUFAs) at sn‐2. We have previously shown that plasmalogens are involved in the regulation of perinatal retinal vascular development and particularly in astrocyte template formation (Saab et al, PLoSONE 2012 9(6):e101076). Since retinal Müller cells and astrocytes can communicate through calcium waves and connexin 43‐rich gap junctions, the aim of our study was to determine whether a reduction of plasmalogen levels affects communication between retinal glial cells. Methods Primary Müller cells and astrocyte were isolated f…

Imagerie multimodale [Table ronde]

Static postural control in children with developmental dyslexia

Correspondence to: Service d’Ophtalmologie, CHU de Dijon, 3 rue du Faubourg Raines, F-21000 Dijon, France. Tel.: +33 3 80 24 68 74; fax: +33 3 80 24 11 39.; International audience; The present investigation tries to better understand potential association and causal relationship between phonological and postural impairment due to developmental dyslexia. The study included 50 boys with developmental dyslexia and selected on the basis of their overall reading difficulties, and 42 control boys. Body sway during a quite standing posture eye open and eye closed on a force platform were tested in the two groups of subjects that were between 10 and 13 years of age. Analysis of classical parameters…

Involvement of plasmalogens in post-natal retinal vascular development

Objective: Proper development of retinal blood vessels is essential to ensure sufficient oxygen and nutrient supplies to the retina. It was shown that polyunsaturated fatty acids (PUFAs) could modulate factors involved in tissue vascularization. A congenital deficiency in ether-phospholipids, also termed "plasmalogens'', was shown to lead to abnormal ocular vascularization. Because plasmalogens are considered to be reservoirs of PUFAs, we wished to improve our understanding of the mechanisms by which plasmalogens regulate retinal vascular development and whether the release of PUFAs by calcium-independent phospholipase A2 (iPLA2) could be involved. [br/] Methods and Results: By characterizi…

Inflammatory cytokines decrease viability and alter ganglioside profile in retinal pigment epithelium cells

Purpose Early stages of Age related Macular Degeneration (AMD) are characterized by dysfunction and degeneration of the retinal pigment epithelium (RPE) cells, which participate in the death of the overlying photoreceptors ultimately leading to loss of vision. Gangliosides (GG) make a wide and heterogeneous family of sialic-acid-containing glycosphingolipids, composed of a sugar chain branched on a ceramide. They are major components of cellular membranes, particularly abundant in the brain and nervous tissue, including retina. While their developmental and neuroprotective actions have been demonstrated, their precise role in retina’s function and its pathologies is still poorly understood.…

Dominant variants in the splicing factor PUF60 cause a recognizable syndrome with intellectual disability, heart defects and short stature

Item does not contain fulltext Verheij syndrome, also called 8q24.3 microdeletion syndrome, is a rare condition characterized by ante- and postnatal growth retardation, microcephaly, vertebral anomalies, joint laxity/dislocation, developmental delay (DD), cardiac and renal defects and dysmorphic features. Recently, PUF60 (Poly-U Binding Splicing Factor 60 kDa), which encodes a component of the spliceosome, has been discussed as the best candidate gene for the Verheij syndrome phenotype, regarding the cardiac and short stature phenotype. To date, only one patient has been reported with a de novo variant in PUF60 that probably affects function (c.505C>T leading to p.(His169Tyr)) associated wi…

Etude de l'impact du contrôle postural associé au port de verres prismatiques dans la réduction des troubles cognitifs chez le dyslexique de développement

But de l’etude L’objectif de ce travail est d’evaluer l’impact des modifications proprioceptives induites par un traitement postural sur les troubles cognitifs d’une population d’enfants souffrant de dyslexie de developpement. Patients et methodes Il a ete constitue un groupe de 20 enfants dyslexiques traites par prismes posturaux, semelles « de posture » et reeducation posturale, et un groupe temoin de 13 enfants dyslexiques portant uniquement des lunettes sans prismes. Tous les enfants etaient de sexe masculin. Lors de leur inclusion dans l’etude (M0) et 6 mois plus tard (M6), tous les participants ont ete evalues par un bilan ophtalmologique et postural et ont recu un examen neuropsychol…

2015-2016 - BCSC - Cours de sciences fondamentales et cliniques

Activation of a caspase-3-independent mode of cell death associated with lysosomal destabilization in cultured human retinal pigment epithelial cells (ARPE-19) exposed to 7beta-hydroxycholesterol

International audience; Purpose: To characterize the possible cytotoxic effects of oxysterols (7-hydroxycholesterol (7-OH), 25-hydroxycholesterol (25-OH)) in human retinal pigment epithelial cells (ARPE-19) and to detail the relationships between some of these effects. Methods: ARPE-19 cells were treated with 7-OH and 25-OH. Cell viability was measured with the MTT assay. Membrane permeability, mitochondrial potential, and lysosomal integrity were measured by flow cytometry with propidium iodide, DiOC6(3), and acridine orange, respectively. Cell death was characterized by staining with Hoechst 33342, transmission electron microscopy, and analysis of the DNA fragmentation pattern. Caspase ac…

Acides gras polyinsaturés de la rétine : ont-ils une origine alimentaire ? Lipid Nutri+

Article publié par l'Organisation nationale interprofessionnelle des graines et fruits oléagineux (Paris, France)

