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1.
Br J Ophthalmol ; 107(2): 289-294, 2023 Feb.
Article in English | MEDLINE | ID: mdl-34561218

ABSTRACT

BACKGROUND: Dacryolith-induced epiphora is caused by a chronic obstruction of the nasolacrimal duct whose aetiology is often specified peroperatively. Dacryocystorhinostomy (DCR) has been often regarded as the gold standard to treat dacryolithiasis. Hasner's valve (HV) incision is a technique to evacuate lithiasis through its physiological track. The purpose of this study was to describe clinical and radiological findings associated with presence of dacryoliths in patients who underwent surgery and to assess the efficacy of these two procedures. METHODS: This study was a comparative interventional multicentric retrospective study including patients referred for an epiphora. The primary endpoint was to determine clinical and endoscopic findings associated with dacryoliths. The secondary endpoints were to evaluate the performance of CT dacryocystography (CT-DG) in the diagnosis of dacryoliths and the success rate of the surgical treatment 6 months postoperatively. RESULTS: 4677 nasolacrimal ducts (NLDs) (78.0% female, mean age 59.2) were included in the study. 3913 underwent DCR, and 764 underwent HV incision. 291 out of 4677 NLDs (6.2%) were found to have dacryoliths. Presence of mucocele associated to a permeable lacrimal system (OR 8.17 (95% 4.62 to 14.44), p<0.01) was associated with presence of lithiasis peroperatively. Success rates at 6 months were 95.6% for endonasal DCR and 94.6% for incision of HV in dacryolithiasis group (p<0.01). CT-DG had a negative predictive value of 96.3% to detect lithiasis (p<0.01). CONCLUSION: Strong clinical and endoscopic findings may improve the imputability of dacryoliths in epiphora. Evacuation of dacryolithiasis through its physiological track was first described in this study in adults with similar results to DCR in patients presenting with dacryolithiasis.


Subject(s)
Dacryocystorhinostomy , Lacrimal Duct Obstruction , Lithiasis , Nasolacrimal Duct , Adult , Humans , Female , Middle Aged , Male , Lacrimal Duct Obstruction/etiology , Lithiasis/diagnosis , Lithiasis/surgery , Lithiasis/complications , Retrospective Studies , Dacryocystorhinostomy/methods , Nasolacrimal Duct/diagnostic imaging , Nasolacrimal Duct/surgery , Endoscopy/adverse effects , Treatment Outcome
2.
Medicina (Kaunas) ; 58(3)2022 Mar 21.
Article in English | MEDLINE | ID: mdl-35334633

ABSTRACT

Background and Objectives: Secondary ocular localizations of hematological malignancies are blinding conditions with a poor prognosis, and often result in a delay in the diagnosis. Materials and Methods: We describe a series of rare cases of ocular involvement in six patients with hematological malignancies, reportedly in remission, who presented secondary ocular localizations, challenging to diagnose. Two patients had an acute lymphoblastic leukemia (ALL) and developed either a posterior scleritis or a pseudo-panuveitis with ciliary process infiltration. One patient had iris plasmacytoma and developed an anterior uveitis as a secondary presentation. Two patients had a current systemic diffuse large B-cell lymphoma (DLBCL) and were referred either for intermediate uveitis or for papilledema and vitritis with secondary retinitis. Finally, one patient with an acute myeloid leukemia (AML) presented a conjunctival localization of a myeloid sarcoma. We herein summarize the current knowledge of ophthalmologic manifestations of extramedullary hematopathies. Results: Inflammatory signs were associated with symptomatic infiltrative lesions well displayed in either the iris, the retina, the choroid, or the cavernous sinus, from the admission of the patients in the ophthalmological department. These findings suggest that patients with ALL, AML, systemic DLBCL, and myeloma can present with ophthalmic involvement, even after having been reported as in remission following an effective systemic treatment and/or allograft. Conclusions: Early detection of hidden recurrence in the eyes may permit effective treatment. Furthermore, oncologists and ophthalmologists should be aware of those rare ocular malignant locations when monitoring patient's progression after initial treatment, and close ophthalmologic examinations should be recommended when detecting patient's ocular symptoms after treatment.


