[Effects of internal limiting membrane peeling in epiretinal membrane surgery on OCT-angiography]. / Effets du pelage de la membrane limitante interne sur la microvascularisation maculaire en OCT-angiographie dans la chirurgie des membranes épirétiniennes.

PURPOSE: To assess macular microvascular parameters using OCT-angiography (OCT-A) in idiopathic epiretinal membrane surgery with or without internal limiting membrane peeling. MATERIALS AND METHODS: We retrospectively studied 17 eyes of 17 patients who underwent vitrectomy surgery for idiopathic epiretinal membrane with (n=10) or without (n=7) internal limiting membrane peeling. Patients operated on between July 2020 and June 2022 at the Colmar Hospital (France) by a single surgeon were evaluated before and 1 month after surgery, using OCT-A (Spectralis OCT-A module, Heidelberg Engineering®, Germany). The parameters studied were the area, perimeter and acircularity index of the foveal avascular zone (FAZ), the foveolar (FVD) and parafoveolar (PRVD) perfusion density and the macular vessel density ratio (MVR) in the superficial vascular complex (SVC) and the deep vascular complex (DVC). These parameters were measured using ImageJ software (National Institutes of Health, Bethesda, Maryland, USA). RESULTS: We found no statistically significant difference between the two groups postoperatively in either area, perimeter, or acircularity index of the FAZ, FVD, PRVD, or MVR in either the SVC or DVC. CONCLUSION: Our results with regard to macular microvasculature demonstrate no difference related to peeling of the internal limiting membrane and thus do not argue against this practice during epiretinal membrane surgery.

[Clinical and pathophysiological contribution of OCT-angiography to epiretinal membranes]. / Apports clinique et physiopathologique de l'OCT-angiographie dans les membranes épirétiniennes.

Epiretinal membranes may lead to centripetal contraction forces on the retina and its vessels. OCT-Angiography (OCT-A) is a recent tool which permits a non-invasive understanding of these vascular changes. This review focuses on the OCT-A findings in idiopathic epiretinal membranes, before and after surgery, and the role of internal limiting membrane peeling. It appears that contraction of the epiretinal membrane is associated with both a reduction in the area and perimeter of the foveal avascular zone and alterations in the superficial and deep capillary plexuses. These changes mainly reflect a vascular shift from the perifoveal to the foveal region, increasing with retinal deformation, but also probable dynamic changes in vascular flow. Membrane peeling allows at least partial improvement of these microvascular parameters. Nevertheless, some limitations of OCT-A, such as segmentation errors on a retina with highly modified architecture, can lead to a selection bias in the studies and should call for caution in the interpretation of the results. Finally, internal limiting membrane peeling contributes to changes in the retinal architecture after surgery, in particular by causing a centripetal movement of the macular capillaries and a displacement of the fovea toward the optic nerve head. This role should be clarified in future studies.

Anatomical and functional outcomes of ILM interposition in surgery for large macular holes: A retrospective study.

INTRODUCTION: While surgery for small macular holes (<400µm) is well-described, the results are not as clear-cut for larger holes (>400µm). Our purpose is to demonstrate the difference in terms of closure and final visual acuity between 3 techniques: the classical technique, the FLAP technique and internal limiting membrane (ILM) transfer. METHODS: This retrospective non-randomized study included consecutive patients with a macular hole greater than 400µm. Myopic eyes (>26.5mm or >6.50D) and eyes with other retinal comorbidities were excluded. All patients underwent pars plana vitrectomy in combination with one of the 3 techniques. RESULTS: We included 84 eyes of 77 patients between 2005 and 2018; 57 in the classic group (A), 13 in the FLAP group (B) and 14 in the ILM transfer group (C). The closure rate at 3 months was 70.18 % in group A, 100 % in group B and 92.86 % in group C. The closure rate was significantly higher in group B and C compared to group A. There was no significant improvement between pre- and post-operative best corrected visual acuity in any group. The gain in BCVA was 2.90 lines (±2.98) in group A, 3.40 lines (±2.40) in group B, and 1.07 lines (±1.04) in group C. The gain was significantly lower in group C compared to group A and B. CONCLUSION: ILM interposition appears to offer a true anatomical advantage for closing large holes, but the functional recovery does not appear to be better or worse.