Complications oculaires de la radiothérapie

Motion perception in early glaucoma

Purpose: The aim of our study was to underline the changes in the movement perception for early glaucoma. Our working hypothesis consisted in inquiring if the impairment of the magnocellular pathway may modify the movement perception capabilities in the visual field, more particularly in its peripheral area.Methods: We included 14 healthy subjects and 14 patients with early primary open angle glaucoma. A moving target was presented on a semicircular screen (1.8 m diameter); participants were asked to localize the Ending Point (EP) of each movement. Each stimulus consisted in a white dot (0,72° of diameter) moving horizontally with the imposed velocity profile. Two different laws of motion w…

Lipid and fatty acid profile of the retina, retinal pigment epithelium/choroid, and the lacrimal gland, and associations with adipose tissue fatty acids in human subjects

International audience; Accumulation of lipids within Bruch’s membrane (BrM) and between BrM and retinal pigment epithelium (RPE) accounts for one of the biological changes associated with normal aging and may contribute to the development of age-related maculopathies. The origin of these lipids is still being actively investigated. The relative contribution of plasma lipids and lipids coming from the neural retina remains a matter of controversy. Low-density lipoproteins (LDLs) have been reported to significantly participate in the retina’s lipid supply, after active remodeling within RPE. Meanwhile, RPE expresses the enzymatic machinery for synthesizing lipoprotein-like particles. The obj…

Red blood cell plasmalogens and docosahexaenoic acid are independently reduced in primary open-angle glaucoma

International audience; Among several theories involved in the pathogenesis of primary open-angle glaucoma (POAG), the vascular theory considers the disease to be a consequence of reduced ocular blood flow associated with red blood cell abnormalities. Red blood cell membrane structure and function are influenced by their phospholipid composition. We investigated whether specific lipid entities that may affect the membrane physiology, namely, polyunsaturated fatty acids (PUFAs) and plasmalogens, are modified in POAG and whether these potential variations are related to the stage of glaucoma. Blood samples were collected from 31 POAG patients and 10 healthy individuals. The stage of glaucoma …

La rétinopathie diabétique : la nouvelle cible des antiVEGF

Trefoil factor TFF1-induced protection of conjunctival cells from apoptosis at premitochondrial and postmitochondrial levels.

PURPOSE. Goblet cells of the conjunctival epithelium synthesize and secrete TFF1 (Trefoil factor 1), a small protease-resistant peptide that, together with mucins, is responsible for the rheologic properties of the tear film. This study aimed to determine whether TFF1, whose synthesis increases in inflammatory conditions such as pterygium, could protect conjunctival cells from apoptosis. METHODS. Chang conjunctival cells, either wild-type or expressing TFF1 through stable transfection, were exposed to benzalkonium chloride (BAK) and ultraviolet (UV) irradiation to trigger apoptosis. The authors used cell fractionation to detect lipid raft‐associated proteins, coimmunoprecipitation to explor…

Cholesterol and ocular pathologies: focus on the role of cholesterol-24S-hydroxylase in cholesterol homeostasis

The retina is responsible for coding the light stimulus into a nervous signal that is transferred to the brain via the optic nerve. The retina is formed by the association of the neurosensory retina and the retinal pigment epithelium that is supported by Bruch’s membrane. Both the physical and metabolic associations between these partners are crucial for the functioning of the retina, by means of nutrient intake and removal of the cell and metabolic debris from the retina. Dysequilibrium are involved in the aging processes and pathologies such as age-related macular degeneration, the leading cause of visual loss after the age of 50 years inWestern countries. The retina is composed of severa…

Erythrocyte Phospholipid and Polyunsaturated Fatty Acid Composition in Diabetic Retinopathy

Background: Long chain polyunsaturated fatty acids (LCPUFAs) including docosahexaenoic acid and arachidonic acid are suspected to play a key role in the pathogenesis of diabetes. LCPUFAs are known to be preferentially concentrated in specific phospholipids termed as plasmalogens. This study was aimed to highlight potential changes in the metabolism of phospholipids, and particularly plasmalogens, and LCPUFAs at various stages of diabetic retinopathy in humans. Methodology and Principal Findings: We performed lipidomic analyses on red blood cell membranes from controls and mainly type 2 diabetes mellitus patients with or without retinopathy. The fatty acid composition of erythrocytes was det…

Eyeexpert

A mouse model of in vivo chemical inhibition of retinal calcium-independent phospholipase A2 (iPLA2).

International audience; Numerous studies have reported the implication of calcium-independent phospholipase A2 (iPLA2) in various biological mechanisms. Most of these works have used in vitro models and only a few have been carried out in vivo on iPLA2(-/-) mice. The functions of iPLA2 have been investigated in vivo in the heart, brain, pancreatic islets, and liver, but not in the retina despite its very high content in phospholipids. Phospholipids in the retina are known to be involved in several various key mechanisms such as visual transduction, inflammation or apoptosis. In order to investigate the implication of iPLA2 in these processes, this work was aimed to build an in vivo model of…

OMD : comment le traiter

Nutrition for the Eye: Different Susceptibility of the Retina and the Lacrimal Gland to Dietary Omega-6 and Omega-3 Polyunsaturated Fatty Acid Incorporation

