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Dentel A, Boulanger E, Chapron T, Senicourt L, Metge F, Dureau P, Vignal-Clermont C, Caputo G, Martin GC. Incidence and Outcomes of Eye Trauma Associated with Recreative Use of Non-Powder Toy-Guns: a 12-years retrospective study. Am J Ophthalmol 2024:S0002-9394(24)00061-8. [PMID: 38373584 DOI: 10.1016/j.ajo.2024.02.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 02/01/2024] [Accepted: 02/07/2024] [Indexed: 02/21/2024]
Abstract
PURPOSE Non-powder toy-guns (NPTG) are responsible for many ocular traumas. This study aims to detail the outcomes of these injuries, depending on the causative NPTG. DESIGN Retrospective observational case series. METHODS Cases of NPTG-associated ocular trauma managed in a Parisian eye emergency department between August 1, 2010, and January 1, 2023, were reviewed. The date of trauma, causative NPTG, patient demographics, initial and follow-up eye examinations, any surgical procedure, and visual outcomes for each ocular trauma were analyzed RESULTS: Over 12 years, NPTG were responsible for 324 eye injuries and 980 visits. Patients were mostly males (77.5%), and mean age at trauma was 16.2 years. Foam bullets or foam darts blasters accounted for 54.9% of traumas and were mainly responsible for corneal injuries and hyphema (30.9% and 27%, respectively). BB-gun/airsoft guns were frequently responsible for anterior segment lesions, as well as intravitreal hemorrhages (14.7%) and commotio retinae (21.1%). Paintball guns accounted for the largest proportion of posterior segment lesions (such as intra- or subretinal hemorrhages leading to macular atrophy/contusion maculopathy), and one-third of casualties had undergone ocular surgery. Among all traumas, final visual acuity was lower than 20/200 in 6.5% of cases. Phthisis occurred in 8 cases: 2 were related to foam bullets or foam darts blaster injuries (1 contusion and 1 rupture), 2 other cases followed a rupture due to BB-guns/airsoft-guns, 1 case occurred after a rupture related to a paintball gunshot, and 3 others were due to other types of compressed air guns (1 rupture, 1 intraocular foreign body and 1 total retinal detachment). CONCLUSION NPTG-related ocular trauma outcomes differ according to the causative toy. Paintball guns and BB-guns/airsoft guns-related traumas were more likely to be associated with severe lesions, but an increasing number of ocular injuries related to the use of foam bullets or foam darts blasters are reported, in younger and younger children. Public health policies should promote the use of protective eyewear.
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Affiliation(s)
- Alexandre Dentel
- Ophthalmology Department, Rothschild Foundation Hospital, 29 Rue Manin, 75019 Paris, France; Institut de la Vision, INSERM, CNRS, Sorbonne Université, F-75012 Paris, France
| | - Etienne Boulanger
- Ophthalmology Department, Rothschild Foundation Hospital, 29 Rue Manin, 75019 Paris, France
| | - Thibaut Chapron
- Ophthalmology Department, Rothschild Foundation Hospital, 29 Rue Manin, 75019 Paris, France; Université Paris Cité, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRAE, F-75004, Paris, France
| | - Lucile Senicourt
- Data Science Unit, Rothschild Foundation Hospital, 29 Rue Manin, 75019 Paris, France
| | - Florence Metge
- Ophthalmology Department, Rothschild Foundation Hospital, 29 Rue Manin, 75019 Paris, France
| | - Pascal Dureau
- Ophthalmology Department, Rothschild Foundation Hospital, 29 Rue Manin, 75019 Paris, France
| | | | - Georges Caputo
- Ophthalmology Department, Rothschild Foundation Hospital, 29 Rue Manin, 75019 Paris, France
| | - Gilles C Martin
- Ophthalmology Department, Rothschild Foundation Hospital, 29 Rue Manin, 75019 Paris, France.
