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Navel V, Labetoulle M, Lazreg S, Brémond-Gignac D, Chiambaretta F. COVID-19 pandemic and impact of universal face mask wear on ocular surface health and risk of infection. J Fr Ophtalmol 2024; 47:104170. [PMID: 38569271 DOI: 10.1016/j.jfo.2024.104170] [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: 10/24/2023] [Accepted: 02/17/2024] [Indexed: 04/05/2024]
Abstract
Universal mask wear is an effective public health intervention to reduce SARS-Cov-2 transmission, especially in enclosed public spaces and healthcare environments. Concerns have been raised about possible transmission of the SARS-Cov-2 through ocular secretions, leading to enhanced protective measures during ophthalmic procedures. However, there is some evidence for air jets from the upper edge of the surgical mask to the ocular surface, especially when the mask is not well fit. Prolonged airflow towards the ocular surface during expiration may alter tear-film stability, leading to hyperosmolarity and ocular surface inflammation. This also raises the question of whether the ocular surface is contaminated with oral flora from airflow directed toward the eyes, thus increasing the risk of ocular infection. Herein we review the impact of patient face mask wear on the ocular surface, eyelids and risk of ocular infection, particularly during ocular surgery. There is some evidence for increased incidence of dry eye or eyelid disease during periods of mandatory face mask wear. While high daily exposure is consistent with a direct association, this should be mitigated by various cofounding factors which could also affect the ocular health during the COVID-19 pandemic. An increased risk of post-intravitreal injection endophthalmitis, possibly due to face mask wear by the patient, including culture-positive endophthalmitis, has been reported in one retrospective study. Several measures have been shown to prevent or limit the risk of developing dry eye disease or exacerbation, eyelid cyst, and ocular infection during intravitreal injections.
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Affiliation(s)
- V Navel
- CHU Gabriel-Montpied, Clermont-Ferrand, France
| | - M Labetoulle
- Service d'ophtalmologie, hôpital Bicêtre, Assistance publique-Hôpitaux de Paris, Le Kremlin Bicêtre, France
| | - S Lazreg
- Centre d'ophtalmologie Lazreg, Blida, Algeria
| | - D Brémond-Gignac
- Hôpital universitaire Necker-Enfants Malades, AP-HP, 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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Sounthakith V, Kolb F, Bennedjai A, Orbach D, Picard A, Belhous K, Brémond-Gignac D, Kadlub N. Orbital exenteration reconstruction using a superficial temporalis muscle flap: The "Carpaccio flap", an innovative approach. J Stomatol Oral Maxillofac Surg 2023; 124:101490. [PMID: 37146792 DOI: 10.1016/j.jormas.2023.101490] [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] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Revised: 05/01/2023] [Accepted: 05/03/2023] [Indexed: 05/07/2023]
Abstract
INTRODUCTION Malignant orbital diseases may lead surgeons to practice an orbital exenteration associated with chemotherapy and/or radiotherapy to ensure curative treatment. That radical procedure makes physicians consider reconstructive filling in order to allow prothesis wearing and reduce esthetic and social after-effects. We first describe the clinical case of a 6-year-old patient who presented an orbital rhabdomyosarcoma and underwent an orbital exenteration with immediate reconstruction by a superficial temporal pedicled on the middle temporalis muscle flap. TECHNICAL NOTE Through that case-report, we propose an original temporal flap to repair ipsilateral midface defects which may reduce donor site side effects and allow furthers corrections. DISCUSSION In pediatrics cases, our Carpaccio flap was an available regional tool to rehabilitate an irradiated orbital socket with an appropriate bulking and vascularization effect after subtotal exenteration. Furthermore, we prescribe that flap as a posterior orbital filling, when eyelid and conjunctiva are spared, to prepare orbital prosthesis implementation. A mild sunken temporal fossa appears with our procedure but by preserving the deep layer of the temporalis muscle, autologous reconstruction such as lipofilling are permitted in post-radiotherapy condition to enhance esthetic sequelae.
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Affiliation(s)
- V Sounthakith
- Unit of Maxillofacial and Plastic Surgery, Reference Center for Cleft and Facial Malformation, Necker Children Hospital, AP-HP, Paris, France; Faculty of Health, Université Paris Cité, Paris, France.
| | - F Kolb
- Department of Plastic Surgery, UCSD, San Diego, CA, USA
| | - A Bennedjai
- Department of Ophthalmology, Quinze-Vingts National Ophtalmology Hospital, Paris, France
| | | | - A Picard
- Unit of Maxillofacial and Plastic Surgery, Reference Center for Cleft and Facial Malformation, Necker Children Hospital, AP-HP, Paris, France; Faculty of Health, Université Paris Cité, Paris, France
| | - K Belhous
- Department of Pediatric Radiology, Necker Children Hospital, AP-HP, Paris, France
| | - D Brémond-Gignac
- Faculty of Health, Université Paris Cité, Paris, France; Ophthalmology Department, Necker Children Hospital, AP-HP, Paris, France
| | - N Kadlub
- Unit of Maxillofacial and Plastic Surgery, Reference Center for Cleft and Facial Malformation, Necker Children Hospital, AP-HP, Paris, France; Faculty of Health, Université Paris Cité, Paris, France
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Thorel D, Ingen-Housz-Oro S, Benaïm D, Daien V, Gabison E, Saunier V, Béral L, Touboul D, Brémond-Gignac D, Robert M, Vasseur R, Royer G, Dereure O, Milpied B, Bernier C, Welfringer-Morin A, Bodemer C, Cordel N, Tauber M, Burillon C, Servant M, Couret C, Vabres B, Tétart F, Cassagne M, Kuoch MA, Muraine M, Delcampe A, Gueudry J. Ocular sequelae of epidermal necrolysis: French national audit of practices, literature review and proposed management. Orphanet J Rare Dis 2023; 18:51. [PMID: 36906580 PMCID: PMC10007779 DOI: 10.1186/s13023-023-02616-6] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Accepted: 01/15/2023] [Indexed: 03/13/2023] Open
Abstract
Stevens-Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN) are serious and rare diseases, most often drug-induced, and their incidence has been estimated at 6 cases/million/year in France. SJS and TEN belong to the same spectrum of disease known as epidermal necrolysis (EN). They are characterized by more or less extensive epidermal detachment, associated with mucous membrane involvement, and may be complicated during the acute phase by fatal multiorgan failure. SJS and TEN can lead to severe ophthalmologic sequelae. There are no recommendations for ocular management during the chronic phase. We conducted a national audit of current practice in the 11 sites of the French reference center for toxic bullous dermatoses and a review of the literature to establish therapeutic consensus guidelines. Ophthalmologists and dermatologists from the French reference center for epidermal necrolysis were asked to complete a questionnaire on management practices in the chronic phase of SJS/TEN. The survey focused on the presence of a referent ophthalmologist at the center, the use of local treatments (artificial tears, corticosteroid eye drops, antibiotic-corticosteroids, antiseptics, vitamin A ointment (VA), cyclosporine, tacrolimus), the management of trichiatic eyelashes, meibomian dysfunction, symblepharons, and corneal neovascularization, as well as the contactologic solutions implemented. Eleven ophthalmologists and 9 dermatologists from 9 of the 11 centers responded to the questionnaire. Based on questionnaire results, 10/11 ophthalmologists systematically prescribed preservative-free artificial tears, and 11/11 administered VA. Antiseptic or antibiotic eye drops or antibiotic-corticosteroid eye drops were recommended as needed by 8/11 and 7/11 ophthalmologists, respectively. In case of chronic inflammation, topical cyclosporine was consistently proposed by 11/11 ophthalmologists. The removal of trichiatic eyelashes was mainly performed by 10/11 ophthalmologists. Patients were referred to a reference center for fitting of scleral lenses (10/10,100%). Based on this practice audit and literature review, we propose an evaluation form to facilitate ophthalmic data collection in the chronic phase of EN and we also propose an algorithm for the ophthalmologic management of ocular sequelae.
