[CORNEAL BURN: CLINICAL PROFILE, CONTRIBUTION OF ANTERIOR SEGMENT OPTICAL COHERENCE TOMOGRAPHY AND MANAGEMENT - EIGHT CASES]. / BRÛLURE CORNÉENNE : PROFIL CLINIQUE, APPORT DE LA TOMOGRAPHIE PAR COHÉRENCE OPTIQUE DU SEGMENT ANTÉRIEUR ET PRISE EN CHARGE - A PROPOS DE HUIT CAS.

Ocular burns can have three origins: chemical (by acid or alkaline agents), luminous (by ultraviolet radiation) or thermal. We report the cases of eight patients with ocular burns (3 thermal and 5 chemical). Of these, one patient had a grade 2 burn according to the Dua classification, two had grade 3 damage and one had grade 4. One patient had grade 3 damage in the right eye and grade 4 in the left eye. Anterior segment optical coherence tomography (AS-OCT) was performed in two patients, showing corneal de-epithelialization, corneal thickening and a hyper-reflective line in the posterior stroma. All patients received medical treatment with topical antibiotics, topical corticosteroids, cycloplegics and wetting agents. Five patients had outpatient treatment with clinical improvement. Three patients were hospitalized, one of whom received an amniotic membrane graft (AMG), one had an AMG followed by a transfixing keratoplasty (TK), and the other is scheduled for a TK. Ocular burns are associated with significant functional risk, warranting prompt and effective management.

[Bilateral central serous chorioretinopathy post-COVID-19]. / Choriorétinopathie séreuse centrale bilatérale post-COVID-19.

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.

[Management of blepharophimosis, ptosis, epicanthus inversus syndrome at a referral center in Tunisia]. / Prise en charge du syndrome de blépharophimosis ptôsis épicanthus inversus (SBPE) dans un centre de référence en Tunisie.

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.

[Impact of glaucoma medications and ocular surface disease on the quality of life of glaucoma patients in the district of Sousse (Tunisia)]. / Impact du traitement antiglaucomateux et de la pathologie de la surface oculaire sur la qualité de vie des patients glaucomateux dans la région de Sousse (Tunisie).

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.

The cardiac proteome in patients with congenital ventricular septal defect: A comparative study between right atria and right ventricles.

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.