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Dentel A, Madani MB, Robert MP, Valleix S, Brémond-Gignac D, Daruich A. Optic Disc Hypoplasia Assessment in PAX6 -Related Aniridia. J Neuroophthalmol 2024:00041327-990000000-00553. [PMID: 38227763 DOI: 10.1097/wno.0000000000002083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
BACKGROUND This study aims to characterize optic disc hypoplasia in congenital aniridia using ultra-wide-field imaging (UWFI) and nonmydriatic retinal photography (NMRP). We also investigated the relation between optic disc hypoplasia and foveal hypoplasia. METHODS This is a retrospective case series of patients diagnosed with PAX6 -related aniridia in a National Referral Center, who underwent UWFI, NMRP, and spectral-domain optical coherence tomography (SD-OCT) . The disc diameter (DD) and the disc-to-fovea distance (DF) were measured. The DD:DF ratio was used to assess the relative size of the optic disc. The analyses were carried with respect to paired age- and sex-matched healthy controls. SD-OCT was used for foveal hypoplasia grading (from 1 to 4) and retinal nerve fiber layer (RNFL) analysis. RESULTS Mean manual DD:DF ratio was 0.33 (95% CI: 0.31-0.35) in aniridia patients versus 0.37 (95% CI: 0.36-0.39) in control patients (n = 20, P = 0.005) measured on NMRP and 0.32 (95% CI: 0.30-0.35) in aniridia patients versus 0.37 (95% CI: 0.37-0.39) in control patients (n = 26, P < 0.0001) when assessed on UWFI. Mean semiautomated DD:DF ratio measured on UWFI in aniridia patients was 0.31 (95% CI: 0.29-0.33) versus 0.37 (95% CI: 0.36-0.38) in control patients ( P < 0.0001). Also, a negative correlation was found significant between the grade of foveal hypoplasia and the mean semiautomated DD:DF ratio (r = -0.52, 95% CI: -0.76 to -0.15, P = 0.0067). Finally, a significant negative correlation was found between the peripapillary temporal RNFL thickness and the grade of foveal hypoplasia ( P = 0.0034). CONCLUSIONS The DD:DF ratio is significantly reduced in PAX6 -related aniridia patients and correlates with the severity of foveal hypoplasia. This ratio is a valuable tool for optic disc hypoplasia assessment in congenital aniridia, especially when provided semiautomatically by UWFI.
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Affiliation(s)
- Alexandre Dentel
- Ophthalmology Department (Alexandre Dentel, MBM, MPR, DB-G, Alejandra Daruich), Necker-Enfants Malades University Hospital, AP-HP, Paris Cité University, Paris, France; Borelli Centre (MPR), UMR 9010, CNRS-SSA-ENS Paris Saclay-Paris Cité University, Paris, France; INSERM (SV, DB-G, Alejandra Daruich), UMRS1138, Team 17, From Physiopathology of Ocular Diseases to Clinical Development, Paris Cité University, Centre de Recherche des Cordeliers, Paris, France; and Medecine Genomic Department of Systemic and Organ Diseases (SV), Cochin Hospital, APHP, Paris Cité University, Paris, France
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Abramowicz S, Dentel A, Chouraqui M, Bodaghi B, Touhami S. Atypical retinopathy in ataxia with vitamin E deficiency: report of a sibship. Neurogenetics 2024; 25:33-38. [PMID: 38105315 DOI: 10.1007/s10048-023-00741-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023]
Abstract
Typical retinitis pigmentosa (RP) may not be the only retinal phenotype encountered in ataxia with vitamin E deficiency (AVED). The following short case series describes a novel form of retinopathy in AVED. We describe two patients with AVED belonging to the same consanguineous sibship. Both presented an unusual retinopathy consisting of scattered, multifocal, nummular, hyperautofluorescent atrophic retinal patches. The retinopathy remained stable under vitamin E supplementation. We hypothesize these changes to be the result of arrested AVED-related RP following early supplementation with α-tocopherol acetate.
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Affiliation(s)
- Stéphane Abramowicz
- Department of Ophthalmology, IHU FOReSIGHT, Hôpital Universitaire Pitié-Salpêtrière, Sorbonne Université, 47-83 Boulevard de l'Hôpital, 75013, Paris, France.