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Affiliation(s)
- Dhyna Thorel
- Ophthalmology Department, CHU Charles Nicolle Rouen, Rouen, France.
- Reference Center for Toxic Bullous Dermatoses and Severe Drug Reactions TOXIBUL, Créteil, France.
| | - Saskia Ingen-Housz-Oro
- Reference Center for Toxic Bullous Dermatoses and Severe Drug Reactions TOXIBUL, Créteil, France
- Dermatology Department, AP-HP, Henri Mondor Hospital, Univ Paris Est Créteil EpidermE, Créteil, France
| | - Daniel Benaïm
- Reference Center for Toxic Bullous Dermatoses and Severe Drug Reactions TOXIBUL, Créteil, France
- Ophthalmology Department, AP-HP, Henri Mondor Hospital, Créteil, France
| | - Vincent Daien
- Reference Center for Toxic Bullous Dermatoses and Severe Drug Reactions TOXIBUL, Créteil, France
- Ophthalmology Department CHU Montpellier, Montpellier, France
| | - Eric Gabison
- 6Ophthalmology Department, Hôpital Fondation Adolphe de Rothschild, Paris, France
| | - Valentine Saunier
- Reference Center for Toxic Bullous Dermatoses and Severe Drug Reactions TOXIBUL, Créteil, France
- Ophthalmology Department, CHU Bordeaux, Bordeaux, France
| | - Laurence Béral
- Reference Center for Toxic Bullous Dermatoses and Severe Drug Reactions TOXIBUL, Créteil, France
- Ophthalmology Department, CHU Pointe À Pitre, Pointe À Pitre, Guadeloupe, France
| | - David Touboul
- Reference Center for Toxic Bullous Dermatoses and Severe Drug Reactions TOXIBUL, Créteil, France
- Ophthalmology Department, CHU Bordeaux, Bordeaux, France
| | - Dominique Brémond-Gignac
- Reference Center for Toxic Bullous Dermatoses and Severe Drug Reactions TOXIBUL, Créteil, France
- Ophthalmology Department, Hôpital Universitaire Necker Enfants-Malades, APHP, Paris, France
| | - Matthieu Robert
- Reference Center for Toxic Bullous Dermatoses and Severe Drug Reactions TOXIBUL, Créteil, France
- Ophthalmology Department, Hôpital Universitaire Necker Enfants-Malades, APHP, Paris, France
| | - Robin Vasseur
- Reference Center for Toxic Bullous Dermatoses and Severe Drug Reactions TOXIBUL, Créteil, France
- Ophthalmology Department, CHU de Nantes, Nantes, France
| | - Gérard Royer
- Reference Center for Toxic Bullous Dermatoses and Severe Drug Reactions TOXIBUL, Créteil, France
- Ophthalmology Department, AP-HP, Henri Mondor Hospital, Créteil, France
| | - Olivier Dereure
- Reference Center for Toxic Bullous Dermatoses and Severe Drug Reactions TOXIBUL, Créteil, France
- Dermatology Department, CHU Montpellier, Montpellier, France
| | - Brigitte Milpied
- Reference Center for Toxic Bullous Dermatoses and Severe Drug Reactions TOXIBUL, Créteil, France
- Dermatology Department, CHU Bordeaux, Bordeaux, France
| | - Claire Bernier
- Reference Center for Toxic Bullous Dermatoses and Severe Drug Reactions TOXIBUL, Créteil, France
- Dermatology Department, CHU Nantes, Nantes, France
| | - Anne Welfringer-Morin
- Reference Center for Toxic Bullous Dermatoses and Severe Drug Reactions TOXIBUL, Créteil, France
- Dermatology Department, AP-HP, Hôpital Universitaire Necker Enfants-Malades, APHP, Paris, France
| | - Christine Bodemer
- Reference Center for Toxic Bullous Dermatoses and Severe Drug Reactions TOXIBUL, Créteil, France
- Dermatology Department, AP-HP, Hôpital Universitaire Necker Enfants-Malades, APHP, Paris, France
| | - Nadège Cordel
- Reference Center for Toxic Bullous Dermatoses and Severe Drug Reactions TOXIBUL, Créteil, France
- Dermatology and Clinical Immunology Department, CHU Guadeloupe, Pointe À Pitre, , Guadeloupe, France
| | - Marie Tauber
- Reference Center for Toxic Bullous Dermatoses and Severe Drug Reactions TOXIBUL, Créteil, France
- Dermatology Department, CHU de Toulouse, Toulouse, France
| | - Carole Burillon
- Reference Center for Toxic Bullous Dermatoses and Severe Drug Reactions TOXIBUL, Créteil, France
- Ophthalmolgy Department, CHU Lyon, Lyon, France
| | - Marion Servant
- Reference Center for Toxic Bullous Dermatoses and Severe Drug Reactions TOXIBUL, Créteil, France
- Ophthalmology Department, CHU de Nantes, Nantes, France
| | - Chloe Couret
- Reference Center for Toxic Bullous Dermatoses and Severe Drug Reactions TOXIBUL, Créteil, France
- Ophthalmology Department, CHU de Nantes, Nantes, France
| | - Bertrand Vabres
- Reference Center for Toxic Bullous Dermatoses and Severe Drug Reactions TOXIBUL, Créteil, France
- Ophthalmology Department, CHU de Nantes, Nantes, France
| | - Florence Tétart
- Ophthalmology Department, CHU Charles Nicolle Rouen, Rouen, France
- Dermatology Department, CHU Charles Nicolle Rouen, Rouen, France
| | - Myriam Cassagne
- Reference Center for Toxic Bullous Dermatoses and Severe Drug Reactions TOXIBUL, Créteil, France
- Ophthalmology Department, CHU de Toulouse, Toulouse, France
| | - Marie-Ange Kuoch
- Reference Center for Toxic Bullous Dermatoses and Severe Drug Reactions TOXIBUL, Créteil, France
- Ophthalmology Department, AP-HP, Henri Mondor Hospital, Créteil, France
| | - Marc Muraine
- Ophthalmology Department, CHU Charles Nicolle Rouen, Rouen, France
- Reference Center for Toxic Bullous Dermatoses and Severe Drug Reactions TOXIBUL, Créteil, France
| | - Agnès Delcampe
- Ophthalmology Department, CHU Charles Nicolle Rouen, Rouen, France
- Reference Center for Toxic Bullous Dermatoses and Severe Drug Reactions TOXIBUL, Créteil, France
| | - Julie Gueudry
- Ophthalmology Department, CHU Charles Nicolle Rouen, Rouen, France