International audience; The purpose of this study was to compare the susceptibility of the retina and the exorbital lacrimal gland to dietary supplies of long-chain omega-3 (omega 3) and omega-6 (omega 6) polyunsaturated fatty acids (LC-PUFAs). Male Wistar rats were fed a 5% lipid diet containing: (1) 10% eicosapentaenoic acid (EPA) and 7% docosahexaenoic acid (DHA), or (2) 10% gamma-linolenic acid (GLA), or (3) 10% EPA, 7% DHA and 10% GLA or (4) a balanced diet deprived of EPA, DHA and GLA for 3 months. Lipids were extracted from plasma phospholipids, retina and exorbital lacrimal gland, and fatty acid composition was determined by gas chromatography. Dietary supplementation with EPA and D…

Lipid nutrition and eye health

 Revue non indexée dans le JCR.; International audience; According to demographic forecasts, the elderly population will represent a growing part of the developed societies in the near future. Eye diseases are the second most prevalent pathologies after the age of 65 years. Age-related macular degeneration (AMD) is the leading cause of irreversible vision loss in western countries. The number of people suffering from ocular pathologies is expected to increase sharply in the near future, becoming a socio-economic burden. Recent data indicate that lipid nutrients may represent new tools in the prevention of eye diseases, and especially AMD.

Age-related macular degeneration: recent advances in treatments

Effect of intravitreal injection of Indocyanine Green, Triamcinolone Acetonide and Trypan Blue on the electroretinographic response of rats

International audience; Purpose:: Indocyanine Green (ICG) and Tripan Blue (TB) are commonly used in macular surgery by making easier the internal limiting membrane (ILM) removing. However, the innocuousness of these dyes is not actually established notably for ICG. Then, several authors proposed the use of triamcinolone acetonide (TA) as an alternative to the use of intraoperative dyes for visualizing the ILM. The purpose of this study was to evaluate the effects of intravitreal injection of ICG, TB and TA on the rat electroretinogram (ERG). Methods:: Three groups of 12-week-old Sprague Dawley rats (n=6) received intravitreal injection in one eye of 0.1mL of either ICG 0.5mg/mL, TB 3mg/mL o…

Oeil et médicament

Blood group related antigens in ocular cicatricial pemphigoid

Aim: To study the MUC5AC and the blood group related antigen expression in ocular cicatricial pemphigoid (OCP) according to the distribution of Lewis and secretor phenotypes in OCP patients compared to normal subjects. Methods: Immunostaining was performed on conjunctival biopsy specimens from 22 consecutive patients suffering from OCP, using monoclonal antibodies (Mabs) directed against the peptidic core MUC5AC mucin (anti-M1/MUC5AC Mabs) and against the saccharide moieties (anti-blood group related antigens). These latter included anti-Lea, anti-Leb, anti-sialyl Lea, and H type 2 Mabs, which immunoreact with Lewis positive and non-secretor (Lea), Lewis positive and secretor (Leb), Lewis p…

Tous les antiangiogéniques sont ils équivalents ?

Facteur prédictif de bonne récupération visuelle dans l'OMD

Proprioception oculaire et dyslexie de développement

But de l’etude L’objectif de ce travail est d’evaluer la presence d’anomalies de la proprioception constituant le syndrome de deficience posturale au sein d’une population d’enfants atteints de dyslexie de developpement. Patients et methodes Soixante patients de sexe masculin, âges en moyenne de 11 ans et 9 mois, ont ete inclus dans l’etude. Le diagnostic de dyslexie de developpement a ete confirme par un examen neuropsychologique a l’aide d’epreuves standardisees. Apres un interrogatoire visant a rechercher les signes fonctionnels evocateurs d’une anomalie proprioceptive, les patients ont fait l’objet d’un examen clinique ophtalmologique et postural en 9 etapes precisement decrites. Result…

New pharmacology development for age-related macular degeneration

Comment optimiser le circuit du patient dans les centres/services d'ophtalmologie

Fructose diet induced short-term impairment of cone sensitivity and gene expression in rat retina

National audience; Abstract: Purpose A high fructose diet has been widely used to trigger insulin resistance in rodent; insulin resistance is one of the major risk factor for the development of type 2 diabetes. Thirty to 40% of diabetic patients develop diabetic retinopathy. In this study, we aimed to evaluate the short-term effect, at 1, 3, 5, 8 days, of a 60% fructose diet, on photoreceptor sensitivity and gene expression in the retina of Brown Norway rats. Methods: Flicker electroretinograms (8Hz) were recorded under anesthesia, from both eyes simultaneously in order to study sensitivity of photoreceptors. Then, rats were euthanized and enucleated. Retinae and posterior poles were collec…

Schéma thérapeutique dans la DMLA

Plasmalogens in the retina: From occurrence in retinal cell membranes to potential involvement in pathophysiology of retinal diseases

Plasmalogens (Pls) represent a specific subclass of glycerophospholipids characterized by the presence of a vinyl-ether bond at the sn-1 position of glycerol. Pls are quantitatively important in membranes of neuronal tissues, including the brain and the retina, where they can represent until almost two-third of ethanolamine glycerophospholipids. They are considered as reservoirs of polyunsaturated fatty acids as several studies have shown that arachidonic and docosahexaenoic acids are preferentially esterified on Pls when compared to other glycerophospholipids. Reduced levels of Pls were observed in a number of neurodegenerative disorders such as glaucoma, the second leading cause of blindn…