| | - Alexandre Dentel
- Department of Ophthalmology, IHU FOReSIGHT, Hôpital Universitaire Pitié-Salpêtrière, Sorbonne Université, 47-83 Boulevard de l'Hôpital, 75013, Paris, France
| | - Maxime Chouraqui
- Department of Ophthalmology, IHU FOReSIGHT, Hôpital Universitaire Pitié-Salpêtrière, Sorbonne Université, 47-83 Boulevard de l'Hôpital, 75013, Paris, France
| | - Bahram Bodaghi
- Department of Ophthalmology, IHU FOReSIGHT, Hôpital Universitaire Pitié-Salpêtrière, Sorbonne Université, 47-83 Boulevard de l'Hôpital, 75013, Paris, France
| | - Sara Touhami
- Department of Ophthalmology, IHU FOReSIGHT, Hôpital Universitaire Pitié-Salpêtrière, Sorbonne Université, 47-83 Boulevard de l'Hôpital, 75013, Paris, France
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Dentel A, Brazhnikova E, Norberg N, Jaillard C, Grieve K, Paques M, Sahel JA, Bertin S, Forster V, Picaud S. Adaptive Optics Flood Illumination Ophthalmoscopy in Nonhuman Primates: Findings in Normal and Short-term Induced Detached Retinae. Ophthalmol Sci 2023; 3:100316. [PMID: 37274010 PMCID: PMC10238594 DOI: 10.1016/j.xops.2023.100316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 03/18/2023] [Accepted: 04/13/2023] [Indexed: 06/06/2023]
Abstract
Objective To describe adaptive optics flood illumination ophthalmoscopy (AO-FIO) of the photoreceptor layer in normal nonhuman primates (NHPs) and in the case of a short-term induced retinal detachment (RD). Design Longitudinal fundamental research study. Subjects Four NHPs were used to image normal retinae with AO-FIO (in comparison with 4 healthy humans); 2 NHPs were used to assess the effects of RD. Intervention The photoreceptor layer (cone mosaic metrics, including cone density, cone spacing, and cone regularity) was followed with AO-FIO imaging (rtx1, Imagine Eyes) during a surgically induced RD in 2 NHPs using a vehicle solution containing dimethyl sulfoxide, classically used as a chemical solvent. We also performed functional testing of the retina (full-field and multifocal electroretinogram [ERG]). Main Outcome Measures Correlation of cone mosaic metrics (cone density, spacing, and regularity) between normal retinae of NHPs and humans, and cone metrics, power spectrum, and ERG wave amplitudes after RD. Results Imaging features were very similar in terms of cone reflectivity, cell density, regularity, and spacing values, showing strong positive correlations between NHPs and humans. After RD, AO-FIO revealed several alterations of the cone mosaic slowly recovering during the 3 months after the reattachment, which were not detected functionally by ERG. Conclusions These results demonstrate by in vivo AO-FIO imaging the transient structural changes of photoreceptors after an RD in the primate retina. They also provide an interesting illustration of the AO-FIO potential for investigating photoreceptor toxicity during preclinical studies in NHPs with a high translatability to human studies. Financial Disclosures Proprietary or commercial disclosure may be found after the references.
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Affiliation(s)
- Alexandre Dentel
- Institut de la Vision, INSERM, CNRS, Sorbonne Université, Paris, France
| | - Elena Brazhnikova
- Institut de la Vision, INSERM, CNRS, Sorbonne Université, Paris, France
| | | | - Céline Jaillard
- Institut de la Vision, INSERM, CNRS, Sorbonne Université, Paris, France
| | - Kate Grieve
- CHNO des Quinze-Vingts, INSERM-DGOS CIC 1423, Paris, France
| | - Michel Paques
- Institut de la Vision, INSERM, CNRS, Sorbonne Université, Paris, France
- CHNO des Quinze-Vingts, INSERM-DGOS CIC 1423, Paris, France
| | - José A. Sahel
- Institut de la Vision, INSERM, CNRS, Sorbonne Université, Paris, France
- CHNO des Quinze-Vingts, INSERM-DGOS CIC 1423, Paris, France
- Department of Ophthalmology, University of Pittsburgh School of Medicine and Medical Center, Pittsburgh, Pennsylvania
| | | | - Valérie Forster
- Institut de la Vision, INSERM, CNRS, Sorbonne Université, Paris, France
| | - Serge Picaud
- Institut de la Vision, INSERM, CNRS, Sorbonne Université, Paris, France
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Dentel A, Touhami S, Bodaghi B. Sight Threat, Life Threat. Ophthalmol Retina 2023; 7:1122. [PMID: 37542499 DOI: 10.1016/j.oret.2023.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 07/08/2023] [Accepted: 07/13/2023] [Indexed: 08/07/2023]
Affiliation(s)
- Alexandre Dentel
- Ophthalmology Department, Pitié-Salpêtrière University Hospital, Paris, France; Institut de la Vision, INSERM, CNRS, Sorbonne Université, Paris, France
| | - Sara Touhami
- Ophthalmology Department, Pitié-Salpêtrière University Hospital, Paris, France; Institut de la Vision, INSERM, CNRS, Sorbonne Université, Paris, France
| | - Bahram Bodaghi
- Ophthalmology Department, Pitié-Salpêtrière University Hospital, Paris, France
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Dentel A, Tauziède-Espariat A, Daruich A. A Blinding Glioma. Ophthalmology 2023; 130:982. [PMID: 36266097 DOI: 10.1016/j.ophtha.2022.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 09/07/2022] [Accepted: 09/13/2022] [Indexed: 06/16/2023] Open
Affiliation(s)
- Alexandre Dentel
- Ophthalmology Department, Necker-Enfants Malades University Hospital, Assistance Publique, Hôpitaux de Paris, Paris, France.