- Reference Center for Toxic Bullous Dermatoses and Severe Drug Reactions TOXIBUL, Créteil, France
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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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Fayet B, Racy E, Ruban JM, Katowitz JA, Katowitz WR, Brémond-Gignac D. Preloaded Monoka (Lacrijet) and congenital nasolacrimal duct obstruction: Initial results. J Fr Ophtalmol 2021; 44:670-679. [PMID: 33836913 DOI: 10.1016/j.jfo.2020.11.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 10/16/2020] [Accepted: 11/05/2020] [Indexed: 10/21/2022]
Abstract
STUDY OBJECTIVE To study the performance of a pre-loaded Monoka stent in the management of congenital nasolacrimal duct obstruction (CNLDO). STUDY DESIGN Non-randomized study of consecutive cases. MATERIALS AND METHODS A preloaded classic Monoka silicone stent contained entirely inside its introducer (Lacrijet) was used to treat a consecutive series of subjects with CNLDO over an 11-month period (May 2019-March 2020). Only subjects with chronic symptomatic CNLDO were included. Subjects with intermittent tearing, canalicular pathology, trisomy 21, facial cleft, or history of lacrimal surgery were excluded. Intraoperative findings were recorded, including the degree and location of the nasolacrimal obstruction, successful metal to metal contact with the probe, any difficulties encountered by the Lacrijet device itself, procedure duration, tolerability of the fixation punctal plug, and finally, inspection of the stent after withdrawal of the inserter. Functional success was defined as disappearance of all symptoms of epiphora. RESULTS A total of 45 preloaded Monoka Lacrijet stents (Lcj) were placed consecutively in 38 children. The mean age was 27.9 months (12-78 months). The mean procedural duration was 2.8minutes (range: 1-10min). The overall success with disappearance of all symptoms of epiphora was 88.8% (40/45). Surgery in cases of simple mucosal stenosis was successful in 92.2% (35/38) of cases, with a mean follow-up time of 7.9 months (range: 1 to 12 months). The duration of stent intubation was for this group was 32 days (range: 1-103). The surgical outcomes for the other 7 cases with more complex intraoperative findings are summarized in the publication. All withdrawn probes were intact. CONCLUSIONS The Lacrijet stent system is a simple and reliable pushed intubation device for CNLDO in appropriately selected cases where bony stenosis of the canal is minimal.
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Affiliation(s)
- B Fayet
- Department of Ophthalmology, Hospital Cochin, University of Paris VI - Medical School, 22, rue du Faubourg-Saint-Jacques, Paris, France.
| | - E Racy
- ENT, Fondation Saint-Jean-de-Dieu, 02, rue Rousselet, 75007 Paris, France
| | - J-M Ruban
- Department of Ophthalmology, Hospital Edouard Herriot, Place d'Arsonval, Lyon, France
| | - J A Katowitz
- Division of Ophthalmology, The Children's Hospital of Philadelphia and The Edwin and Fannie Gray Hall Center for Human Appearance, University of Pennsylvania, Philadelphia PA, USA
| | - W R Katowitz
- Division of Ophthalmology, The Children's Hospital of Philadelphia and The Edwin and Fannie Gray Hall Center for Human Appearance, University of Pennsylvania, Philadelphia PA, USA
| | - D Brémond-Gignac
- Department of Ophthalmology, Hôpital Necker-Enfants malades, 149, rue de Sèvres, 75015 Paris, France
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Georgelin D, Jonqua F, Makowiecka K, Wheeler S, Baudouin C, Brémond-Gignac D, Labbé A. [Prevalence of visual impairment in school-age children: Data analysis from PlanVue® pilot project]. J Fr Ophtalmol 2021; 44:358-366. [PMID: 33494974 DOI: 10.1016/j.jfo.2020.08.010] [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: 08/11/2020] [Accepted: 08/27/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE To assess the prevalence of visual disturbances among school-aged children in prioritized education zones in France. METHODS The PlanVue® pilot project was designed to detect and manage visual disturbances in school-aged children in the prioritized education areas of the city of Nanterre, France. During this pilot study, a cohort of 515 children aged 4 to 13 years underwent a school vision screening between January and March 2019, consisting of an overall evaluation of the child's visual behavior, measurement of uncorrected visual acuity in each eye, objective refraction with a photoscreener and strabismus screening. If the examination was abnormal as determined by impaired vision or an algorithm based on the abnormalities found, the children were referred to an ophthalmologist. RESULTS Decreased visual acuity was found in 20% of school-aged children. Out of the 515 children screened, 22% were referred to an ophthalmologist. Among these children, 13% were diagnosed with amblyopia, 73% with spherical ametropia, 57% with astigmatism and 2% with strabismus. Of the entire population screened, 12% of the children needed optical correction but had not received glasses. CONCLUSION This study confirms the high prevalence of uncorrected refractive errors among school-age children. A screening program carried out in a school environment by paramedical professionals might make it possible to considerably reduce the rate of uncorrected visual disorders and their consequences.
