[Vision screening for children: Recommended practices from AFSOP]. / Le dépistage visuel chez l'enfant : les recommandations de l'Association Francophone de Strabologie et d'Ophtalmologie Pédiatrique (AFSOP).

In light of the international literature, a workgroup of experts from the AFSOP met in February 2019 to formulate updated recommendations for visual screening in children. An ophthalmologic examination during the first month of life is recommended for children at risk of developing infantile organic amblyopia. An ophthalmologic examination including cycloplegic refraction between 12 and 15 months of age is recommended for children at risk of developing functional amblyopia. At any age, a prompt ophthalmologic examination is recommended for a child suspected of functional or organic ocular pathology. In children without risk factors or warning signs, a systematic orthoptic screening examination is recommended during the third year of life, including a monocular visual acuity test, a cover-test and a refraction by photoscreener. The child is referred to the ophthalmologist only in the case of an abnormal screening result, according to the following criteria: visual acuity <5/10, or >1 difference between eyes, abnormal cover test, photodetection refraction values <-3D or>+2.5D for the sphere,>1.5D for astigmatism and>1D for anisometropia. Finally, we review normal childhood refractive errors as a function of age as well as the correct use of photo screening devices.

[Evaluation of the results of 12-mm recession of the inferior oblique muscle in superior oblique palsy: retrospective study in six patients]. / Evaluation de l'efficacité du recul isolé de 12 mm du muscle oblique inférieur dans la paralysie congénitale du muscle oblique supérieur: étude rétrospective de 6 patients.

INTRODUCTION: Surgical possibilities in superior oblique palsy are numerous. The aim of this study was to evaluate the results of a 12-mm inferior oblique recession in each cardinal position of gaze. PATIENTS AND METHODS: Six patients suffering from superior oblique palsy were studied. All of them presented disabling symptoms such as right-left incomitance, and hypertropia in primary gaze equal to or lower than 25 diopters. They all underwent a pre- and postoperative deviometry. The surgical protocol was a 12-mm inferior oblique muscle recession, with reinsertion 4 mm behind the inferior rectus. RESULTS: Functional results were positive. Mean hypertropia in primary gaze was 14.7 diopters for far and 12.7 diopters for near vision. The reduction of hypertropia in primary gaze was approximately 10 diopters, corresponding to 71.6% for far and 81.4% hypertropia for near vision. The mean postoperative vertical deviation was equal to 4.2 diopters for far and 2.3 diopters for near vision. Results in adduction were good even if there was a high level of hypertropia in this gaze position. CONCLUSION: Many authors suggest considering anatomic abnormalities to improve surgical results such as traction testing on the oblique superior and superior rectus muscles. We can suggest a first-intention 12-mm recession of the inferior oblique muscle in cases of right-left incomitance with hypertropia in primary gaze lower than 25 diopters.

Protective effect of trimetazidine in a model of ischemia-reperfusion in the rat retina.

Trimetazidine is an anti-ischemic agent which is frequently prescribed as a prophylactic treatment of episodes of angina pectoris and as a symptomatic treatment of vertigo and tinnitus. It has also shown beneficial effects in models of visual dysfunction, but the mechanism(s) by which this occurs is as yet undefined. The present study was intended to evaluate the influence of trimetazidine on retinal damage induced by ischemia-reperfusion in a rat model. Retinal ischemia was induced by increasing intraocular pressure to 160 mm Hg for 60 min. Trimetazidine or buffer controls were administered 3 days before the ischemia or in the postischemic period. The degree of retinal damage was assessed after 15 and 30 days of reperfusion after the ischemic insult by histopathologic study according to Hughes' quantification of ischemic damage. Retinal ischemia led to significant reductions in thickness and cell number, mainly in the inner retinal layers. The results from the study demonstrate that treatment with intraperitoneally injected trimetazidine conferred significant protection against retinal ischemic damage. Better results were obtained in the pretreatment group after 15 days of reperfusion. Trimetazidine protects the rat retina from pressure-induced ischemic injury and might be considered a potential therapeutic modality for combating retinal ischemia.

Case-control study of the risk factors for age related macular degeneration. France-DMLA Study Group.