Subject(s)
Leukemia, Myeloid, Acute , Multiple Myeloma , Papilledema , Acute Disease , Humans , Iris
3.
Eur J Ophthalmol ; 32(6): 3644-3649, 2022 Nov.
Article in English | MEDLINE | ID: mdl-35172628

ABSTRACT

PURPOSE: To assess the impact of the Covid-19 pandemic and subsequent lockdown on the number and clinical characteristics of patients with retinal detachment (RD) in a French public university eye hospital. METHODS: Single-center, retrospective non-interventional study. Patients consulting at the emergency room (ER) of Quinze-Vingts Hospital (France) for rhegmatogenous RD before and after instauration of the lockdown were reviewed. We compared the characteristics of patients with RD between the containment period (March17th - April27th,2020) and the period preceding the lockdown (February18th - March16th,2020). We compared the number of RD surgeries performed between the first month of lockdown (March17th - April19th,2020) and the corresponding period of 2019. Number of cases, delay between diagnosis and surgery, visual acuity was measured. RESULTS: During the first month of lockdown, 59 RDs were operated on, compared to 107 in the corresponding period in 2019 (-44,8%). Mean time from first symptoms to surgery was significantly higher during the lockdown 12.7 (11.3) days vs 7.6 (7.8) days (p = 0.031) before. During the lockdown, the mean BCVA was lower albeit the difference did not reach statistical significance (1.16 (0.9) during pre-containment vs 1.5 (0.9) during containment; p = 0.09). Reasonsfor delayed consultation were: fear of Covid-19 (31%; p = 0.0001), absence of referral doctor (31%; p = 0.003) and difficulties in getting to public transport (10.3%;p = 0.859). CONCLUSION: Despite maintaining accessto emergency eye care facilitiesin our hospital, the lockdown affected visual health. Should the lockdown be reinstated, we postulate that a better information about eye care access for non-Covid emergencies may attenuate its effect on visual health.


Subject(s)
COVID-19 , Retinal Detachment , COVID-19/epidemiology , Communicable Disease Control , Humans , Incidence , Pandemics , Retinal Detachment/epidemiology , Retinal Detachment/etiology , Retinal Detachment/surgery , Retrospective Studies
4.
Retin Cases Brief Rep ; 16(4): 500-506, 2022 Jul 01.
Article in English | MEDLINE | ID: mdl-32568961

ABSTRACT

PURPOSE: To report a case of the surgical management of vitreoretinal complications during disseminated intravascular coagulation secondary to meningococcemia. METHODS: A case report. RESULTS: A 25-year-old man presented with loss of vision due to retinal and vitreous hemorrhages during disseminated intravascular coagulation secondary to meningococcemia. Examination revealed the visual acuity to be counting fingers in the right eye and light perception in the left eye. Bilateral vitreous hemorrhages were found on fundus examination. A dome-shaped lesion overlying the macula consistent with a subinternal limiting membrane hemorrhage was seen on optical coherence tomography. Bilateral vitrectomy was performed. Multiple subinternal limiting membrane hemorrhages were evident in the posterior pole. A membrane forceps was used to peel the internal limiting membrane and remove the fibrin under it. The internal limiting membrane and vitreous samples were sent for anatomopathological examination confirming our hypothesis. The peripheral retina revealed bilateral multiple ischemic areas, and argon laser photocoagulation was performed on it. Both eyes were filled with silicone oil. Eight months after surgery, his vision improved to 70 and 65 on the early diabetic retinopathy study scale in the right and left eyes, respectively. CONCLUSION: Published cases of retinal and vitreous hemorrhages during disseminated intravascular coagulation secondary to meningococcemia are few. There is no specific and codified management of these ocular complications. This case is the first reporting positive visual recovery after surgical treatment. Surgical procedure seems to be effective to treat multiple vitreoretinal hemorrhages secondary to meningococcemia.


