[Real life visual and anatomic outcomes of aflibercept treatment for treatment-naive patients with exudative age-related macular degeneration]. / Réponse visuelle et anatomique en condition de « vraie vie ¼ du traitement par aflibercept chez les patients naïfs atteints de dégénérescence maculaire liée à l'âge exsudative.

Anti-VEGF therapies have revolutionized the treatment of neovascular age-related macular degeneration (AMD). PURPOSE: The goal of this study was to evaluate the "real life" visual and anatomical outcomes of aflibercept treatment for treatment-naive patients with exudative AMD. METHODS: This was a retrospective study of patients treated with aflibercept in the department of Ophthalmology at the University Hospital of Bordeaux between November 2013 and July 2015. The follow-up period varied from 3months to 2years. All patients received an induction phase with 3monthly intravitreal injections (IVT) followed by personalized monitoring. ETDRS best-corrected visual acuity (BCVA), fundus examination and OCT were performed at each visit. Data were collected at day 0, 3 months, 6, 9, 12months, 18 and 24months. RESULTS: Forty-three eyes of forty patients, mean age 77.7years, were included, with a minimum of 3months follow-up. Twenty-five eyes were followed for 1year; 5 eyes for two years. At baseline, the mean BCVA was 55.7 letters. Patients received 7.5 injections on average the first year and 2.6 the 2nd year. The mean gain of visual acuity was +7.3 letters at 3 months, +6.2 letters at 12 months, and +6.8 letters at 2years. Anatomically, the OCT data showed a decline of all parameters. The central macular thickness decreased by 118.3µm at 3months, 136.4µm at 12months and 65.5µm at 2years. CONCLUSION: Aflibercept can achieve effective visual and anatomical outcomes with results, which approach the pivotal studies, despite the use of personalized protocols and longer monitoring intervals.

["En face" optical coherence tomography for multiple evanescent white dot syndrome]. / Apport de l'imagerie « en face ¼ en tomographie par cohérence optique dans le syndrome des taches blanches évanescentes multiples.

INTRODUCTION: Multiple evanescent white dot syndrome (MEWDS) is a rare, usually unilateral, retinal disease associated with transient loss of vision. Its pathogenesis remains elusive. The purpose of this study was to determine the spatial location of the lesions in the neurosensory retina of a patient with MEWDS, using a new technology, i.e. "en face" optical coherence tomography ("en face" OCT). METHODS: A 21-year-old woman presenting with bilateral MEWDS underwent Cirrus(®) OCT with advanced "en face" reconstructions of the various retinal layers and inner choroid, fluorescein angiography, and infracyanine green angiography (ICGA). RESULTS: During the acute stage of MEWDS, advanced "en face" visualization mode of the IS/OS photoreceptor junction and the inner choroid showed areas of strong signal attenuation, forming a spot pattern identical to that of the hypofluorescent IGCA dots. One month later, visual acuity returned to 20/25 in both eyes and the reflectivity map of the IS/OS junction and inner choroid displayed no areas of signal attenuation. CONCLUSION: "En face" OCT is a new, noninvasive technology, capable of visualizing specific attenuation of the IS/OS junction in MEWDS, which form a spot pattern identical to those revealed by ICGA.

[Granular corneal dystrophy treated with deep anterior lamellar keratoplasty: comparing histological analysis and optical coherence tomography]. / Dystrophie granuleuse de type Groenouw 1 traitée par kératoplastie lamellaire antérieure profonde: analyses histologique et tomographique par cohérence optique.

Granular corneal dystrophy is a rare autosomal dominant disease. It is characterized by breadcrumb-like granular opacities in the central corneal stroma. The mutation has been localized in the TGFßI gene, which codes for keratoepithelin, an adhesion protein found in corneal epithelium and stroma. We report the case of granular corneal dystrophy in a 60-year-old man complaining of reduced visual acuity. Slit-lamp examination revealed multiple opacities in the central stroma of his left eye, and recurrent deposits in his other eye 13 years after penetrating keratoplasty. An anterior segment optical coherence tomography (Visante(®) OCT) was used to determine the location of deposits, then a deep anterior lamellar keratoplasty was performed in his left eye. The depth of the deposits revealed by Visante(®) OCT correlated well with the postsurgical histological findings. Visante(®) OCT can therefore help choose between phototherapeutic keratectomy and lamellar keratoplasty, techniques that are less invasive than penetrating keratoplasty, which is advantageous since this dystrophy is known to recur after surgery.