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10.
J Fr Ophtalmol ; 44(10): 1484-1490, 2021 Dec.
Article in French | MEDLINE | ID: mdl-34756744

ABSTRACT

Coronavirus disease (COVID-19) can result in many ocular manifestations. We report a rare case of bilateral central serous chorioretinopathy post-infection with COVID-19 in a 38-year-old woman who presented with bilateral blurred vision 1 month after infection with COVID-19. She reported fever, cough, and shortness of breath and was COVID-PCR positive. During her 10-day hospital stay, she received oxygen, antibiotics, heparin and corticosteroids intravenously and then orally. After her recovery from COVID-19, the patient developed progressive visual loss in both eyes: her corrected visual acuity was 3/10 in both eyes, the anterior segment was normal, and the vitreous was clear. Fundus examination, optical coherence tomography and fluorescein angiography showed bilateral serous retinal detachments. Her course was characterized by improvement in visual acuity and regression of the retinal detachments. Central serous chorioretinopathy can occur after COVID-19 infection due to the administration of corticosteroids; thus, ophthalmologic examination is essential to detect ocular involvement as early as possible.


Subject(s)
COVID-19 , Central Serous Chorioretinopathy , Adult , Central Serous Chorioretinopathy/diagnosis , Central Serous Chorioretinopathy/etiology , Female , Fluorescein Angiography , Fundus Oculi , Humans , SARS-CoV-2 , Tomography, Optical Coherence
13.
J Fr Ophtalmol ; 44(1): 53-62, 2021 Jan.
Article in French | MEDLINE | ID: mdl-33279286

ABSTRACT

INTRODUCTION: Blepharophimosis ptosis epicanthus inversus syndrome (BPES) is a rare congenital hereditary abnormality. It includes complex orbital-palpebral malformations, causing aesthetic and functional ramifications. Management of BPES requires two steps : diagnosis and treatment. PATIENTS AND METHODS: We performed a retrospective descriptive study of 44 patients (88 eyelids) with blepharophimosis-ptosis-epicanthus inversus syndrome (BPES). In our series, we opted for two-stage surgery in 28 cases : epicanthus-telecanthus surgery followed by ptosis surgery. Simultaneous surgery was performed in 5 cases. RESULTS: The mean age at the first visit was 6 years (6.1±6.4). The mean age of our patients at the time of the first surgery was 6.6 years. Epicanthus surgery was performed in 35 cases. The two techniques used to correct epicanthus were Y-V plasty in 30 cases (85.7%, n=35) and Y-V+double Z plasty in 5 cases (14.3%, n=35). Correction of the telecanthus was performed at the same time by a medial canthal tendon plication in 31 cases (88.6%, n=35) or transnasal canthopexy in 4 cases (11.4%, n=35). The mean age at the time of ptosis surgery was 7.23 years (±6.25), ranging from 8 months to 27 years. Ptosis surgery was performed in 41 cases (79 eyelids), of which 3 patients underwent unilateral ptosis surgery due to asymmetrical ptosis. The techniques used were levator resection in 64 eyelids and frontal suspension in 15 eyelids. CONCLUSION: BPES is often clinically diagnosed. The difficulty in management lies in the complex surgery required. There is no established consensus regarding surgical techniques or the timing of the surgeries.


Subject(s)
Blepharophimosis , Blepharoptosis , Blepharophimosis/diagnosis , Blepharophimosis/surgery , Blepharoptosis/diagnosis , Blepharoptosis/epidemiology , Blepharoptosis/etiology , Child , Humans , Referral and Consultation , Retrospective Studies , Tunisia/epidemiology
18.
J Fr Ophtalmol ; 42(5): 464-470, 2019 May.
Article in French | MEDLINE | ID: mdl-30928241

ABSTRACT

PURPOSE: To assess the impact of glaucoma treatment and ocular surface disease (OSD) on the vision-specific quality-of-life (VS-QoL) of glaucoma patients attending Farhat Hached university hospital Sousse-Tunisia. METHODS: This was a cross-sectional study enrolling one-hundred-twenty patients followed for primary open angle glaucoma. All patients successfully responded to the Arabic version of the National Eye Institute Visual Function Questionnaire 25 (NEI-VFQ 25). QoL was quantified in terms of scores (0-100) and correlated with the characteristics of glaucoma treatment and status of the ocular surface. RESULTS: One hundred and twenty patients were studied. The mean number of medications and instilled drops was 1.95 (1-4) and 2.69 (1-7) respectively. A total of 66.7% patients reported side effects of treatment. On examination, moderate or severe dry eye syndrome was identified in 90% of cases. A total of 16.7% of patients had superficial punctate keratopathy. The number of instilled drops per day, the use of brimonidine or oral carbonic anhydrase inhibitors, and the presence of OSD had a negative impact on the NEI-VFQ 25 scores. CONCLUSIONS: Glaucoma treatment and OSD are 2 factors potentially reducing the QoL of glaucoma patients, on which the ophthalmologist can act by optimizing treatment and regularly examining the ocular surface of glaucoma patients.