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Affiliation(s)
- D Georgelin
- Service d'ophtalmologie, Hôpital Ambroise Paré, AP-HP, IHU FOReSIGHT, Université de Versailles Saint-Quentin-en-Yvelines, 9, avenue Charles De Gaulle, 92100 Boulogne Billancourt; Service d'Ophtalmologie, Centre Hospitalier Universitaire Necker-Enfants Malades, APHP, Inserm 1138, T17, Université de Paris, 149, rue de Sèvres, 75015 Paris
| | - F Jonqua
- Association CADET, 8 rue Nina Berberova, 92100 Boulogne-Billancourt
| | - K Makowiecka
- Centre Point Vision La Défense, 77, esplanade du Général de Gaulle, 92800 Puteaux
| | - S Wheeler
- Helen Keller International Europe, 12, rue Vivienne, 75002 Paris
| | - C Baudouin
- Service d'ophtalmologie, Hôpital Ambroise Paré, AP-HP, IHU FOReSIGHT, Université de Versailles Saint-Quentin-en-Yvelines, 9, avenue Charles De Gaulle, 92100 Boulogne Billancourt; Service d'ophtalmologie 3, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, IHU FOReSIGHT, Université de Versailles Saint-Quentin-en-Yvelines, 28, rue de Charenton, 75012 Paris
| | - D Brémond-Gignac
- Association CADET, 8 rue Nina Berberova, 92100 Boulogne-Billancourt; Service d'Ophtalmologie, Centre Hospitalier Universitaire Necker-Enfants Malades, APHP, Inserm 1138, T17, Université de Paris, 149, rue de Sèvres, 75015 Paris
| | - A Labbé
- Service d'ophtalmologie, Hôpital Ambroise Paré, AP-HP, IHU FOReSIGHT, Université de Versailles Saint-Quentin-en-Yvelines, 9, avenue Charles De Gaulle, 92100 Boulogne Billancourt; Service d'ophtalmologie 3, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, IHU FOReSIGHT, Université de Versailles Saint-Quentin-en-Yvelines, 28, rue de Charenton, 75012 Paris.
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Martin GC, Robert MP, Challe G, Trinh NTH, Attié-Bitach T, Brémond-Gignac D, Bodaghi B, Abadie V. Functional Vision Analysis in Patients With CHARGE Syndrome. J Pediatr Ophthalmol Strabismus 2020; 57:120-128. [PMID: 32203596 DOI: 10.3928/01913913-20200207-02] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 01/13/2020] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate functional vision in patients with CHARGE syndrome (coloboma, heart defects, atresia of the choanae, retardation of growth and development, genital and urinary anomalies, and ear anomalies) by using a new questionnaire entitled VISIOCHARGE. METHODS Ophthalmological data including fundus description and visual acuity, when available, were extracted from the charts of 83 patients with CHARGE syndrome, and the VISIOCHARGE questionnaire was prospectively mailed to 55 of those patients. The answers from the 36 responders (18 males) allowed for the calculation of three scores that assessed distance vision, near vision, and overall ability scores. RESULTS Visual acuity measurements were extracted from the charts of 20 of the 36 patients. The mean visual acuity was 20/50. The mean distance vision score of 0.62 ± 0.30 and near vision score of 0.78 ± 0.23 were correlated with visual acuity in the 20 patients (ρ = 0.64, P = .002 and ρ = 0.61, P = .005, respectively) and were associated with the severity of colobomatous malformation (P = .049 and P = .008, respectively). Severity of the ocular malformation was not associated with the overall ability score (P = .64). CONCLUSIONS The VISIOCHARGE questionnaire is feasible for patients with CHARGE syndrome and may help in the assessment of visual function. The mean visual acuity and answers to the VISIOCHARGE questionnaire showed relatively good visual skills in patients with CHARGE syndrome in everyday life, even in those with bilateral colobomas, which contrasts with the pessimistic conclusions usually resulting from the initial fundus examination. [J Pediatr Ophthalmol Strabismus. 2020;57(2):120-128.].
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Touzé R, Heuzé Y, Robert MP, Brémond-Gignac D, Roux CJ, James S, Paternoster G, Arnaud E, Khonsari RH. Extraocular muscle positions in anterior plagiocephaly: V-pattern strabismus explained using geometric mophometrics. Br J Ophthalmol 2019; 104:1156-1160. [PMID: 31694836 DOI: 10.1136/bjophthalmol-2019-314989] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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: 07/24/2019] [Revised: 10/02/2019] [Accepted: 10/20/2019] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Ophthalmological involvement in anterior plagiocephaly (AP) due to unicoronal synostosis (UCS) raises management challenges. Two abnormalities of the extraocular muscles (EOM) are commonly reported in UCS without objective quantification: (1) excyclorotation of the eye and (2) malposition of the trochlea of the superior oblique muscle. Here we aimed to assess the positions of the EOM in AP, using geometric morphometrics based on MRI data. MATERIALS AND METHODS Patient files were listed using Dr WareHouse, a dedicated big data search engine. We included all patients with AP managed between 2013 and 2018, with an available digital preoperative MRI. MRIs from age-matched controls without craniofacial conditions were also included. We defined 13 orbital and skull base landmarks in order to model the 3D position of the EOM. Cephalometric analyses and geometric morphometrics with Procrustes superimposition and principal component analysis were used with the aim of defining specific EOM anomalies in UCS. RESULTS We included 15 preoperative and 7 postoperative MRIs from patients with UCS and 24 MRIs from age-matched controls. Cephalometric analyses, Procrustes superimposition and distance computations showed a significant shape difference for the position of the trochlea of the superior oblique muscle and an excyclorotation of the EOM. CONCLUSIONS Our results confirm that UCS-associated anomalies of the superior oblique muscle function are associated with malposition of its trochlea in the roof of the orbit. This clinical anomaly supports the importance of MRI imaging in the surgical management of strabismus in patients with UCS.