Surveillance des patients sous APS : ce qui est fiable

Influence de l'acuité visuelle initiale sur le résultat final

Problématiques de la nutrition en ophtalmologie – application à la dégénérescence maculaire liée à l’âge

Nutrition in ophthalmology – clinical application to age-related macular degeneration «Let food be your medicine.» This contribution from Hippocrates is still timely addressed, especially in the field of ophthalmology. Observational epidemiology reports close associations between food habits and the risk or prevention of several ocular pathologies such as cataract or Age-related Macular Degeneration (AMD). Anti-oxidant vitamins, minerals and lipids are the nutrients that have been the most widely studied. Interventional epidemiology and experimental works partially corroborated these findings. Unexpectedly, the benefit of long chain omega 3 polyunsaturated fatty acids in the prevention of l…

Les endophtalmies aiguës postopératoires

Maculopathies liées à l'âge : quel degré de vigilance

In vivo consequences of cholesterol-24S-hydroxylase (CYP46A1) inhibition by voriconazole on cholesterol homeostasis and function in the rat retina

International audience; Cholesterol 24S-hydroxylase (CYP46A1) converts cholesterol into 24S-hydroxycholesterol in neurons and participates in cholesterol homeostasis in the central nervous system, including the retina. We aimed to evaluate the consequences of CYP46A1 inhibition by voriconazole on cholesterol homeostasis and function in the retina. Rats received daily intraperitoneal injections of voriconazole (60 mg/kg), minocycline (22 mg/kg), voriconazole plus minocycline, or vehicle during five consecutive days. The rats were submitted to electroretinography to monitor retinal functionality. Cholesterol and 24S-hydroxycholesterol were measured in plasma, brain and retina by gas chromatog…

Comment sélectionner un traitement sur le profil de mon patient ?

ApoB100,LDLR-/- mice exhibit reduced electroretinographic response and cholesteryl esters deposits in the retina

International audience; PURPOSE. To evaluate the retinal phenotype of 7- and 14-month-old apoB100,LDLR–/– mice, a relevant animal model of lipid metabolism dysfunction. METHODS. Single-flash electroretinograms were obtained from 7- and 14-month-old apoB100,LDLR–/– and control mice fed a standard diet under both scotopic and photopic conditions. Visual cycle retinoids were analyzed in eyes from dark-adapted mice. Retinal and choroidal vascularization was evaluated with scanning laser ophthalmoscopy. Fatty acids were analyzed in the retina. Esterified and free cholesterol was detected in eye cryosections. RESULTS. Scotopic and photopic b-wave amplitudes were significantly reduced in apoB100,L…

Early adaptive response of the retina to a pro-diabetogenic diet: Impairment of cone response and gene expression changes in high-fructose fed rats

The lack of plasticity of neurons to respond to dietary changes, such as high fat and high fructose diets, by modulating gene and protein expression has been associated with functional and behavioral impairments that can have detrimental consequences. The inhibition of high fat-induced rewiring of hypothalamic neurons induced obesity. Feeding rodents with high fructose is a recognized and widely used model to trigger obesity and metabolic syndrome. However the adaptive response of the retina to short term feeding with high fructose is poorly documented. We therefore aimed to characterize both the functional and gene expression changes in the neurosensory retina of Brown Norway rats fed duri…

L'ophtalmologie française sur le front de la DMLA

Assessment of induced corneal hypoxia in diabetic patients

Comparative Study Address correspondence and reprint requests to Dr. C. Creuzot-Garcher, Service d'Ophtalmologie, CHU, Hopital Général, 3 Rue du Faubourg Raines, BP 1519, 21033 Dijon, France. E-mail: Catherine.creuzot-garcher@chu-dijon.fr; To assess the control of corneal hydration in patients with diabetes during a contact lens-induced hypoxia. Corneal stress was induced in 15 patients with diabetes and 23 healthy patients by having them wear contact lenses for 2 hours. Pachymetries were measured and corneal parameters (percentage recovery per hour [PRPH], time for deswelling [T99%] and induced swelling [IS]) were calculated. In the mean time, tears were collected to assess the activity of…

Utilisation des antibiotiques en ophtalmologie : merci la sécu

L’œdème maculaire, une fatalité

Introduction of subspecialty examinations by the European Board of Ophthalmology (EBO) in close collaboration with European Subspecialty Ophthalmological Societies: FEBO-SA.

Abstract: The European Board of Ophthalmology (EBO) aims to establish common European standards in ophthalmology. The comprehensive EBO Diploma (EBOD) examination has been officially used since 1995 by an increasing number of European countries to assess the level of education in ophthalmology of their residents at the end of their training. The current comprehensive EBOD examination ensures a minimum standard of knowledge. We present an update on the EBO plans to establish a subspecialty advanced EBOD (AdEBOD) examination in order to award ophthalmologists who complete subspecialty training with formal recognition of their expertise. The purpose, structure and process of the AdEBOD examina…

Comparative study of post-natal retinal vascular development in mice models of iPLA2 inhibition and plasmalogen deficiency