Subject(s)
Antihypertensive Agents/adverse effects , Dry Eye Syndromes/epidemiology , Glaucoma, Open-Angle/drug therapy , Glaucoma, Open-Angle/epidemiology , Keratitis/epidemiology , Quality of Life , Adult , Aged , Aged, 80 and over , Antihypertensive Agents/administration & dosage , Cross-Sectional Studies , Dry Eye Syndromes/chemically induced , Eye/drug effects , Eye/pathology , Female , Glaucoma, Open-Angle/pathology , Humans , Intraocular Pressure/drug effects , Keratitis/chemically induced , Male , Middle Aged , Ophthalmic Solutions/administration & dosage , Ophthalmic Solutions/adverse effects , Surface Properties/drug effects , Surveys and Questionnaires , Treatment Outcome , Tunisia/epidemiology , Vision Disorders/epidemiology , Vision Disorders/etiology , Visual Fields/drug effects
19.
J Proteomics ; 191: 107-113, 2019 01 16.
Article in English | MEDLINE | ID: mdl-29572163

ABSTRACT

Right ventricle (RV) remodelling occurs in neonatal patients born with ventricular septal defect (VSD). The presence of a defect between the two ventricles allows for shunting of blood from the left to right side. The resulting RV hypertrophy leads to molecular remodelling which has thus far been largely investigated using right atrial (RA) tissue. In this study we used proteomic and phosphoproteomic analysis in order to determine any difference between the proteomes for RA and RV. Samples were therefore taken from the RA and RV of five infants (0.34 ±â€¯0.05 years, mean ±â€¯SEM) with VSD who were undergoing cardiac surgery to repair the defect. Significant differences in protein expression between RV and RA were seen. 150 protein accession numbers were identified which were significantly lower in the atria, whereas none were significantly higher in the atria compared to the ventricle. 19 phosphorylation sites (representing 19 phosphoproteins) were also lower in RA. This work has identified differences in the proteome between RA and RV which reflect differences in contractile activity and metabolism. As such, caution should be used when drawing conclusions based on analysis of the RA and extrapolating to the hypertrophied RV. SIGNIFICANCE: RV hypertrophy occurs in neonatal patients born with VSD. Very little is known about how the atria responds to RV hypertrophy, especially at the protein level. Access to tissue from age-matched groups of patients is very rare, and we are in the unique position of being able to get tissue from both the atria and ventricle during reparative surgery of these infants. Our findings will be beneficial to future research into heart chamber malformations in congenital heart defects.


Subject(s)
Heart Septal Defects, Ventricular/metabolism , Myocardium/chemistry , Proteome/analysis , Heart Atria/chemistry , Heart Septal Defects, Ventricular/pathology , Heart Ventricles/chemistry , Heart Ventricles/pathology , Humans , Hypertrophy , Infant , Phosphoproteins/analysis , Proteomics/methods
20.
J Fr Ophtalmol ; 40(3): 196-201, 2017 Mar.
Article in French | MEDLINE | ID: mdl-28318724

ABSTRACT

PURPOSE: To assess the vision-specific quality-of-life (VS-QoL) of glaucoma patients followed at Farhat Hached university hospital, Sousse-Tunisia, and identify clinical and sociodemographic factors potentially affecting it. METHODS: This was a cross-sectional study enrolling one-hundred twenty patients followed for primary open angle glaucoma (POAG). All the patients successfully responded to the Arabic version of the National Eye Institute Visual Function Questionnaire 25 (NEI-VFQ 25). Quality of life was quantified in terms of scores (0-100) and correlated with sociodemographic and clinical factors. RESULTS: One hundred and twenty patients were studied. The mean age was 62.38±10.68years. The global mean score (GMS) score was 70.11±18.45% ranging from 23.71 to 98%. Urban residence was associated with a better total score (P=0.01). Educational background was correlated with the subscale scores of distant activities (P=0.01), social functioning (P=0.03), physical activity limitations (P=0.01) and peripheral vision (P=0.01). The total NEI-VFQ 25 had a statistically significantly negative correlation with the duration of the glaucoma (P=0.002), the cup to disc ratio of the better and the worse eye (P<10-4), the visual acuity of the better and the worse eye (P<10-4), but not with the intraocular pressure. A higher number of glaucoma medications had a negative impact on the total score (P=0.03) and the subscales of physical activity limitations (P=0.04) and driving (P=0.002). CONCLUSIONS: Vision-specific quality of life of glaucoma patients, as measured by the NEI-VFQ 25, is correlated to many sociodemographic and clinical elements. QoL evaluation is an essential factor to be considered in the management of glaucoma patients. In our context, research should be directed first to the validation of a questionnaire in the local dialect.


Subject(s)
Glaucoma/epidemiology , Glaucoma/pathology , Adult , Aged , Aged, 80 and over , Cross-Sectional Studies , Female , Glaucoma/physiopathology , Humans , Intraocular Pressure , Male , Middle Aged , Pilot Projects , Quality of Life , Socioeconomic Factors , Surveys and Questionnaires , Tunisia/epidemiology , Visual Acuity
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