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Affiliation(s)
- Romain Touzé
- Department of Ophthalmology, Hôpital Universitaire Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris; Université de Paris, Sorbonne Paris Cité, Paris, France
| | - Yann Heuzé
- CRNS, Université de Bordeaux, MCC, PACEA, UMR5199, Pessac, France
| | - Matthieu P Robert
- Department of Ophthalmology, Hôpital Universitaire Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris; Université de Paris, Sorbonne Paris Cité, Paris, France.,COGNAC-G, UMR 8257, CNRS-SSA-Université de Paris, Paris, France
| | - Dominique Brémond-Gignac
- Department of Ophthalmology, Hôpital Universitaire Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris; Université de Paris, Sorbonne Paris Cité, Paris, France
| | - Charles-Joris Roux
- Department of Pediatric Radiology, Hôpital Universitaire Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris; Université de Paris, Sorbonne Paris Cité, Paris, France
| | - Syril James
- Department of Neurosurgery, Craniofacial surgery unit, Hôpital Universitaire Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris; Centre de Référence des Malformations Craniofaciale CRANIOST, Filière Maladies Rares TeteCou; Université Paris Descartes, Université de Paris, Paris, France.,Department of Neurosurgery, Clinique Marcel Sembat, Boulogne-Billancourt, France
| | - Giovanna Paternoster
- Department of Neurosurgery, Craniofacial surgery unit, Hôpital Universitaire Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris; Centre de Référence des Malformations Craniofaciale CRANIOST, Filière Maladies Rares TeteCou; Université Paris Descartes, Université de Paris, Paris, France
| | - Eric Arnaud
- Department of Neurosurgery, Craniofacial surgery unit, Hôpital Universitaire Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris; Centre de Référence des Malformations Craniofaciale CRANIOST, Filière Maladies Rares TeteCou; Université Paris Descartes, Université de Paris, Paris, France.,Department of Neurosurgery, Clinique Marcel Sembat, Boulogne-Billancourt, France
| | - Roman Hossein Khonsari
- Department of Neurosurgery, Craniofacial surgery unit, Hôpital Universitaire Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris; Centre de Référence des Malformations Craniofaciale CRANIOST, Filière Maladies Rares TeteCou; Université Paris Descartes, Université de Paris, Paris, France.,Department of Maxillo-Facial Surgery and Plastic Surgery, Hôpital Universitaire Necker - Enfants Malades, Assistance Publique - Hôpitaux de Paris; Centre de Référence des Malformations Rares de la Face et de la Cavité Buccale MAFACE, Filière Maladies Rares TeteCou; Université Paris Descartes, Université de Paris, Paris, France
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10
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Valensi M, Goldman G, Marchant D, Van Den Berghe L, Jonet L, Daruich A, Robert MP, Krejci E, Klein C, Mascarelli F, Versaux-Botteri C, Moulin A, Putterman M, Guimiot F, Molina T, Terris B, Brémond-Gignac D, Behar-Cohen F, Abitbol MM. Sostdc1 is expressed in all major compartments of developing and adult mammalian eyes. Graefes Arch Clin Exp Ophthalmol 2019; 257:2401-2427. [PMID: 31529323 DOI: 10.1007/s00417-019-04462-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 04/16/2019] [Revised: 08/20/2019] [Accepted: 09/04/2019] [Indexed: 01/16/2023] Open
Abstract
PURPOSE This study was conducted in order to study Sostdc1 expression in rat and human developing and adult eyes. METHODS Using the yeast signal sequence trap screening method, we identified the Sostdc1 cDNA encoding a protein secreted by the adult rat retinal pigment epithelium. We determined by in situ hybridization, RT-PCR, immunohistochemistry, and western blot analysis Sostdc1 gene and protein expression in developing and postnatal rat ocular tissue sections. We also investigated Sostdc1 immunohistolocalization in developing and adult human ocular tissues. RESULTS We demonstrated a prominent Sostdc1 gene expression in the developing rat central nervous system (CNS) and eyes at early developmental stages from E10.5 days postconception (dpc) to E13 dpc. Specific Sostdc1 immunostaining was also detected in most adult cells of rat ocular tissue sections. We also identified the rat ocular embryonic compartments characterized by a specific Sostdc1 immunohistostaining and specific Pax6, Sox2, Otx2, and Vsx2 immunohistostaining from embryonic stages E10.5 to E13 dpc. Furthermore, we determined the localization of SOSTDC1 immunoreactivity in ocular tissue sections of developing and adult human eyes. Indeed, we detected SOSTDC1 immunostaining in developing and adult human retinal pigment epithelium (RPE) and neural retina (NR) as well as in several developing and adult human ocular compartments, including the walls of choroidal and scleral vessels. Of utmost importance, we observed a strong SOSTDC1 expression in a pathological ocular specimen of type 2 Peters' anomaly complicated by retinal neovascularization as well in the walls ofother pathological extra-ocular vessels. CONCLUSION: As rat Sostdc1 and human SOSTDC1 are dual antagonists of the Wnt/β-catenin and BMP signaling pathways, these results underscore the potential crucial roles of these pathways and their antagonists, such as Sostdc1 and SOSTDC1, in developing and adult mammalian normal eyes as well as in syndromic and nonsyndromic congenital eye diseases.
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Affiliation(s)
- Maud Valensi
- Centre de Recherches des Cordeliers, UMR_S INSERM 1138, Equipe 17, Université Paris Descartes, 15 rue de l'école de médecine, 75006, Paris, France
| | - Gabrielle Goldman
- APHP, Service de Pathologie de L'Hôpital Cochin-Hôtel-Dieu, Université Paris Descartes, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France
| | - Dominique Marchant
- Centre de Recherches des Cordeliers, UMR_S INSERM 1138, Equipe 17, Université Paris Descartes, 15 rue de l'école de médecine, 75006, Paris, France
- Sorbonne Paris Cité, UFR SMBH, Laboratoire Hypoxie et poumons, Université Paris 13, EA 2363, 93017, Bobigny, France
| | - Loïc Van Den Berghe
- Centre de Recherches des Cordeliers, UMR_S INSERM 1138, Equipe 17, Université Paris Descartes, 15 rue de l'école de médecine, 75006, Paris, France
- Inserm UMR 1037, CRCT (Cancer Research Center of Toulouse), 31037, Toulouse, France
| | - Laurent Jonet
- Centre de Recherches des Cordeliers, UMR_S INSERM 1138, Equipe 17, Université Paris Descartes, 15 rue de l'école de médecine, 75006, Paris, France
| | - Alejandra Daruich
- Centre de Recherches des Cordeliers, UMR_S INSERM 1138, Equipe 17, Université Paris Descartes, 15 rue de l'école de médecine, 75006, Paris, France
- AP-HP, Hôpital Universitaire Necker-Enfants-Malades, Service d'Ophtalmologie, 149 rue de Sèvres, 75015, Paris, France
| | - Matthieu P Robert
- AP-HP, Hôpital Universitaire Necker-Enfants-Malades, Service d'Ophtalmologie, 149 rue de Sèvres, 75015, Paris, France
- COGnition and Action Group, UMR 8257, CNRS, Université Paris Descartes, Paris, France
| | - Eric Krejci
- COGnition and Action Group, UMR 8257, CNRS, Université Paris Descartes, Paris, France
| | - Christophe Klein
- Centre d'Imagerie Cellulaire et de Cytométrie (CICC), Centre de Recherche des Cordeliers (CRC), Université Pierre et Marie Curie - Paris 6, Université Paris Descartes - Paris 5, UMR_S 1138, 75006, Paris, France
| | - Frédéric Mascarelli
- Centre de Recherches des Cordeliers, UMR_S INSERM 1138, Equipe 17, Université Paris Descartes, 15 rue de l'école de médecine, 75006, Paris, France
| | - Claudine Versaux-Botteri
- Centre de Recherches des Cordeliers, UMR_S INSERM 1138, Equipe 17, Université Paris Descartes, 15 rue de l'école de médecine, 75006, Paris, France
| | - Alexandre Moulin
- Département de Pathologie, Hôpital Ophtalmique Jules-Gonin , 15, avenue de France, 1004, Lausanne, Switzerland
| | - Marc Putterman
- APHP, Service de Pathologie de l'Hôpital Universitaire Necker-Enfants-Malades, Université Paris Descartes, 149 rue de Sèvres, 75015, Paris, France
| | - Fabien Guimiot
- Unité Fonctionnelle de Foeto-Pathologie, Hôpital Universitaire Robert Debré, 48 Boulevard Serrurier, 75019, Paris, France
| | - Thierry Molina
- APHP, Service de Pathologie de l'Hôpital Universitaire Necker-Enfants-Malades, Université Paris Descartes, 149 rue de Sèvres, 75015, Paris, France
| | - Benoît Terris
- APHP, Service de Pathologie de L'Hôpital Cochin-Hôtel-Dieu, Université Paris Descartes, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France
| | - Dominique Brémond-Gignac
- AP-HP, Hôpital Universitaire Necker-Enfants-Malades, Service d'Ophtalmologie, 149 rue de Sèvres, 75015, Paris, France
| | - Francine Behar-Cohen
- Centre de Recherches des Cordeliers, UMR_S INSERM 1138, Equipe 17, Université Paris Descartes, 15 rue de l'école de médecine, 75006, Paris, France
- AP-HP, Service d'Ophtalmologie, Hôpital Universitaire Cochin-Hôtel-Dieu, 27 rue du Faubourg Saint-Jacques, 75014, Paris, France
| | - Marc M Abitbol
- Centre de Recherches des Cordeliers, UMR_S INSERM 1138, Equipe 17, Université Paris Descartes, 15 rue de l'école de médecine, 75006, Paris, France.