Purpose: Plasmalogens are particular phospholipids characterized by the presence of a vinyl-ether bond and of a polyunsaturated fatty acid (PUFA) at sn-1 and sn-2 positions of glycerol, respectively. Even if the plasmalogen content of organs and tissues is well documented, their biological functions are still enigmatic. Plasmalogen deficiency in DAPAT-/- mice leads to developmental abnormalities in retinal vasculature (Acar et al, ARVO 2007 E-Abstract 2978) and to persistent hyaloïd arteries. We hypothesize that plasmalogens regulate retinal vascular development through the liberation of PUFA by a plasmalogen-specific calcium-independent phospholipase A2 (iPLA2). We have performed a compara…

Metabolic syndrome triggered by high-fructose diet favors choroidal neovascularization and impairs retinal light sensitivity in the rat

Diabetic retinopathy and age-related macular degeneration are the leading causes of blindness in Western populations. Although it is a matter of controversy, large-scale population-based studies have reported increased prevalence of age-related macular degeneration in patients with diabetes or diabetic retinopathy. We hypothesized that metabolic syndrome, one of the major risk factors for type 2 diabetes, would represent a favorable environment for the development of choroidal neovascularization, the main complication of age-related macular degeneration. The fructose-fed rat was used as a model for metabolic syndrome in which choroidal neovascularization was induced by laser photocoagulatio…

Coordination du dossier : Oedème maculaire, du diagnostic à sa prise en charge

Antiangiogéniques et facteurs de risque vasculaire

Intraocular pressure and central corneal thickness in an old French population: The MONTRACHET study

Purpose: To describe the distribution of intraocular pressure (IOP) and central corneal thickness (CCT) in an old French population. Methods: About 9000 individuals 65 years and older were included in the 3C cohort study since 1999 in 3 French cities (Bordeaux, Dijon and Montpellier). In Dijon, an additional ophthalmic examination was performed 10 years after the initial inclusions to assess the relation between systemic age-related diseases and eye diseases in the MONTRACHET Study (Maculopathy Optic Nerve nuTRition neurovAsCular and HEarT diseases). In this population-based stuy a thorough eye examination and a questionnaire were undertaken in each participant. Intraocular pressure (IOP) w…

Oestrus ovis external ophtalmomyiasis : a case report in Burgundy France

Background External ophtalmomyiasis (EOM) is a zoonosis related to the presence of Oestrus ovis larvae at the ocular level in small ruminants (i.e. ovine, caprine). In humans, EOM is a rare cosmopolitan disorder, mostly described in warm and dry rural areas in patients living close to livestock areas. In metropolitan France (excluding Corsica), EOM is an exceptional disease with less than 25 cases recorded since 1917. Case presentation We report a case of EOM in a 19-years old man in the last week of September 2016 in Burgundy. Conclusion The diagnosis of an EOM in Burgundy, a French region described as cold and humid, is surprising and could be due to a more marked climatic warming during …

Procedural aspects of the organization of the comprehensive European Board of Ophthalmology Diploma examination.

International audience; The comprehensive European Board of Ophthalmology Diploma (EBOD) examination is one of 38 European medical specialty examinations. This review aims at disclosing the specific procedures and content of the EBOD examination. It is a descriptive study summarizing the present organization of the EBOD examination. It is the 3rd largest European postgraduate medical assessment after anaesthesiology and cardiology. The master language is English for the Part 1 written test (knowledge test with 52 modified type X multiple-choice questions) (in the past the written test was also available in French and German). Ophthalmology training of minimum 4 years in a full or associated…

Incidence de l’endophtalmie aiguë postopératoire après chirurgie de la cataracte par phacoémulsification et injection intracamérulaire d’antibiotiques, en France de 2005 à 2014

National audience; Introduction La chirurgie de la cataracte est l’intervention la plus fréquente dans le monde. Parmi ses complications, l’endophtalmie aiguë postopératoire (EAPO) est une infection intraoculaire sévère, qui peut conduire à la cécité. Les objectifs étaient de déterminer l’incidence de l’EAPO après chirurgie de la cataracte par phacoémulsification en France de 2005 à 2014 et d’analyser l’association entre injection intracamérulaire d’antibiotique (IICA) et EAPO. Méthodes Tous les patients hospitalisés pour une chirurgie de la cataracte en France entre le 1er janvier 2005 et le 31 décembre 2014 ont été identifiés dans le programme de médicalisation des systèmes d’information …

Dossier : Épigénétique et ophtalmologie dans éditorial

Endophthalmitis after intravitreal injections: incidence, presentation, management, and visual outcome

Purpose To report the incidence and characteristics of endophthalmitis after intravitreal injections of anti–vascular endothelial growth factor agents or corticosteroids and to describe the clinical and bacteriologic characteristics, management, and outcome of these eyes with acute endophthalmitis in France. Design Retrospective, nationwide multicenter case series. Methods From January 2, 2008 to June 30, 2013, a total of 316 576 intravitreal injections from 25 French ophthalmic centers were included. For each center, the number of intravitreal injections was determined using billing codes and the injection protocol was recorded. A registry and hospital records were reviewed to identify pat…

Combined effects of aging and a pro-diabetic diet on retinal function in a murine model of aging of the human eye

 ; Purpose: Improvement of life expectancy and changes in the dietary behaviour of developed populations are accompanied with the prevalence of diabetes and age-related ocular pathologies. Aging of the retina is characterized by accumulation of lipids at the basement of the retinal pigment epithelium - Bruch’s membrane complex.Meanwhile increased oxidative stress is one of the features of aging and diabetes. A fructose-rich diet induces insulin resistance and hypertriglyceridemia, mimicking diabetes. The goal of our study was to evaluate the effects of a pro-diabetic fructose-enriched diet on the retinal function of the ApoB100,LDLR-/- mice, a murine model of aging of the human eye. Methods…