| | - Arnault Tauziède-Espariat
- Neuropathology Department, GHU Paris Psychiatry and Neurosciences, Sainte-Anne Hospital, Paris, France
| | - Alejandra Daruich
- Ophthalmology Department, Necker-Enfants Malades University Hospital, Assistance Publique, Hôpitaux de Paris, Paris, France; Centre de Recherche des Cordeliers, Paris, France
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Dentel A, Ferrari M, Robert MP, Valleix S, Bremond-Gignac D, Daruich A. Optical Coherence Tomography Angiography Assessment in Congenital Aniridia. Am J Ophthalmol 2023; 253:44-48. [PMID: 37059316 DOI: 10.1016/j.ajo.2023.04.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Revised: 04/05/2023] [Accepted: 04/07/2023] [Indexed: 04/16/2023]
Abstract
PURPOSE This study aims to characterize foveal vasculature assessed by optical coherence tomography angiography (OCT-A) in congenital aniridia which is hallmarked by foveal hypoplasia (FH). DESIGN Cross-sectional case-control analysis. METHODS At the National Referral Center for congenital aniridia, patients with confirmed PAX6-related aniridia and FH diagnosed on spectral-domain OCT (SD-OCT) with available OCT-A and matched control subjects were included. OCT-A was performed in patients with aniridia and control subjects. Foveal avascular zone (FAZ) and vessel density (VD) were collected. VD in the foveal and parafoveal areas at the level of the superficial and deep capillary plexi (SCP and DCP, respectively) were compared between the 2 groups. In patients with congenital aniridia, correlation between VD and the grading of FH was assessed. RESULTS Among 230 patients with confirmed PAX6-related aniridia, high-quality macular B-scans and OCT-A were available in 10 patients. On the foveal area, mean VD was higher in aniridia patients (41.10%, n = 10) than in control subjects (22.65%, n = 10) at the level of the SCP and the DCP (P = .0020 and P = .0273, respectively). On the parafoveal area, mean VD was lower in patients with aniridia (42.34%, n = 10) than in healthy subjects (49.24%, n = 10) at the level of both plexi (P = .0098 and P = .0371, respectively). In patients with congenital aniridia, a positive correlation was found between the grading of FH and the foveal VD at the SCP (r = 0.77, P = .0106). CONCLUSIONS Vasculature is altered in PAX6-related congenital aniridia, higher in foveal and lower in parafoveal areas, especially when FH is severe, which is consistent with the concept that the absence of retinal blood vessels is essential for foveal pit development.
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Affiliation(s)
- Alexandre Dentel
- From the Ophthalmology Department (A.D., M.F., M.P.R., D.B-G., A.D.), Necker-Enfants Malades University Hospital, Paris.
| | - Marco Ferrari
- From the Ophthalmology Department (A.D., M.F., M.P.R., D.B-G., A.D.), Necker-Enfants Malades University Hospital, Paris
| | - Matthieu P Robert
- From the Ophthalmology Department (A.D., M.F., M.P.R., D.B-G., A.D.), Necker-Enfants Malades University Hospital, Paris; Borelli Centre (M.P.R.), UMR 9010, CNRS-SSA-ENS Paris Saclay-Paris Cité University, Paris
| | - Sophie Valleix
- INSERM (S.V., D.B-G., A.D.), UMRS1138, Team 17, From Physiopathology of Ocular Diseases to Clinical Development, Sorbonne Paris Cité University, Centre de Recherche des Cordeliers, Paris; Genomic Medicine Department of Systemic and Organ Diseases (S.V.), Cochin Hospital, Paris City University, Paris, France
| | - Dominique Bremond-Gignac
- From the Ophthalmology Department (A.D., M.F., M.P.R., D.B-G., A.D.), Necker-Enfants Malades University Hospital, Paris; INSERM (S.V., D.B-G., A.D.), UMRS1138, Team 17, From Physiopathology of Ocular Diseases to Clinical Development, Sorbonne Paris Cité University, Centre de Recherche des Cordeliers, Paris
| | - Alejandra Daruich
- From the Ophthalmology Department (A.D., M.F., M.P.R., D.B-G., A.D.), Necker-Enfants Malades University Hospital, Paris; INSERM (S.V., D.B-G., A.D.), UMRS1138, Team 17, From Physiopathology of Ocular Diseases to Clinical Development, Sorbonne Paris Cité University, Centre de Recherche des Cordeliers, Paris
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Ail D, Nava D, Hwang IP, Brazhnikova E, Nouvel-Jaillard C, Dentel A, Joffrois C, Rousseau L, Dégardin J, Bertin S, Sahel JA, Goureau O, Picaud S, Dalkara D. Inducible nonhuman primate models of retinal degeneration for testing end-stage therapies. Sci Adv 2023; 9:eadg8163. [PMID: 37531424 PMCID: PMC10396314 DOI: 10.1126/sciadv.adg8163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 06/29/2023] [Indexed: 08/04/2023]
Abstract