- AP-HP, Hôpital Universitaire Necker-Enfants-Malades, Service d'Ophtalmologie, 149 rue de Sèvres, 75015, Paris, France.
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11
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Fayet B, Racy E, Katowitz J, Katowitz W, Ruban JM, Brémond-Gignac D. Insertion of a preloaded Monoka™ stent for congenital nasolacrimal obstruction: Intraoperative observations. A preliminary study. J Fr Ophtalmol 2019; 42:248-254. [PMID: 30871792 DOI: 10.1016/j.jfo.2018.12.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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: 12/11/2018] [Accepted: 12/13/2018] [Indexed: 11/27/2022]
Abstract
STUDY OBJECTIVE To study the intraoperative deployment of a pre-loaded probe for a "pushed" monocanalicular nasolacrimal intubation. STUDY DESIGN Non-randomized study of consecutive cases. MATERIALS AND METHODS Description: A classical Monoka™ silicone stent with the silicone tube attached at right angles to the punctal plug is contained entirely inside an introducer connected to a piston. Insertion: The procedure begins with intubation of the nasolacrimal duct with the metallic introducer. Traction on the piston retracts the metallic introducer inside the handpiece. This relative shortening progressively ejects the stent, starting with its free end at the bottom of the introducer. The operation was observed endoscopically under single-blind conditions. RESULTS Twenty-eight preloaded Monoka™ stents were placed consecutively, in 28 congenital nasolacrimal duct intubations in 22 patients (28 sides). Endoscopic examination showed that the free part of the stent was progressively ejected from the introducer during retraction of the piston. Insertion of this pushed stent into the nasal cavity was effective in 23/28 cases (82.1%). A total of 28 preloaded stent insertions were attempted and 23 were correctly deployed. DIFFICULTIES ENCOUNTERED At the end of nasolacrimal duct intubation, contact between the punctal plug and the lacrimal punctum was problematic in four cases (4/28=14.2%). At the beginning of stent placement, premature ejection of the punctal plug within the end of the introducer occurred in five cases (5/28=17.8%). These five stents failed to insert properly into the nasal cavity. At the end of insertion, retention of the punctal plug in the introducer occurred in two cases (2/28=7.1%). COMPLICATIONS No cases of intraoperative or postoperative epistaxis were observed. CONCLUSIONS Intraoperative nasal endoscopy validated the concept of the preloaded Monoka stent and its deployment. Reproducibility and improved reliability may require a change in stenting technique and a design modification.
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Affiliation(s)
- B Fayet
- Department of ophthalmology, Hospital Cochin, University of Paris Descartes - Medical School, rue du faubourg Saint-Jacques, Paris, France.
| | - E Racy
- ENT, Fondation Saint-Jean-de-Dieu, 02, rue Rousselet, 75007 Paris, France
| | - J Katowitz
- Department of ophthalmology, The Children's Hospital of Philadelphia and the Scheie Eye Institute, University of Pennsylvania, Philadelphia PA, USA
| | - W Katowitz
- Department of ophthalmology, The Children's Hospital of Philadelphia and the Scheie Eye Institute, University of Pennsylvania, Philadelphia PA, USA
| | - J-M Ruban
- Department of ophthalmology, hospital Edouard-Herriot, place D'Arsonval, 69003 Lyon, France
| | - D Brémond-Gignac
- Department of ophthalmology, Hôpital Necker-Enfants malades, 149, rue de Sèvres, 75015 Paris, France
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12
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Delfosse G, Brémond-Gignac D, Kapoula Z. Postural Patterns of the Subjects with Vergence Disorders: Impact of Orthoptic Re-education, a Pilot Study. Br Ir Orthopt J 2018; 14:64-70. [PMID: 32999967 PMCID: PMC7510372 DOI: 10.22599/bioj.116] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Aim: Vergence insufficiency is a common oculomotor disorder which causes visual but also general, and even postural symptoms. This study aimed to characterise postural control of subjects with isolated vergence disorder and assess whether orthoptic therapy affects it. Method: Vergence disorders were evaluated and treated by orthoptists. Postural control quality was measured before and after orthoptic therapy in different conditions to study the role of vision, fixating distance, binocular vision and ocular dominance. Results: Before orthoptic therapy, we recorded less body sway when subjects had their eyes closed than when they had their eyes open, and also less sway for the binocular condition when compared with monocular viewing conditions. This is opposite to well-known normal behaviour. Moreover, no distance or ocular dominance effect was found. After orthoptic therapy, our subject’s body sway was less when they had their eyes open than with their eyes closed and less when they looked at near fixation. No difference was found between monocular and binocular viewing conditions, but a small advantage of ocular dominance was found for one parameter. Conclusion: We conclude that subjects with vergence disorders show postural behaviour that is not characterized by the normal regularities observed in healthy subjects. Orthoptic re-education may have contributed to promoting such regularities. Further studies are needed to confirm these preliminary results.