[Prognostic factors for idiopathic macular hole surgery: Report of 107 eyes (Approach by univariate statistical analysis)]. / Les facteurs pronostiques de la chirurgie des trous maculaires idiopathiques : à propos de 107 yeux (Approche par analyse univariée).

PURPOSE: To identify prognostic factors influencing the success of idiopathic macular hole surgery, including initial visual acuity, hole size and stage, and type of gas used for tamponade. PATIENTS AND METHODS: Retrospective single-center descriptive analysis of all patients with an idiopathic macular hole operated by the same surgeon, treated in the ophthalmology department of Mulhouse hospital, between January 2004 and July 2014. Patients whose functional and anatomical results could be confounded by the coexistence of other ocular pathologies and patients with secondary macular holes were excluded. RESULTS: We included and followed 107 eyes of 104 patients for at least 6 months. Initial closure after the first surgery was obtained in 92 eyes (85.98 %), allowing 2 groups to be defined, the cases of success and failure. Initial visual acuity, hole size, stage according to Gass, Gaudric and IVTS classifications, and presence or absence of a PVD, were statistically significant prognostic factors (P<0.05) CONCLUSION: Our univariate statistical analysis identified multiple prognostic factors. These factors may predict success and the choice of surgical technique, including whether to peel the internal limiting membrane, the choice of gas for tamponade, and postoperative positioning.

Obstructive sleep apnoea in people with Type 1 diabetes: prevalence and association with micro- and macrovascular complications.

AIMS: Few reports have assessed the relationship between Type 1 diabetes and sleep disorders. The purposes of our study were to determine the prevalence of obstructive sleep apnoea in Type 1 diabetes and to compare the clinical profile of people with Type 1 diabetes with or without obstructive sleep apnoea. METHODS: In this cross sectional study of 67 consecutive people with Type 1 diabetes, we performed polysomnography as part of their yearly check-ups. RESULTS: In our cohort, with a mean BMI of 25.8 ± 4.7 kg/m(2), the prevalence of obstructive sleep apnoea [apnoea-hypopnoea index (AHI) > 10/h] was 46%. Severe obstructive sleep apnoea (AHI ≥ 30/h) was present in 19% of the patients. We found no significant differences in age, sex, body mass index, HbA1c or Epworth sleepiness scale score between people with or without obstructive sleep apnoea. People with obstructive sleep apnoea had a longer course of diabetes mellitus (P < 0.01) and a higher prevalence of retinopathy (P < 0.01), neuropathy (P = 0.05), cardiovascular disease (P < 0.01) and hypertension (P < 0.01). The occurrence of macrovascular complications was independently associated with the presence of OSA [odds ratio (OR) 8.28; 95% confidence interval (CI), 1.56-43.97; P = 0.013] and the duration of diabetes (OR 1.08; 95% CI, 1.02-1.15; P = 0.01). Moreover, retinopathy was independently associated with OSA (OR 4.54; 95% CI, 1.09-18.82; P = 0.04) and the duration of diabetes (OR 1.09; 95% CI, 1.04-1.15; P = 0.001). CONCLUSIONS: The prevalence of obstructive sleep apnoea was high in people with Type 1 diabetes. Obstructive sleep apnoea was independently associated with macrovascular complications and retinopathy. Obesity and excessive daytime sleepiness were uncommon in this population.

Structural and content diversity of mitochondrial genome in beet: a comparative genomic analysis.