The anatomical differences between the retinas of humans and most animal models pose a challenge for testing novel therapies. Nonhuman primate (NHP) retina is anatomically closest to the human retina. However, there is a lack of relevant NHP models of retinal degeneration (RD) suitable for preclinical studies. To address this unmet need, we generated three distinct inducible cynomolgus macaque models of RD. We developed two genetically targeted strategies using optogenetics and CRISPR-Cas9 to ablate rods and mimic rod-cone dystrophy. In addition, we created an acute model by physical separation of the photoreceptors and retinal pigment epithelium using a polymer patch. Among the three models, the CRISPR-Cas9-based approach was the most advantageous model in view of recapitulating disease-specific features and its ease of implementation. The acute model, however, resulted in the fastest degeneration, making it the most relevant model for testing end-stage vision restoration therapies such as stem cell transplantation.
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Affiliation(s)
- Divya Ail
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, F-75012 Paris, France
| | - Diane Nava
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, F-75012 Paris, France
| | - In Pyo Hwang
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, F-75012 Paris, France
| | - Elena Brazhnikova
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, F-75012 Paris, France
| | | | - Alexandre Dentel
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, F-75012 Paris, France
- CHNO des Quinze-Vingts, INSERM-DGOS CIC 1423, F-75012 Paris, France
- Department of Ophthalmology, Pitié-Salpêtrière University Hospital, F-75013 Paris, France
| | - Corentin Joffrois
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, F-75012 Paris, France
| | - Lionel Rousseau
- ESYCOM, Université Eiffel, CNRS, CNAM, ESIEE Paris, F-77454 Marne-la-Vallée, France
| | - Julie Dégardin
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, F-75012 Paris, France
| | - Stephane Bertin
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, F-75012 Paris, France
- CHNO des Quinze-Vingts, INSERM-DGOS CIC 1423, F-75012 Paris, France
| | - José-Alain Sahel
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, F-75012 Paris, France
- CHNO des Quinze-Vingts, INSERM-DGOS CIC 1423, F-75012 Paris, France
- Department of Ophthalmology, The University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
- Fondation Ophtalmologique Adolphe de Rothschild, F-75019 Paris, France
| | - Olivier Goureau
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, F-75012 Paris, France
| | - Serge Picaud
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, F-75012 Paris, France
| | - Deniz Dalkara
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, F-75012 Paris, France
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Parreau S, Dentel A, Mhenni R, Dumonteil S, Régent A, Gondran G, Monnet D, Brézin AP, Ly KH, Liozon É, Sené T, Terrier B. Clinical, biological, and ophthalmological characteristics differentiating arteritic from non-arteritic anterior ischaemic optic neuropathy. Eye (Lond) 2023; 37:2095-2100. [PMID: 36273039 PMCID: PMC10333225 DOI: 10.1038/s41433-022-02295-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Revised: 09/27/2022] [Accepted: 10/13/2022] [Indexed: 11/08/2022] Open
Abstract
BACKGROUND/AIMS To identify characteristics that can distinguish AAION from NAAION in emergency practice. METHODS This is a multicentre retrospective case-control study. Ninety-four patients with AAION were compared to ninety-four consecutive patients with NAAION. We compared the clinical, biological, and ophthalmological characteristics at baseline of patients with AAION and those with NAAION. RESULTS Patients with AAION were older and more likely to have arterial hypertension. Cephalic symptoms and acute-phase reactants were more frequent in AAION. Profound vision loss and bilateral involvement were more frequent in AAION at baseline. Central retinal and cilioretinal artery occlusions was only observed in AAION, and delayed choroidal perfusion was more frequently observed in AAION than in NAAION. Using logistic regression, an age >70 years (OR = 3.4, IC95% = 0.8-16.1, p = 0.105), absence of splinter haemorrhage (OR = 4.9, IC95% = 1.4-20.5, p = 0.019), delayed choroidal perfusion (OR = 7.2, IC95% = 2.0-28.0, p = 0.003), CRP > 7 mg/L (OR = 43.6, IC95% = 11.6-229.1, p < 0.001) and platelets >400 × G/L (OR = 27.5, IC95% = 4.6-270.9, p = 0.001) were independently associated with a diagnosis of AAION. An easy-to-use score based on these variables accurately distinguished AAION from NAAION with a sensitivity of 93.3% and specificity of 92.4%. CONCLUSION In patients presenting with AION, a set of ophthalmological and laboratory criteria can efficiently discriminate patients with AAION and NAAION and can identify which patients would benefit from high-dose glucocorticoids. External validation of our results is required.