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Affiliation(s)
- Gwenaelle Delfosse
- IRIS Team - Physiopathologie de la Vision et Motricité Binoculaire - CNRS - Université Paris Descartes, FR
| | | | - Zoï Kapoula
- IRIS Team - Physiopathologie de la Vision et Motricité Binoculaire - CNRS - Université Paris Descartes, FR
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13
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Fayet B, Racy E, Katowitz WR, Katowitz JA, Ruban JM, Brémond-Gignac D. Intralacrimal migration of Masterka ® stents. J Fr Ophtalmol 2018; 41:206-211. [PMID: 29576330 DOI: 10.1016/j.jfo.2017.11.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 10/16/2017] [Revised: 11/18/2017] [Accepted: 11/21/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Tearing and conjunctivitis in children are commonly due to lacrimal drainage system obstruction. Congenital nasolacrimal obstruction is a common pathology treated by probing with or without silicone stent insertion, depending upon the age of the child. The silicone stent is self-retaining and placed for at least one month. Masterka® is a recent version of Monoka®, which may lead to the same surgical complications, such as intralacrimal migration. SUBJECTS AND METHODS The medical records of two patients surgically treated with the Masterka® probe for nasolacrimal duct obstruction, who developed intralacrimal migration of the stent, were retrospectively reviewed and analyzed. A 41-month-old child and an 18-month-old child presented with disappearance of the silicone tube after 7 days and 2 years respectively. In the first case, the tube migrated completely within the lacrimal system and became externalized through the nose at 2 years, while in the second case, the Masterka® was retrieved through a canalicular approach. In both cases, infants had no further tearing. DISCUSSION The frequency self-retaining stent disappearance is estimated at 15%. Among these cases, intralacrimal migration is only reported in 0.5% of cases. To prevent intralacrimal migration, the surgical technique must follow a certain number of rules. Management, based on residual epiphora, is discussed. CONCLUSION Prevention of intralacrimal migration of self-retaining stents involves a rigorous analysis of the relationship between the meatus and the fixation head at the time of placement. After lacrimal intubation, scheduled monitoring is necessary to screen for stent disappearance. Management is based on clinical findings, anterior rhinoscopy and even exploratory canaliculotomy.
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Affiliation(s)
- B Fayet
- Ophthalmology Department, hôpitaux universitaires Paris Centre, hôpital Cochin, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; Ophthalmology Department, University Hospital Necker-Enfants malades, AP-HP, Paris V René Descartes University, 149, rue de Sèvres, 75015 Paris, France.
| | - E Racy
- ENT Department, clinique Saint-Jean-de-Dieu, 2, rue Rousselet, 75007 Paris, France
| | - W R Katowitz
- Division of Ophthalmology, The Children's Hospital of Philadelphia and the University of Pennsylvania, 19104 Pennsylvania, USA
| | - J A Katowitz
- Division of Ophthalmology, The Children's Hospital of Philadelphia and the University of Pennsylvania, 19104 Pennsylvania, USA
| | - J-M Ruban
- Ophthalmology Department, Edouard Herriot Hospital, place d'Arsonval, 69003 Lyon, France
| | - D Brémond-Gignac
- Ophthalmology Department, University Hospital Necker-Enfants malades, AP-HP, Paris V René Descartes University, 149, rue de Sèvres, 75015 Paris, France; CNRS Research Unit FR3636, Paris V University, 75005 Paris, France
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14
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Martin GC, Dénier C, Zambrowski O, Grévent D, Bruère L, Brousse V, de Montalembert M, Brémond-Gignac D, Robert MP. Visual Function in Asymptomatic Patients With Homozygous Sickle Cell Disease and Temporal Macular Atrophy. JAMA Ophthalmol 2017; 135:1100-1105. [PMID: 28837721 DOI: 10.1001/jamaophthalmol.2017.3008] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Importance Temporal macular involvement in sickle cell disease can now easily be detected by optical coherence tomography (OCT). However, while recent studies have demonstrated its high prevalence, little is known about its potential consequences on visual function. Objective To assess the visual function of patients with sickle cell disease with no visual symptoms despite temporal macular atrophy. Design, Setting, and Participants This retrospective case series included data collection and explorations made in a single referral center for sickle cell disease in 2016. Three patients with sickle cell disease exhibiting preserved visual acuity but showing temporal macular retinal atrophy were included. Exposures Patients underwent the following explorations: best-corrected distance and near visual acuity evaluation; dilated fundus examination; OCT with 12 × 6-mm thickness map; horizontal, vertical, and en face sections; OCT angiography of the 6 × 6-mm perifoveal retina; 30° and 12° central visual fields; Lanthony 15-hue color vision test; automated static contrast sensitivity test; and global electroretinography. Main Outcomes and Measures The OCT thickness maps were checked for areas of retinal thinning, appearing as blue patches. When present, these areas were compared with the areas of superficial and deep capillary flow loss on OCT angiography and with the scotomas on visual fields. Contrast sensitivity and color vision loss were quantified. Results All 3 patients included had homozygous sickle cell disease. They presented with a 20/20 distance visual acuity, and Parinaud 1,5 near visual acuity in both eyes. They were all followed up for a severe cerebral vasculopathy related to sickle cell disease. The areas of atrophy involved the inner retinal layers and were associated with an absence of signal in the deep capillary plexuses in OCT angiography. These patches of retinal thinning were also matching with scotomas in the automated visual fields. Color vision ability and contrast sensitivity were impaired in all patients. Global electroretinography findings were normal. Conclusions and Relevance Temporal macular atrophy in sickle cell disease may have direct consequences on visual function, including in children, even when visual acuity is preserved. Optical coherence tomographic imaging may be warranted when evaluating patients with sickle cell disease, even if asymptomatic with 20/20 visual acuity.