Evolving European guidance on the medical management of neovascular age related macular degeneration

BACKGROUND: Until recently, only two options were available for the treatment of choroidal neovascularisation (CNV) associated with age related macular degeneration (AMD)-thermal laser photocoagulation and photodynamic therapy with verteporfin (PDT-V). However, new treatments for CNV are in development, and data from phase III clinical trials of some of these pharmacological interventions are now available. In light of these new data, expert guidance is required to enable retina specialists with expertise in the management of AMD to select and use the most appropriate therapies for the treatment of neovascular AMD. METHODS: Consensus from a round table of European retina specialists was obt…

Intérêt des anti-VEGF dans le traitement des MacTel de type 1

Les télangiectasies maculaires de type 1 (MacTel 1) appartiennent au groupe plus large des télangiectasies maculaires. Leur diagnostic clinique se fait sur un aspect de dilatations anévrysmales de petite taille et d’ectasies paracentrales. Le patient peut présenter une baisse de vision avec un aspect d’oedème maculaire. À ce titre, les télangiectasies maculaires appartiennent aux causes d’oedème maculaire d’origine vasculaire. Le plus souvent ces télangiectasies surviennent dans un contexte de trouble de l’angiogenèse comme on le constate dans le diabète, les occlusions veineuses ou les vascularites… Elles sont alors qualifiées de secondaires. L’examen clinique confirme souvent l’existence …

Subretinal drusenoid deposits in the elderly in a population-based study (the Montrachet study: Maculopathy, Optic Nerve, nuTRition, neurovAsCular and HEarT diseases)

International audience

Lipid composition of the human eye: are red blood cells a good mirror of retinal and optic nerve fatty acids?

International audience; BACKGROUND: The assessment of blood lipids is very frequent in clinical research as it is assumed to reflect the lipid composition of peripheral tissues. Even well accepted such relationships have never been clearly established. This is particularly true in ophthalmology where the use of blood lipids has become very common following recent data linking lipid intake to ocular health and disease. In the present study, we wanted to determine in humans whether a lipidomic approach based on red blood cells could reveal associations between circulating and tissue lipid profiles. To check if the analytical sensitivity may be of importance in such analyses, we have used a do…

Dietary polyunsaturated fatty acids reduce retinal stress induced by an elevation of intraocular pressure in rats.

International audience; N-6 and n-3 polyunsaturated fatty acids (PUFAs) have been shown to prevent tissue release of inflammatory molecules. We have shown that a combination of n-6 and n-3 PUFAs is more efficient than single supplementations on the long-term consequences of intraocular pressure elevation. We hypothesized that such an association is also more effective during early retinal stress by modifying retinal proinflammatory prostaglandin and cytokine productions. Rats were supplemented for 3 months with n-6 PUFAs, n-3 PUFAs, or both n-6 and n-3 PUFAs. After 3 months, a surgical elevation of intraocular pressure was induced. Retinal morphometry and glial cell activation were evaluate…

Membrane épirétinienne chez le myope

Can ‘Fellow of the European Board of Ophthalmology Subspecialty Diploma in Glaucoma,’ a subspecialty examination on glaucoma induce the qualification standard of glaucoma clinical practice in Europe?

From 2015, the examination of Fellow of the European Board of Ophthalmology Subspecialty Diploma in Glaucoma (FEBOS-Glaucoma) was launched by the European Board of Ophthalmology (EBO) in cooperation with the European Glaucoma Society (EGS). This opinion aims at disclosing the background of the examination, prerequisite to the examination, and the value of the FEBOS-Glaucoma diploma.

Comment savoir si une rétinopathie diabétique est bien stabilisée ?

La rétinopathie diabétique (RD) est responsable de lésions microvasculaires et d’une dysfonction rétinienne d’évolution progressive. Elle est secondaire à l’exposition chronique à l’hyperglycémie et à d’autres facteurs de risque, comme l’hypertension artérielle, qui entraînent des cascades de changements biochimiques et physiologiques. Elle peut être responsable de complications cécitantes telles que l’hémorragie du vitré, le décollement de rétine tractionnel ou le glaucome néovasculaire. Afin qu’elle n’évolue vers de telles pathologies, il est important de la stabiliser par l’équilibration des facteurs de risque systémiques (optimisation glycémique et tensionnelle), parfois par la réalisat…

24S-hydroxycholesterol and cholesterol-24S-hydroxylase (CYP46A1) in the retina: from cholesterol homeostasis to pathophysiology of glaucoma.

http://www.sciencedirect.com/; International audience; Free cholesterol is the predominant form of cholesterol in the neural retina. The vertebrate neural retina exhibits its own capacity to synthesize cholesterol and meets its demand also by taking it from the circulation. Defects in cholesterol synthesis and trafficking in the neural retina has detrimental consequences on its structure and function, highlighting the crucial importance of maintaining cholesterol homeostasis in the retina. Our purpose was to give a review on the functioning of the retina, the role of cholesterol and cholesterol metabolism therein, with special emphasis on cholesterol-24S-hydroxylase (CYP46A1). Similar to th…