Subject(s)
Diabetic Retinopathy , Disseminated Intravascular Coagulation , Meningococcal Infections , Adult , Diabetic Retinopathy/surgery , Disseminated Intravascular Coagulation/complications , Disseminated Intravascular Coagulation/pathology , Humans , Male , Meningococcal Infections/complications , Retina/pathology , Vitrectomy/adverse effects , Vitreous Hemorrhage/etiology , Vitreous Hemorrhage/pathology , Vitreous Hemorrhage/surgery
5.
Eur J Dermatol ; 31(6): 759-770, 2021 Dec 01.
Article in French | MEDLINE | ID: mdl-34911675

ABSTRACT

The advent of tissue engineering and the clinical applications with cultured epidermal autograft (CEA) have improved the prognosis of severely burned patients. Marjolin ulcers (MUs) are a well-known complication of burns. These malignant neoplasm transformations of burn scars are usually squamous cell carcinomas with a higher incidence of regional metastases. Radical surgery remains the treatment of choice. To identify cases of malignant transformation occurring at sites of CEA in a cohort of 68 massively burned patients. A retrospective single-centre study was performed from April 2017 to June 2019 at the Military Hospital of Clamart (France). A total of 34 patients treated between 1991 and 2013 (including one post-mortem) were included. Four cases of squamous cell carcinoma occurred in areas previously covered by CEA. The data from clinical and histopathological examination as well as treatment modalities are presented. One patient died as a result of the evolution of his squamous cell carcinoma, and two others required salvage amputation due to locoregional recurrence. The prevalence of these CEA-MUs is estimated at between 5.9% and 11.7% and the person-time incidence rate of CEA-related MUs is about 5.9 per 1,000 persons-years. In our study, the average time to malignant transformation seems considerably shortened (32-35 years for "classic burn MU" versus 15.7 years for CEA-MU). This first documented case series of CEA-MUs demonstrates the need to inform caregivers and educate patients. Further studies are needed to specify the true incidence of CEA-graft site malignancy.


Subject(s)
Burns/pathology , Burns/surgery , Carcinoma, Squamous Cell/pathology , Cell Transformation, Neoplastic , Epidermis/transplantation , Skin Neoplasms/pathology , Skin Ulcer/pathology , Adult , Burns/complications , Cells, Cultured , Child , Female , Humans , Male , Middle Aged , Retrospective Studies , Skin Ulcer/etiology , Transplantation, Autologous
6.
BMC Ophthalmol ; 21(1): 273, 2021 Jul 10.
Article in English | MEDLINE | ID: mdl-34246229

ABSTRACT

BACKGROUND: PreserFlo® MicroShunt (PM) (also known as InnFocus® MicroShunt) is a subconjunctival stent implanted ab externo via a minimally invasive surgical procedure. The current indication is progressive, mild to moderate, open angle glaucoma uncontrolled on topical medications. According to the literature, adverse events are rare, mild and transient. CASE PRESENTATION: Two cases of stand-alone PreserFlo MicroShunt® implantation in patients with uncontrolled open-angle glaucoma are reported. Exposure occurred 7 days and 3 months respectively after implantation. These cases shared common features including preexisting blepharitis and the lack of a Tenon's flap. In both cases, removal of the device was required after several attempts at repair. CONCLUSIONS: PreserFlo MicroShunt® exposure is a potentially vision-threatening complication because of the risk of endophthalmitis. Potential risk factors include the absence of a Tenon's flap and pre-existing ocular surface inflammation. Ocular surface inflammation should be detected and treated prior to PM implantation. If a deficiency in Tenon's capsule is noted intraoperatively, close monitoring should be performed because of the higher risk of PM exposure.