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Affiliation(s)
- Simon Parreau
- Department of Internal Medicine, Paris Descartes University, Referral Center for Rare Autoimmune and Systemic Diseases, Hôpital Cochin, Paris, France.
- Department of Internal Medicine, Hôpital Dupuytren, Limoges, France.
| | - Alexandre Dentel
- Department of Ophthalmology, Fondation Adolphe-de-Rothschild hospital, Paris, France
| | - Rania Mhenni
- Université de Paris, Department of Ophthalmology, Hôpital Cochin, Paris, France
| | | | - Alexis Régent
- Department of Internal Medicine, Paris Descartes University, Referral Center for Rare Autoimmune and Systemic Diseases, Hôpital Cochin, Paris, France
| | | | - Dominique Monnet
- Université de Paris, Department of Ophthalmology, Hôpital Cochin, Paris, France
| | - Antoine P Brézin
- Université de Paris, Department of Ophthalmology, Hôpital Cochin, Paris, France
| | - Kim-Heang Ly
- Department of Internal Medicine, Hôpital Dupuytren, Limoges, France
| | - Éric Liozon
- Department of Internal Medicine, Hôpital Dupuytren, Limoges, France
| | - Thomas Sené
- Department of Internal Medicine, Fondation Adolphe-de-Rothschild hospital, Paris, France
| | - Benjamin Terrier
- Department of Internal Medicine, Paris Descartes University, Referral Center for Rare Autoimmune and Systemic Diseases, Hôpital Cochin, Paris, France
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Martin GC, Boulanger E, Maalej R, Partouche S, Dentel A, Grosselin M, Ettayeb R, Chapron T, Caputo G, Vignal-Clermont C. Specificities of pediatric ocular emergencies before and during the COVID-19 era: A retrospective comparative study in an eye-related emergency department in Paris. Arch Pediatr 2023:S0929-693X(23)00095-7. [PMID: 37394362 DOI: 10.1016/j.arcped.2023.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 02/05/2023] [Accepted: 06/04/2023] [Indexed: 07/04/2023]
Abstract
INTRODUCTION Epidemiological data on the use of eye-related emergency services by children are limited. The objective of this study was to determine how COVID-19 affected the epidemiological trends of pediatric ocular emergencies. METHODS We performed a retrospective chart review of children under the age of 18 years who visited our eye-related emergency department between March 17 and June 7, 2020 and between March 18 and June 9, 2019. This was a descriptive and comparative analysis of the two study periods based on the demographic characteristics of patients and the diagnosis reported by the ophthalmologist in the digital medical charts. One of the investigators performed a second reading of the files to homogenize the diagnosis classification based on the most frequently found items. RESULTS In total, 754 children were seen in our eye-related emergency department during the 2020 study period versus 1399 in 2019, representing a 46% decrease. In 2019, the four main diagnoses were traumatic injury (30%), allergic conjunctivitis (15%), infectious conjunctivitis (12%), and chalazion/blepharitis (12%). In the 2020 study period there was a significant decrease in the proportion of patients presenting with traumatic injuries (p < 0.001), infectious conjunctivitis (p = 0.03), and chalazion/blepharitis (p < 0.001). Consultations for chalazion/blepharitis were the most affected by the pandemic, followed by traumatic injuries (-72% and -64%, respectively). The proportion of patients who required surgery after trauma was higher in 2020 than in 2019 (p < 0.01), but the absolute number of severe trauma cases remained stable. CONCLUSIONS The COVID-19 pandemic was accompanied by a decrease in the overall use of a pediatric eye-related emergency services in Paris. Visits due to benign causes and ocular trauma also decreased, but visits for more severe pathologies were not affected. Longer-term epidemiological studies may confirm or refute a change in eye emergency department use habits.