Trends in eye care use in adults treated for diabetes between 2008 and 2017 in France: a nationwide study

Management of diabetic macular edema with visual impairment in real-life practice in France: findings from the cross-sectional BOREAL DME study

International audience

Type 1 macular telangiectasia

L’identification à l’examen clinique de petites dilatations anévrismales et d’ectasies paracentrales fait évoquer le diagnostic de télangiectasies maculaires. Celles-ci sont le plus souvent secondaires à une pathologie, notamment au diabète, aux occlusions veineuses, aux vascularites, à un néovaisseau choroïdien de type 3, etc. Le contexte et le reste de l’examen identifieront généralement l’affection primitive. Les télangiectasies maculaires de type 1 (MacTel 1) sont idiopathiques sans cause retrouvée. Ce sont des affections rares, en grande majorité unilatérales, touchant préférentiellement l’homme d’âge moyen (1).

Corticoïdes et rétine : le bien et le mal

Comment suivre un OMD ?

Rétine et diabète

Incidence de l’endophtalmie postopératoire aiguë après chirurgie maculaire en France entre 2006 et 2016

Etat de la question L’objectif de cette etude nationale etait de rapporter l’incidence de l’endophtalmie postoperatoire aigue (EPOA) apres chirurgie maculaire en France entre 2006 et 2016 et d’identifier si le passage a la vitrectomie transconjonctivale en 2010–2011 etait associe a une modification du risque d’EPOA en France. Materiel et methodes Toutes les interventions chirurgicales pour membrane epiretinienne ou trou maculaire realisees en France entre janvier 2006 et octobre 2016 ont ete incluses a partir du PMSI. L’EPOA etait identifiee dans les 42 jours apres la chirurgie maculaire. Les effets du changement de technique (periode), des facteurs demographiques et cliniques sur la surven…

Visual outcomes and complications of congenital cataract surgery

Corresponding author at: Department of Ophthalmology, 14, rue Paul-Gaffarel, 21000 Dijon, France. This work is issued from the oral presentation during the 123rd congress of the French Ophthalmological Society.; International audience; PURPOSE: To describe the visual results and postoperative complications of congenital cataract surgeries performed between 2005 and 2016. METHODS: A retrospective consecutive case series of congenital cataract surgeries was carried out at the Dijon University Hospital in France. Intraocular lens implantation was primary or secondary according to age. Pre- and post-operative assessment was performed through ophthalmologic consultations with orthoptic measureme…

Perioperative risk of bleeding with antithrombotic agents in macular surgery: a national, prospective, multicentre study

International audience; Purpose To compare the risk of haemorrhagic complications in elective macular surgery between patients with no antithrombotic (AT) treatment (defined as patients with no history of AT therapy or who discontinued AT therapy) and patients who continued AT treatment during the surgery. Methods E-case report forms were prospectively recorded in a database before vitreoretinal surgery and 1 month after. Data on patient characteristics, surgical techniques, haemorrhagic complications and antithrombotic status were collected. Patients with retinal detachment, proliferative diabetic retinopathy and previous retinal haemorrhage were excluded. Results A total of 748 procedures…

Facteurs prédictifs de bonne récupération visuelle

Retinal optical coherence tomography angiography as a biomarker of acute kidney injury after acute coronary syndrome

Background Contrast-induced nephropathy (CIN) after percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS) is frequent and associated with long-term renal impairment and mortality. Retinal vessel density (RVD) measured by OCT-Angiography could reflect the global cardiovascular burden of ACS patients and thus provide a fast and non-invasive assessment of the systemic microcirculation, that may be involved in CIN occurrence. Methods Between October 2016 and March 2017, 452 ACS patients were admitted in our coronary care unit. Retinal OCT-A was performed within two days after PCI. Patients were divided in two groups, according to Acute kidney injury (AKI) occurrence (KDIGO …

Falsely elevated intraocular pressure due to increased central corneal thickness

PURPOSE: To evaluate whether ocular hypertensive subjects have a higher central corneal thickness than other individuals. METHODS: In this prospective study, 48 subjects with ocular hypertension, 63 patients with open-angle glaucoma, 56 nonglaucomatous patients with diabetes mellitus, and 106 control subjects were evaluated. Corneal thickness was measured by ultrasound pachymetry, and intraocular pressure was determined by Goldmann applanation tonometry. RESULTS: Central corneal thickness was significantly higher in the ocular hypertensive subjects, mean +/- S.D., 592+/-39 microm, than in the patients with glaucoma (536+/-34 microm), the nonglaucomatous patients with diabetes mellitus (550+…

Quand demander un FO et intérêt des classifications. Oedème maculaire dans les OVR : arbre décisionnel [Table ronde]

Treatment of macular oedema (excluding age-related macular degeneration (AMD))

Macular oedema corresponds to an increase in macular thickness most often associated with a rupture of the hematoretinal barriers. Diagnosis is based on the notion of reduced vision, but above all on multimodal imaging in which optical coherence tomography (OCT) plays an essential role both for the initial diagnosis and for follow-up. The mechanisms involved in the occurrence of macular oedema are primarily vascular endothelial growth factor (VEGF) and cytokines regardless of the aetiology of the oedema. Treatment often involves a combination of local treatment - primarily intravitreal injections of anti-VEGF or corticosteroids - and, in certain situations, such as diabetes or uveitis, gene…