Subject(s)
Glaucoma Drainage Implants , Glaucoma, Open-Angle , Glaucoma Drainage Implants/adverse effects , Glaucoma, Open-Angle/surgery , Humans , Intraocular Pressure , Tenon Capsule , Tonometry, Ocular
7.
Invest Ophthalmol Vis Sci ; 62(2): 42, 2021 02 01.
Article in English | MEDLINE | ID: mdl-33635311

ABSTRACT

Purpose: The purpose of this study was to describe capillary changes in patients with nonarteritic anterior ischemic optic neuropathy (NAION) using optical coherence tomography-angiography (OCT-A) and correlate the results with best corrected visual acuity (BCVA), visual field, OCT retinal nerve fiber layer (RNFL), and combined thickness of ganglion cell and inner plexiform layers (GCIPL) thicknesses. Methods: We enrolled 22 eyes with acute NAION and 30 normal control (NC) subjects in this study. Whole en face image vessel density (WiVD) was measured in the radial peripapillary capillary plexus (RPC), superficial capillary plexus (SCP), and deep vascular complex (DVC) using OCT-A. The examination was repeated at 1 (M1), 3 (M3), 6 (M6), and 9 (M9) months after presentation for NAION. Results: The initial RPC WiVD was significantly reduced in the acute NAION group compared to the NC group (P < 0.0001). Over the course of NAION follow-up, RPC WiVD was significantly reduced at M1 (P < 0.001 compared to M0) and M3 (P < 0.0001 compared to M1). However, there was no significant further decrease at M6 and M9. The initial SCP WiVD was significantly reduced in the NAION group compared to the NC group (P < 0.0001 for both). Over the course of NAION follow-up, a significant decrease was observed for SCP WiVD at M1 (P < 0.001 compared to M0), but no significant change was seen at M3, M6, or M9. DVC was normal in the NAION group. Correlations were found between GCIPL and SCP WiVD in the NAION acute phase (R = 0.604, P = 0.003) and in the M9 atrophic stage (R = 0.551, P = 0.009). At M9, RPC WiVD was correlated with BCVA (R = -0.562, P = 0.007), mean deviation (R = 0.518, P = 0.01), and RNFL (R = 0.655, P = 0.001). Conclusions: Over the course of NAION, OCT-A provided detailed visualization of retinal capillary plexus involvement.


Subject(s)
Fluorescein Angiography/methods , Optic Disk/pathology , Optic Neuropathy, Ischemic/diagnosis , Retinal Ganglion Cells/pathology , Retinal Vessels/pathology , Tomography, Optical Coherence/methods , Visual Fields/physiology , Adult , Aged , Case-Control Studies , Female , Follow-Up Studies , Fundus Oculi , Humans , Male , Middle Aged , Nerve Fibers/pathology , Optic Neuropathy, Ischemic/physiopathology , Prospective Studies , Visual Acuity
8.
J Ophthalmol ; 2020: 3439182, 2020.
Article in English | MEDLINE | ID: mdl-33110658

ABSTRACT

INTRODUCTION: To assess the safety and efficacy of selective laser trabeculoplasty (SLT) for ocular hypertension (OHT) induced by a dexamethasone (DEX) intravitreal implant. MATERIALS AND METHODS: We performed a retrospective study of patients who underwent an SLT procedure for ocular hypertension induced by injection of a DEX intravitreal implant. Patients had, at least, one injection of the DEX-implant for symptomatic macular edema. SLT was delivered to 360° of the trabecular meshwork in two sessions. The primary outcome was a decrease in IOP, evaluated at one, three, and six months after the SLT procedure. RESULTS: Twenty-six eyes of 22 patients were included. The mean intraocular pressure (IOP) measured after DEX-implant injection was 25.4 ± 5.4 mmHg, and the mean increase in IOP was 35.8 ± 14.6%. The mean follow-up after SLT was 18.3 ± 7.7 months. After SLT, the mean IOP dropped by 30.9% at one month (16.9 ± 4.5 mmHg, p=0.01), 33.6% at three months (16.0 ± 2.7 mmHg, p < 0.01), and 34.9% at six months (15.6 ± 2.1 mmHg, p < 0.01). Each patient had a minimum follow-up of 6 months after SLT. Eight eyes (31%) received a second DEX-implant injection after the SLT procedure without experiencing an increase in the IOP above 21 mmHg or >20%. No glaucoma surgery was required during the follow-up. The mean number of medications (1.65 ± 1.36) was significantly reduced at one (1.19 ± 1.20, p=0.04), three (0.96 ± 1.03, p < 0.01), and six months (0.77 ± 0.95, p < 0.01) after SLT. CONCLUSION: SLT is an effective and safe procedure to control OHT following DEX-implant intravitreal injection.