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Affiliation(s)
- Gilles C Martin
- Rothschild Foundation Hospital, Ophthalmology Department, Paris, France.
| | - Etienne Boulanger
- Rothschild Foundation Hospital, Ophthalmology Department, Paris, France
| | - Rim Maalej
- Rothschild Foundation Hospital, Ophthalmology Department, Paris, France
| | - Sarah Partouche
- Rothschild Foundation Hospital, Ophthalmology Department, Paris, France
| | - Alexandre Dentel
- Rothschild Foundation Hospital, Ophthalmology Department, Paris, France
| | | | - Rizlene Ettayeb
- Rothschild Foundation Hospital, Ophthalmology Department, Paris, France
| | - Thibaut Chapron
- Rothschild Foundation Hospital, Ophthalmology Department, Paris, France
| | - Georges Caputo
- Rothschild Foundation Hospital, Ophthalmology Department, Paris, France
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Dentel A, Boulanger E, Vignal-Clermont C, Caputo G, Martin GC. Incidence of Eye Trauma in Children Associated With Foam Bullets or Foam Darts From Nonpowder Guns. JAMA Ophthalmol 2023; 141:604-605. [PMID: 37166783 PMCID: PMC10176182 DOI: 10.1001/jamaophthalmol.2023.1464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 03/20/2023] [Indexed: 05/12/2023]
Abstract
This case series estimates the annual incidence of pediatric eye injuries associated with recreational use of nonpowder guns at an ophthalmologic emergency department in France.
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Affiliation(s)
- Alexandre Dentel
- Ophthalmology Department, Rothschild Foundation Hospital, Paris, France
| | - Etienne Boulanger
- Ophthalmology Department, Rothschild Foundation Hospital, Paris, France
| | | | - Georges Caputo
- Ophthalmology Department, Rothschild Foundation Hospital, Paris, France
| | - Gilles C. Martin
- Ophthalmology Department, Rothschild Foundation Hospital, Paris, France
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12
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Dentel A, Bremond-Gignac D, Robert MP. Intravitreal Glioma in a Boy Aged 7 Years. JAMA Ophthalmol 2023; 141:e230083. [PMID: 37199810 DOI: 10.1001/jamaophthalmol.2023.0083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Affiliation(s)
- Alexandre Dentel
- Service d'Ophtalmologie, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Dominique Bremond-Gignac
- Service d'Ophtalmologie, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France
- Centre Borelli, Centre National de la Recherche Scientifique-Ecole Normale Supérieure, Paris Saclay-Service de Santé des Armées-Université de Paris, Paris, France
| | - Matthieu P Robert
- Service d'Ophtalmologie, Hôpital Necker-Enfants Malades, Assistance Publique-Hôpitaux de Paris, Paris, France
- Centre Borelli, Centre National de la Recherche Scientifique-Ecole Normale Supérieure, Paris Saclay-Service de Santé des Armées-Université de Paris, Paris, France
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13
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Dentel A, Vignal Clermont C, Hage R. Néovaisseaux péripapillaires dans des hypertensions intracrâniennes idiopathiques : diagnostic et évolution sous traitement. Rev Neurol (Paris) 2023. [DOI: 10.1016/j.neurol.2023.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/29/2023]
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Fabre S, Bourmaud M, Mabilleau G, Goulet R, Couturier A, Dentel A, Picaud S, Funck‐Brentano T, Collet C, Cohen‐Solal M. Lrp5
p.
Val667Met
variant compromises bone mineral density and matrix properties in osteoporosis. JBMR Plus 2023. [DOI: 10.1002/jbm4.10741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/17/2023] Open
Affiliation(s)
- Stéphanie Fabre
- INSERM U1132 Bioscar, Université Paris Cité Paris France
- Department of Rheumatology, APHP Lariboisière Hospital Paris France
| | | | | | - Ruben Goulet
- Sorbonne Université, INSERM, CNRS, Institut de la Vision Paris France
| | - Aude Couturier
- Ophthalmology Department Université Paris Cité, AP‐HP, Lariboisière Hospital Paris France
| | - Alexandre Dentel
- Sorbonne Université, INSERM, CNRS, Institut de la Vision Paris France
| | - Serge Picaud
- Sorbonne Université, INSERM, CNRS, Institut de la Vision Paris France
| | - Thomas Funck‐Brentano
- INSERM U1132 Bioscar, Université Paris Cité Paris France
- Department of Rheumatology, APHP Lariboisière Hospital Paris France
| | - Corinne Collet
- INSERM U1132 Bioscar, Université Paris Cité Paris France
- Molecular Genetic department Robert Debré Hospital Paris France
| | - Martine Cohen‐Solal
- INSERM U1132 Bioscar, Université Paris Cité Paris France
- Department of Rheumatology, APHP Lariboisière Hospital Paris France
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Dentel A, Koch E. Keratitis due to global warming. J Fr Ophtalmol 2023; 46:201. [PMID: 36653254 DOI: 10.1016/j.jfo.2022.09.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 09/08/2022] [Indexed: 01/17/2023]
Affiliation(s)
- A Dentel
- Service d'ophtalmologie, centre hospitalier de Versailles, 1, rue Richaud, 78000 Versailles, France.