Despite their monophyletic origin, mitochondrial (mt) genomes of plants and animals have developed contrasted evolutionary paths over time. Animal mt genomes are generally small, compact, and exhibit high mutation rates, whereas plant mt genomes exhibit low mutation rates, little compactness, larger sizes, and highly rearranged structures. We present the (nearly) whole sequences of five new mt genomes in the Beta genus: four from Beta vulgaris and one from B. macrocarpa, a sister species belonging to the same Beta section. We pooled our results with two previously sequenced genomes of B. vulgaris and studied genome diversity at the species level with an emphasis on cytoplasmic male-sterilizing (CMS) genomes. We showed that, contrary to what was previously assumed, all three CMS genomes belong to a single sterile lineage. In addition, the CMSs seem to have undergone an acceleration of the rates of substitution and rearrangement. This study suggests that male sterility emergence might have been favored by faster rates of evolution, unless CMS itself caused faster evolution.

[Screening diabetic retinopathy using a telediagnosis system. Results of the upper Rhine survey]. / Dépistage de la rétinopathie diabétique par télédiagnostic dans le Haut-Rhin.

INTRODUCTION: The aim of this study was to present the results of diabetic retinopathy screening using a nonmydriatic fundus camera in the upper Rhine (France). METHOD: The screening period took place from September 2004 to December 2007. Patients came to three referring medical centers (Altkirch, Mulhouse, Thann) and all had three fundus photographs on both eyes without pupillary dilatation. The data were stored on a website. The photographs were then analyzed by the team of experts from the Department of Ophthalmology of the Mulhouse General Hospital. The results were sent to the general practitioner with treatment guidelines. The campaign was evaluated at the end of the screening period using a questionnaire. RESULTS: In this study, 1050 diabetics patients were screened: 18% had diabetic retinopathy; of these 1.5% had proliferative or serious nonproliferative diabetic retinopathies and 74.2% mild nonproliferative forms. The mean value of hemoglobin A1C was 9.3% (+/-2.55), the patients' mean age of patients was 61.5 (+/-14.3) years, and the mean onset of diabetes was 16.6 (+/-7.9) years before screening. After screening, 70% of the patients consulted an ophthalmologist. Ninety percent of the referent practitioners received the results of the screening. CONCLUSION: The diabetic retinopathy screening campaign in the upper Rhine provided a real benefit in terms of public health and prevention of diabetic retinal complications.

[Ocular complications of hepatitis C treatment]. / Complications ophtalmologiques du traitement de l'hépatite C.

INTRODUCTION: Hepatitis C is a viral infection that can lead to hepatocellular carcinoma. According to current recommendations, the treatment is based on the association of pegylated interferon and ribavirin. Strict treatment criteria are available and apply for the 8,000 patients diagnosed every year in France. Ophthalmological side effects are numerous, unpredictable, and sometimes severe. CASE REPORT: We report the case of a patient treated with an association of interferon and ribavirin for hepatitis C, who presented two periods of decreased visual acuity 4 years apart. Interferon-related toxic retinopathy was suggested for the first event, while optical neuropathy was diagnosed for the second. CONCLUSION: Ocular complications of hepatitis C treatment with interferon and ribavirin are frequent but often benign. Our recommendations are periodic ophthalmological examinations, including visual acuity and fundus examination, before starting the treatment, at 3 months, and if necessary at 9 months.

[Mediterranean spotted fever. Apropos of a case]. / La fièvre boutonneuse méditerranéenne. A propos d'un cas.

We report the case of a patient who presented an engigmatic chorioretinopathy. The rickettsial etiology was confirmed late. This case recalls the general ophthalmological features of Mediterranean spotted fever. The serology pattern and different clinical arguments led to diagnosis.

[Ocular involvement in dermatomyositis. Apropos of the case of a 15-year-old girl]. / Atteinte oculaire au cours de la dermatomyosite. A propos du cas d'une jeune fille de 15 ans.

We relate the case of a 15 years old girl who suffered a sudden and severe bilateral lowering of the eyesight, on the occasion of a dermatomyositis. The evolution, over a year, showed a remission of the systematic appearances but there was a limited recovery of the eyesight, the diffuse retinal lesions are the sign of a more extensive vascular problem, found in case of paediatric dermatomyositis.