9.
J Glaucoma ; 29(2): 97-103, 2020 Feb.
Article in English | MEDLINE | ID: mdl-31764578

ABSTRACT

PRéCIS:: Subliminal subthreshold transscleral cyclophotocoagulation (SS-TSCPC) with duty cycles 25% and 31.3% seems to be an effective approach to reduce intraocular pressure (IOP) in glaucoma that is refractory to medical management. OBJECTIVE: The objective of this study was to compare the effectiveness and the tolerance of SS-TSCPC with a duty cycle of 25% versus 31.3% with Supra 810 nm Subliminal Quantel Medical laser stimulation for advanced glaucoma. MATERIALS AND METHODS: This was a retrospective, single-center, comparative case series of patients treated by SS-TSCPC between January 2017 and July 2017. The diagnostic and inclusion criteria were patients with advanced and refractory glaucoma, defined as IOP >21 mm Hg on maximal tolerated medical therapy with or without previous glaucoma surgical procedures, a minimum follow-up of 12 months, and patients who refused or were poor candidates for additional filtering surgery or implantation of glaucoma drainage devices. The primary endpoint was surgical success defined as an IOP of 6 to 21 mm Hg or a reduction of IOP by 20% from baseline without an increase in glaucoma medication from baseline. The secondary endpoints were the mean IOP and best visual corrected acuity best-corrected visual acuity at 12 months after surgery, retreatment outcomes, glaucoma medications, and complications such as inflammation, uveitis, cataract, mydriasis, and phthisis. RESULTS: Forty eyes of 32 patients were included: 20 eyes were subjected to SS-TSCPC with 31.3% duty cycle and 20 eyes with a 25% duty cycle. The surgical success of the TSCPC 12 months after the first procedure was better in the 31.3% duty cycle group (83.5%) than in the 25% duty cycle group (65%). The most common complications were inflammation (50%, 1 mo after surgery) and IOP spikes (increase in IOP of >25% from baseline within 1 mo of laser) in both groups. Inflammation was higher in the 31.3% duty cycle group. CONCLUSIONS: SS-TSCPC at 31.3% and 25% duty cycle seems to be an effective approach to reduce IOP in glaucoma that is refractory to medical management. SS-TSCPC at 31.3% duty cycle is more effective than the 25% duty cycle SS-TSCPC. However, the 31.3% duty cycle SS-TSCPC induces more inflammation than the 25% duty cycle SS-TSCPC. Each procedure should be considered on a case by case basis.


Subject(s)
Ciliary Body/surgery , Glaucoma/surgery , Laser Coagulation/methods , Sclera/surgery , Aged , Aged, 80 and over , Female , Glaucoma/physiopathology , Humans , Intraocular Pressure/physiology , Male , Middle Aged , Retrospective Studies , Tonometry, Ocular , Treatment Outcome , Visual Acuity/physiology
10.
Am J Ophthalmol ; 208: 429-437, 2019 12.
Article in English | MEDLINE | ID: mdl-31465755