| | - E Koch
- Service d'ophtalmologie, centre hospitalier de Versailles, 1, rue Richaud, 78000 Versailles, France; Inserm, centre d'investigation clinique 1423, centre hospitalier national des Quinze-Vingts, université Pierre-et-Marie-Curie - Paris 6, 75012 Paris, France
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Dentel A, Koch E. Thrombectomy: An unexpected retinochoroidal journey. J Fr Ophtalmol 2022; 45:836-838. [DOI: 10.1016/j.jfo.2021.09.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 09/06/2021] [Accepted: 09/22/2021] [Indexed: 10/18/2022]
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17
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Dentel A, Brémond-Gignac D, Daruich A. Human T-Lymphotropic Virus 1-Related Retinal Vasculitis in Adult T-Cell Lymphoma. Ophthalmol Retina 2022; 6:795. [PMID: 36084994 DOI: 10.1016/j.oret.2022.05.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 05/11/2022] [Accepted: 05/13/2022] [Indexed: 06/15/2023]
Affiliation(s)
- Alexandre Dentel
- Ophthalmology Department, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris University, Paris, France
| | - Dominique Brémond-Gignac
- Ophthalmology Department, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris University, Paris, France; Inserm, UMRS1138, Centre de Recherche des Cordeliers, Paris, France
| | - Alejandra Daruich
- Ophthalmology Department, Necker-Enfants Malades University Hospital, Assistance Publique-Hôpitaux de Paris, Paris University, Paris, France; Inserm, UMRS1138, Centre de Recherche des Cordeliers, Paris, France
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Dentel A, Clavel G, Savatovsky J, Vignal C, Senè T, Charbonneau F, Zuber K, Lecler A, Hage R. Use of Retinal Angiography and MRI in the Diagnosis of Giant Cell Arteritis With Early Ophthalmic Manifestations. J Neuroophthalmol 2022; 42:218-225. [PMID: 35051984 DOI: 10.1097/wno.0000000000001517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Giant cell arteritis (GCA) is a vasculitis often revealed by visual signs. Diagnosis is challenging and urgent. Retinal angiography (RA) and MRI allow effective diagnosis. We compared those and proposed an imaging-based approach to diagnose GCA in ophthalmological practice. METHODS We conducted a retrospective study based on the data collected from patients suspected to have GCA on ophthalmological findings. Fluorescein (FA) and indocyanine green (ICG) RAs and MRI were performed and compared with final diagnosis. RESULTS Among the 41 patients included, 25 were diagnosed with GCA. Sensitivities and specificities of FA and ICG were not different. MRI showed a higher sensitivity and specificity. The approach consisting in performing RA followed by MRI provided a better accuracy. CONCLUSION Our study shows that RA can be supplemented by MRI in a specialized center to provide the most accurate diagnosis in GCA revealed by visual signs.
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Affiliation(s)
- Alexandre Dentel
- Department of Ophthalmology (AD, CV, RH), Foundation Adolphe de Rothschild Hospital, Paris, France; Department of Internal Medicine (GC, TS), Foundation Adolphe de Rothschild Hospital, Paris, France; Department of Neuroradiology (JS, FC, AL), Foundation Adolphe de Rothschild Hospital, Paris, France ; and Department of Clinical Research (KZ), Foundation Adolphe de Rothschild Hospital, Paris, France
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Dentel A, Speybrouck A, Koch E. [Between Roth spots and cotton-wool spots]. J Fr Ophtalmol 2022; 45:559-563. [PMID: 35331560 DOI: 10.1016/j.jfo.2021.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 10/06/2021] [Accepted: 11/18/2021] [Indexed: 10/18/2022]
Affiliation(s)
- A Dentel
- Service d'ophtalmologie, hôpital André-Mignot, 177, rue de Versailles, 78150 Le Chesnay-Rocquencourt, France.
| | - A Speybrouck
- Service d'ophtalmologie, hôpital André-Mignot, 177, rue de Versailles, 78150 Le Chesnay-Rocquencourt, France
| | - E Koch
- Service d'ophtalmologie, hôpital André-Mignot, 177, rue de Versailles, 78150 Le Chesnay-Rocquencourt, France
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