Maintenance of anticoagulant and antiplatelet agents for patients undergoing vitreoretinal surgery

International audience; Purpose: To establish the prevalence of anticoagulant, aspirin, and clopidogrel use in patients undergoing vitreoretinal surgery, and to compare the outcome of peribulbar anesthesia between users and non-users. Materials and Methods: We conducted a retrospective case series in one academic center between January and June 2009. We analyzed the chart of 239 eyes who underwent posterior segment surgery with peribulbar anesthesia. Data included age, reasons for anticoagulant and/or antiplatelet agents, operative procedure, history of diabetes mellitus, high blood pressure, axial globe length, pre and post operative visual acuity, complications rates during and after anes…

Flow cytometric analysis of conjunctival epithelium in ocular rosacea and keratoconjunctivitis sicca

Abstract Purpose To investigate by flow cytometry and impression cytology (IC) specimens the inflammatory status of the conjunctival epithelium and goblet cell density in two series of patients with rosacea and dry eye syndrome compared with a population of healthy subjects. Design Nonrandomized, prospective, comparative case series. Participants Twenty-six eyes of 13 patients with rosacea, 26 eyes of 13 patients with dry eye syndrome, and 24 eyes of 12 control subjects were included in this study. Methods IC specimens were collected after clinical examination of the ocular surface and analyzed by flow cytometry, using antibodies directed to human lymphocyte antigen-DR (HLA-DR), intercellul…

Ocular surface assessment in soft contact lens wearers; the contribution of tear osmolarity among other tests.

: Purpose:  To determine whether tear osmolarity contributes to the assessment of the ocular surface in soft contact lens (CL) wearers. Methods:  Prospective, case–control series in 44 CL wearers (28 tolerant and 16 intolerant) and 34 healthy subjects. Every patient underwent a thorough ophthalmic examination with a tear osmolarity test (TearLab System), conjunctival impression cytology and meibomian lipid sampling. Symptoms, break-up time (BUT), tear osmolarity, conjunctival expression of HLA-DR and meibomian fatty acid composition were evaluated. Results:  Tear osmolarity did not differ between controls and CL wearers (p = 0.23). Flow cytometry results expressed in antibody-binding capaci…

Prevalence of Age-Related Macular Degeneration in Europe

Manuscript no. 2016-1147 Supplemental material is available at www.aaojournal.org/; International audience; [u]Purpose:[/u] Age-related macular degeneration (AMD) is a frequent, complex disorder in elderly of European ancestry. Risk profiles and treatment options have changed considerably over the years, which may have affected disease prevalence and outcome. We determined the prevalence of early and late AMD in Europe from 1990 to 2013 using the European Eye Epidemiology (E3) consortium, and made projections for the future. [u]Design:[/u] Meta-analysis of prevalence data. [u]Participants:[/u] A total of 42 080 individuals 40 years of age and older participating in 14 population-based cohor…

Faire face à l'urgence [Présentation de l'enquête des secrétaires d'ophtalmologie]

Steady-state levels of retinal 24S-hydroxycholesterol are maintained by glial cells intervention after elevation of intraocular pressure in the rat

Purpose: Our previous studies suggested that CYP46A1 and 24S-hydroxycholesterol. (24SOH) may be associated with glaucoma. Loss of CYP46A1-expressing retinal. ganglion cells is involved in the activation of glia, and therefore possibly in the. disbalance of cholesterol. In this context, the purpose of our present work was to. emphasize the glial and longitudinal CYP46A1 expression after an interventional. glaucoma-related stress triggered by elevated intraocular pressure (IOP). Methods: Sprague–Dawley rats were submitted to laser photocoagulation of the. trabecular meshwork, limbus and episcleral veins in one eye to induce elevated IOP. Rats were euthanized at days 3, 14, 30 and 60 (n = 10 p…

Plasma gangliosides and age-related macular degeneration

Purpose Age-related macular degeneration (AMD) is a multifactorial and polygenic disease and is the main cause of vision loss in developed countries after 50 years old. Indeed, dry AMD leads to progressive retinal atrophy and exsudative AMD induces a rapid alteration of the macula through neovascularisation. Gangliosides (GG) make a wide and heterogeneous family of sialic-acid-containing glycosphingolipids, composed of a sugar chain branched on a ceramide. They are major components of cellular membranes and are particularly abundant in the brain and nervous tissue, including retina. They are also found circulating in the plasma. GG are known for their neuroprotective properties in the nervo…

Définir un ordre hierarchique dans les examens devant une OVR

Endophtalmies post IVT (injection intravitréenne)

Additional file 1: of Oestrus ovis external ophtalmomyiasis: a case report in Burgundy France

Figure S1. Parasite cycle of Oestrus ovis. Oestrus ovis exerts a strict parasitism of the nasal cavities of small sheep and goat ruminants. The viviparous females of Oestrus ovis deposit first-stage larvae (L1) directly in the nasal orifices of sheep and goats. L1 actively penetrate through the nasal orifices and colonize the cornets and septum where they will develop. Once located at the ethmoid level, L1 molt to stage 2 larvae (L2). L2 further ascend from the nasal cavity to the frontal sinuses where they molt to stage 3 larvae (L3). Thereafter, L3 are expelled from the nasal cavity of the host by sneezing via the nasal mucus that subsequently contaminate the soils. Then, L3 turn into a p…