ABSTRACT

PURPOSE: To describe outer retinal structure in patients with Best vitelliform macular dystrophy (BVMD) using spectral-domain optical coherence tomography (OCT) and correlate these results with best-corrected visual acuity (BCVA) and patient age. DESIGN: Retrospective cross-sectional study. METHODS: Patients with molecularly confirmed BVMD were compared with normal control subjects (NCs). A complete clinical evaluation was performed, including BCVA, fundus photography, spectral-domain OCT, and fundus autofluorescence. Spectral-domain OCT images were analyzed to determine the stage of the lesion, the central macular thickness (CMT), the foveal outer nuclear layer (ONL) thickness, and tomographic structural changes. RESULTS: Forty-two patients with BVMD (42 eyes) with a molecular diagnosis and 42 NCs (42 eyes) were included. Clinical stages (Gass clinical classification) were distributed as follows: 4.8% for stage 1, 23.8% for stage 2, 16.6% for stage 3, 45.2% for stage 4, and 9.5% for stage 5. The presence of subretinal fluid and vitelliform material was noted in 76% and 79% of the BVMD eyes examined, respectively, and was not associated with BCVA modification (P = .758 and P = .968, respectively). The median ONL thickness was significantly lower compared with the NCs (P < .001). BCVA was significantly correlated with stage (R = 0.710; P < .01), age (R = 0.448; P < .01), CMT (R = -0.411; P < .01), and ONL thickness (R = -0.620; P < .01). The disruption of the external limiting membrane and the ellipsoid zone was associated with a decreased BCVA (P < .001 for both). Among the 32 eyes with subretinal detachment, photoreceptor outer segment length was significantly correlated with BCVA (R = -0.467; P < .01) and ONL thickness (R = 0.444; P = < .01). CONCLUSION: This study shows the correlation between BCVA, age, and spectral-domain OCT features in patients with BVMD. ONL thickness as well as photoreceptor outer segment length are relevant functional correlates and outcome measures to follow photoreceptor impairments and disease progression.


Subject(s)
Retina/pathology , Visual Acuity/physiology , Vitelliform Macular Dystrophy/physiopathology , Adult , Aged , Bestrophins/genetics , Cross-Sectional Studies , DNA Mutational Analysis , Female , Humans , Male , Middle Aged , Retina/diagnostic imaging , Retinal Pigment Epithelium/pathology , Retrospective Studies , Tomography, Optical Coherence , Vitelliform Macular Dystrophy/diagnostic imaging , Vitelliform Macular Dystrophy/genetics
11.
Turk J Ophthalmol ; 49(6): 334-341, 2019 12 31.
Article in English | MEDLINE | ID: mdl-31893589

ABSTRACT

Objectives: To compare biochemical outcomes, effectiveness, and tolerance of two high-density silicone oils (HDSOs), silicone oil- RMN3 (Oxane® HD) and silicone oil-Densiron-68 (Densiron® 68), for the management of complicated retinal detachment (RD) associated with inferior proliferative vitreoretinopathy (PVR). Materials and Methods: This was a retrospective, single-centre, comparative case series of 23 patients treated between September 2014 and June 2016. The main inclusion criteria were RD with inferior PVR receiving Oxane® HD or Densiron® 68 following pars plana vitrectomy. The main outcome measures were anatomical success, rate of RD recurrence, and best-corrected visual acuity (BCVA) at 6 months. Secondary outcomes were short-term complications. Results: Twenty-three eyes were included: 16 eyes with Densiron® 68 tamponade and 7 eyes with Oxane® HD tamponade. Anatomical success under HDSO was significantly higher in the Densiron® 68 group (100%) than in the Oxane® HD group (42.8%) (p=0.0455). Recurrent RD was observed in 42.8% of eyes under Oxane® HD, but in none of the patients under Densiron® 68 (p=0.001). Six months after surgery, mean BVCA values (+/- standard deviation) with Densiron® 68 and Oxane® HD were 0.83±0.62 logMAR and 1.81±0.65 logMAR, respectively. BVCA was significantly better in the Densiron® 68 group (p=0.006). No significant differences were observed with regard to intraocular pressure, emulsification, or intraocular inflammation. Conclusion: Densiron® 68 appears to be more effective than Oxane® HD for the management of RD associated with PVR. A randomized, controlled, interventional study is needed to demonstrate this difference.