AIM: A case-control study was initiated to determine the risk factors for the development of age related macular degeneration (AMD). METHODS: Study participants, who were all white, aged 50-85 years, and were recruited from private ophthalmology practices. Each practitioner enrolled patients with bilateral AMD, who were then matched with controls for sex and age. Environmental factors and systemic and ocular histories were screened. All patients had bilateral red-free fundus photographs and fluorescein angiography. Photographs were classified into pigment epithelium alterations, drusen, geographic atrophy, and exudative AMD. Statistical analysis included the identification of risk factors for AMD. A multivariate analysis was performed at the end of the study. Analysis included the entire study population and was carried out for each stage of AMD. RESULTS: 1844 controls were compared with 1844 patients with AMD. Mean age was 71 years for controls and 72 for cases. Logistic regression identified six major risk factors for AMD (whole population): arterial hypertension (odds ratio (OR) = 1.28), coronary disease (OR = 1.31), hyperopia (OR = 1.33), light coloured irises (OR = 1.22), and lens opacities or previous cataract surgery (OR = 1.55). The significance of vascular risk factors was increased for late stages of AMD, especially the atrophic forms (coronary disease, OR = 3.19). CONCLUSIONS: This large case-control study confirms some of the risk factors previously identified and may contribute to the determination of methods for prevention of AMD.

[Use of nerve division in oculomotor paralysis]. / Usage des secteurs dans les paralysies oculomotrices.

Sectors have a double interest in an extraocular muscle palsy: to avoid the diplopia and to aid the reeducation of palsied muscles. Patient can alternatively wear the two types of glasses with sectors. Authors decrease sector's size when motility improves. They are stopped if regression, and in other cases, patients can wait surgical time with maximum comfort. Clinical examples are presented: VI, III and IV cranial nerve palsies and generalized diplopia.

[Results of surgical treatment of alphabetical syndromes in esotropia. Apropos of 98 cases]. / Résultats du traitement chirurgical des syndromes alphabétiques dans les ésotropies. A propos de 98 cas.

The authors report the results of 98 cases of esotropia treated by global surgery. They treated 72 "V" syndromes, 22 "A" syndromes and 4 cases without vertical incommitance but presenting visible hyperactivities of the oblique muscles. The alphabetical variations have been treated by weakening of the oblique muscles and sometimes have been treated by weakening of the oblique muscles and sometimes of the vertical recti which are part of the same torsional couple (inferior oblique - inferior rectus in the "V" syndrome, superior oblique - superior rectus in the "A" syndrome). Post-operative improvement has been obtained in 76% of the cases for the "V" syndrome and in 63% of the cases for the "A" syndrome. The surgery of the oblique muscle must be done according to the importance of the incommitance. The arc-technique permits these adjustments. Some pronounced "X" syndromes appear in the post-operative period. All anomalies found during motility examination should be surgically corrected.

[Involvement of the posterior eye segment in HLA B27(+) iridocyclitis. Incidence. Value of surgical treatment]. / Atteintes du segment postérieur de l'oeil dans les iridocyclites HLA B27 (+). Fréquence. Intérêt du traitement chirurgical.

46 patients with the association of acute anterior uveitis and the presence of HLA B27 antigen were studied. Ankylosing spondylitis was found in 19 patients (41.3%). Ophthalmoscopy showed a diffuse vitreous haze in 63%, a macular disease in 21.7%, a papillitis in 17.4%. We performed pars plana vitrectomy on 8 patients (10 eyes) with severe posterior uveitis and/or cystoid macular edema. The postoperative follow-up period averaged 14 months with visual acuity improvement in 5 eyes. The surgical indications are described.

[Terson's syndrome. Apropos of 7 cases]. / Le syndrome de Terson. A propos de 7 cas.

We studied seven cases of Terson's syndrome, in association with bleeding in the subarachnoid space caused by rupture of vascular malformation or cranial traumatism. The association of rapid increase of intracranial pressure with subarachnoid hemorrhage could explain the development of a Terson's syndrome. The retinal hemorrhages associated with the vitreous hemorrhage are variable in morphology and topography. Pars plana vitrectomy has been performed in eight eyes with most often good results.

[A case of multiple epitheliopathy associated with sub-retinal neovascularization]. / Un cas d'épithéliopathie en plaques associé à des néovaisseaux sous-rétiniens.

Gass described the acute posterior multifocal placoid pigment epitheliopathy in 1968. The disturbance of visual function is generally temporary with subsequent recovery. We describe one case of peripapillary and macular neovascularization with decreasing visual acuity due to macular haemorrhage followed by a fibro-glial scar. The pathogeny of the syndrome can explain the possible neovascularization. Neovascularization has been more often described with serpiginous choroiditis.