Subject(s)
Endotamponade/methods , Retinal Detachment/surgery , Silicone Oils/administration & dosage , Vitrectomy , Aged , Female , Humans , Male , Middle Aged , Retinal Detachment/etiology , Retinal Detachment/physiopathology , Retrospective Studies , Treatment Outcome , Visual Acuity/physiology , Vitreoretinopathy, Proliferative/complications
12.
Invest Ophthalmol Vis Sci ; 59(2): 870-877, 2018 02 01.
Article in English | MEDLINE | ID: mdl-29490340

ABSTRACT

Purpose: To analyze retinal and choroidal microvasculature in patients with nonarteritic anterior ischemic optic neuropathy (NAION) by using optical coherence tomography angiography (OCT-A). Methods: In this case-control retrospective observational study, patients with atrophic NAION (at least 3 months after onset of symptoms) and normal subjects underwent a complete ophthalmic examination including spectral-domain OCT, visual field (VF), and OCT-A. Whole en face image vessel density (wiVD) was used to assess retinal blood flow of the radial peripapillary capillaries (RPCs), circumpapillary RPC vessel density (cpVD), superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris (CC). Statistical correlations between wiVD measurements and visual acuity, VF parameters, retinal nerve fiber layer (RNFL), and combined thickness of retinal ganglion cell and inner plexiform layers were analyzed. Results: Twenty-four patients (26 eyes) with NAION and 24 age-matched normal controls (NCs) (24 eyes) were included. OCT-A showed significant reduction of the RPC wiVD (P < 0.0001) and the cpVD (P < 0.0001) in NAION eyes compared with NC and correlated with RNFL thickness (P = 0.002, P = 0.004), visual acuity (P = 0.042), and mean deviation of the VF (P = 0.001). Macular OCT angiograms showed capillary rarefaction in the SCP (P < 0.0001) and DCP (P < 0.0001) in the NAION group, both correlated with visual acuity (P = 0.02, P = 0.024). However, wiVD of the CC was not significantly different between the two groups in the peripapillary (P = 0.218) and macular (P = 0.786) areas. Conclusions: OCT-A provided detailed visualization of the peripapillary and macular retinal capillary rarefaction, correlated with VF and visual acuity loss. OCT-A could be a useful tool for quantifying and monitoring ischemia in NAION.


Subject(s)
Choroid/blood supply , Choroid/diagnostic imaging , Microvessels/diagnostic imaging , Optic Neuropathy, Ischemic/diagnostic imaging , Retinal Vessels/diagnostic imaging , Tomography, Optical Coherence , Aged , Arteritis/diagnostic imaging , Arteritis/physiopathology , Case-Control Studies , Female , Humans , Male , Microvessels/physiopathology , Middle Aged , Nerve Fibers/pathology , Optic Neuropathy, Ischemic/physiopathology , Regional Blood Flow , Retinal Ganglion Cells/pathology , Retrospective Studies , Visual Acuity/physiology , Visual Fields/physiology
13.
Curr Drug Saf ; 2017 05 23.
Article in English | MEDLINE | ID: mdl-28545357

ABSTRACT

Multiple meningiomas growth in patients under cyproterone acetate (CPA) is now well known. However, time between initial CPA intake and diagnosis remains unclear. The exposure time differs in each reported case: from 2 to 10 years. We present the case of an old man with acute visual impairment caused by an unusual bilateral optic nerve compression by three likely planum sphenoidale meningiomas rapidly induced by the admistration of CPA for prostatic adenocarinoma. This case is the first reported with a short exposure time (7 months) to CPA treatment before diagnosis of multiple meningiomas and stabilization on clinical follow-up after CPA treatment discontinuation.

14.
Oral Maxillofac Surg ; 21(2): 227-232, 2017 Jun.
Article in English | MEDLINE | ID: mdl-28365803

ABSTRACT

PURPOSE: The aim of this study is to determine patients' opinion regarding listening to music before an ambulatory maxillofacial surgery and effects on anxiety and pain reduction. METHODS: This study was conducted on outpatients having a maxillofacial surgery between December 2015 and April 2016 at Poissy/Saint-Germain-en-Laye hospital (France). Patients listened with headphones to an easy-listening music in the operation theater before the first ambulation. A questionnaire including a visual analog scale (VAS) for pain and anxiety was given to participants. The primary endpoint was to determine patients' opinion regarding listening to music before surgery. Secondary endpoints were to determine VAS pain mean, VAS anxiety mean before surgery, VAS anxiety mean after surgery, and if patients wanted to listen to their own playlist. We decided to compare VAS anxiety and pain mean between patients who accepted to listen to music (ALM) and who refused to listen to music (RLM). RESULTS: Nineteen patients ALM and 8 patients RLM to music. 78.9% of patients considered that listening to music before surgery decreased their anxiety. In patients who ALM, the mean (standard deviation, SD) of VAS pain after surgery was 3.42 (1.95), the mean (SD) of VAS anxiety before surgery was 3.1 (2.3), and the mean (SD) of VAS anxiety was 1.21 (0.85). There was a statistically significantly difference of the VAS anxiety mean (SD) before surgery between patients who ALM 3.10 (2.30) and who RLM 6.12 (1.88) (p = 0.005). There was a statistically significantly difference of the VAS anxiety mean (SD) after surgery between patients who ALM 1.21 (0.85) and who RLM 2.62 (1.30) (p = 0.009). Fifty percent of the patients wanted to choose their own music. CONCLUSION: Music seems to reduce anxiety before maxillofacial surgery. An interventional randomized study is needed to demonstrate the positive impact of music on anxiety before maxillofacial surgery.


Subject(s)
Ambulatory Surgical Procedures/psychology , Anxiety Disorders/psychology , Anxiety Disorders/therapy , Dental Anxiety/psychology , Dental Anxiety/therapy , Music Therapy , Otorhinolaryngologic Surgical Procedures/psychology , Pain, Postoperative/psychology , Pain, Postoperative/therapy , Surgery, Oral/psychology , Adolescent , Adult , Evaluation Studies as Topic , Humans , Middle Aged , Pain Measurement , Patient Satisfaction , Surveys and Questionnaires , Young Adult
15.
Therapie ; 71(5): 457-465, 2016 Oct.
Article in English | MEDLINE | ID: mdl-27203164

ABSTRACT

PURPOSE: Irvine-Gass syndrome is a macular edema (ME) that specifically occurs after cataract surgery. Its incidence varies from 0.2-2%. The purpose of this study is to evaluate the effectiveness of intravitreal dexamethasone implant injections in patients with Irvine-Gass syndrome. METHODS: Patients with ME secondary to cataract surgery who underwent intravitreal injections of dexamethasone implant between December 2011 to October 2014 at François-Quesnay hospital (Mantes-la-Jolie, France) were retrospectively reviewed. The patients were followed for at least 10 months. All the patients were handled by intravitreal injection of dexamethasone in the eye of study among which some resisted to a preliminary treatment by non-steroidal anti-inflammatory drug (NSAID) and acetazolamide. The patients were examined each month. The patients were again handled by intravitreal injection of dexamethasone if they presented a recurrence. The primary endpoint of the study was determined on best corrected visual acuity (BCVA) using early diabetic retinopathy study (ETDRS) scale and central macular thickness (CMT) [µm] using optical coherence tomography (OCT) 3 and 6 months after the first injection. Secondary endpoints were the number of recurrences, the number of injections, the duration average before the first recurrence, the BCVA 10 months after the first injection and the tolerance. RESULTS: Six eyes of six patients were studied. At baseline, the mean (standard deviation [SD]) of the BCVA was 59.8±11. Three months after the first injection, the mean (SD) of the BCVA showed a statistically significant increase to 72.2±8.6 (P=0.03). Six months after the first injection, the mean (SD) of the BCVA showed a statistically significant increase to 72±11.8 (P=0.03). Concerning the CMT, the mean (SD) was 495.6±135.2 before treatment. Three months after the first injection, the mean (SD) of the CMT showed a statistically significant decrease to 268.6±57.8 (P=0.03). Six months after the first injection, the mean (SD) of the CMT showed a significant decrease to 350.1±56.3 (P=0.09). CONCLUSION: In this study, both mean BCVA and mean CMT had significantly improved from baseline after treatment with dexamethasone implant in patients with Irvine-Gass syndrome.


Subject(s)
Dexamethasone/therapeutic use , Glucocorticoids/therapeutic use , Macular Edema/drug therapy , Visual Acuity , Aged , Cataract Extraction/adverse effects , Female , Humans , Intravitreal Injections , Macular Edema/etiology , Male , Retrospective Studies
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