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Affiliation(s)
- Gilles C Martin
- Ophthalmology Department, Necker-Enfants Malades University Hospital, APHP, Paris, France
| | - Charlotte Dénier
- Ophthalmology Department, Necker-Enfants Malades University Hospital, APHP, Paris, France
| | - Olivia Zambrowski
- Ophthalmology Department, Necker-Enfants Malades University Hospital, APHP, Paris, France.,Ophthalmology Department, Centre hospitalier intercommunal de Créteil, Creteil, France
| | - David Grévent
- Radiology Department, Necker-Enfants Malades University Hospital, APHP, Paris, France
| | - Lenaïc Bruère
- Ophthalmology Department, Necker-Enfants Malades University Hospital, APHP, Paris, France
| | - Valentine Brousse
- Pediatrics Department, Necker-Enfants Malades University Hospital, APHP, Paris, France
| | | | - Dominique Brémond-Gignac
- Ophthalmology Department, Necker-Enfants Malades University Hospital, APHP, Paris, France.,CNRS FR3636, Paris Descartes University, Paris, France
| | - Matthieu P Robert
- Ophthalmology Department, Necker-Enfants Malades University Hospital, APHP, Paris, France.,Cognition and Action Group, Paris Descartes University, Sorbonne Paris Cité, Paris, France
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15
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Burin des Roziers C, Rothschild P, Barjol A, Clément C, Edelson C, Derrien S, Metge F, Michau S, Robert M, Prévot C, Dollfus H, Layet V, Delphin N, Bernardelli M, Ghiotti T, Hanein S, Fourrage C, Bonnefont J, Rozet J, Brézin A, Caputo G, Brémond-Gignac D, Valleix S. Targeted NGS: an effective approach for molecular diagnosis of hereditary vitreoretinopathies. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.02361] [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] [Indexed: 11/29/2022]
Affiliation(s)
- C. Burin des Roziers
- Laboratoire de Génétique Ophtalmologique; Institut Imagine - Institut des maladies génétiques; Paris France
| | - P.R. Rothschild
- Département d'ophtalmologie; Groupe Hospitalier Cochin-Hôtel-Dieu; Paris France
| | - A. Barjol
- Service d'ophtalmologie; Fondation Rothschild; Paris France
| | - C.A. Clément
- Service d'ophtalmologie; Fondation Rothschild; Paris France
| | - C. Edelson
- Service d'ophtalmologie; Fondation Rothschild; Paris France
| | - S. Derrien
- Service d'ophtalmologie; Fondation Rothschild; Paris France
| | - F. Metge
- Service d'ophtalmologie; Fondation Rothschild; Paris France
| | - S. Michau
- Service d'ophtalmologie; Centre Hospitalier Universitaire de Montpellier; Montpellier France
| | - M. Robert
- Service d'ophtalmologie; Hôpital Necker - Enfants malades; Paris France
| | - C. Prévot
- Service d'ophtalmologie; Fondation Rothschild; Paris France
| | - H. Dollfus
- Centre Hospitalier Universitaire de Strasbourg; Centre de référence pour les Affections Rares en Génétique Ophtalmologique CARGO; Strasbourg France
| | - V. Layet
- Groupe Hospitalier du Havre; Service de génétique clinique; Le Havre France
| | - N. Delphin
- Service de génétique moléculaire; Hôpital Necker - Enfants malades; Paris France
| | - M. Bernardelli
- Service de génétique moléculaire; Hôpital Necker - Enfants malades; Paris France
| | - T. Ghiotti
- Service de génétique moléculaire; Groupe Hospitalier Cochin-Hôtel-Dieu; Paris France
| | - S. Hanein
- Plateforme de génomique; Institut Imagine - Institut des maladies génétiques; Paris France
| | - C. Fourrage
- Service de génétique moléculaire; Hôpital Necker - Enfants malades; Paris France
| | - J.P. Bonnefont
- Service de génétique moléculaire; Hôpital Necker - Enfants malades; Paris France
| | - J.M. Rozet
- Laboratoire de Génétique Ophtalmologique; Institut Imagine - Institut des maladies génétiques; Paris France
| | - A. Brézin
- Département d'ophtalmologie; Groupe Hospitalier Cochin-Hôtel-Dieu; Paris France
| | - G. Caputo
- Service d'ophtalmologie; Fondation Rothschild; Paris France
| | - D. Brémond-Gignac
- Service d'ophtalmologie; Hôpital Necker - Enfants malades; Paris France
| | - S. Valleix
- Service de génétique moléculaire; Hôpital Necker - Enfants malades; Paris France
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Morize A, Brémond-Gignac D, Daniel F, Kapoula Z. Effects of Pure Vergence Training on Initiation and Binocular Coordination of Saccades. Invest Ophthalmol Vis Sci 2017; 58:329-342. [PMID: 28114594 DOI: 10.1167/iovs.16-19837] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose We hypothesized that saccade eye movement properties, particularly latency and binocular coordination, depend on vergence quality. Methods We studied 11 students clinically diagnosed for vergence disorders versus 8 healthy controls. Rehabilitation of vergence disorders was done with a novel research-based method, using vergence in midsagittal plane. Vergence and saccades were recorded in separate blocks, before and after five weekly rehabilitation sessions. Results Healthy controls showed higher accuracy and velocity of convergence and divergence relative to the vergence disorders group; then rehabilitation led to significant decrease of latency and increase of gain and peak velocity of vergence. Before rehabilitation of the vergence disorders, saccade parameters did not differ significantly from healthy controls, except the binocular coordination that was significantly deteriorated. Following vergence rehabilitation, saccade properties improved: The latency decreased significantly, the gain increased particularly at far, and the binocular coordination improved significantly. Latency and accuracy improved in a durable way, with values even better than the range of accuracy measured in healthy controls; binocular coordination of saccades, although improved, did not normalize. In healthy controls, binocular coordination was optimal at 40 cm (working distance), and the vergence disorders group showed improvement at 40 cm. Results confirm the hypothesis, which is further corroborated by the correlation between vergence and saccade latency. Conclusions Results are in line with the hypothesis of permanent interaction between saccades and vergence, even when the task requires only saccades. Relevance of such interaction is emphasized by improvements of binocular saccades through the novel research-based method of vergence rehabilitation.
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Affiliation(s)
- Aurélien Morize
- IRIS Team, Physiopathology of vision and binocular control, FR3636 (Fédération de Recherche en Neurosciences), University Paris Descartes, Centre National de la Recherche Scientifique (CNRS), Paris, France
| | | | - François Daniel
- IRIS Team, Physiopathology of vision and binocular control, FR3636 (Fédération de Recherche en Neurosciences), University Paris Descartes, Centre National de la Recherche Scientifique (CNRS), Paris, France
| | - Zoï Kapoula
- IRIS Team, Physiopathology of vision and binocular control, FR3636 (Fédération de Recherche en Neurosciences), University Paris Descartes, Centre National de la Recherche Scientifique (CNRS), Paris, France
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Daniel F, Morize A, Brémond-Gignac D, Kapoula Z. Benefits from Vergence Rehabilitation: Evidence for Improvement of Reading Saccades and Fixations. Front Integr Neurosci 2016; 10:33. [PMID: 27812325 PMCID: PMC5071378 DOI: 10.3389/fnint.2016.00033] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 09/30/2016] [Indexed: 11/17/2022] Open
Abstract
We hypothesize that binocular coordination of saccades is based on continuous neuroplasticity involving interactions of saccades and vergence. To test this hypothesis we study reading saccades in young students who were diagnosed for vergence disorders before and after vergence rehabilitation. Following orthoptic evaluation and symptomatology screening, 5 weekly sessions of vergence rehabilitation were applied with the REMOBI vergence double step protocole (see Kapoula et al., 2016). Using the Eyeseecam videoculography device we measured vergence as well as saccades and fixations during a reading test four times: at the beginning and at the end of the first and of the fifth vergence rehabilitation session. The results show elimination of symptoms, improvement of clinical orthoptic scores, and importantly increase of measured vergence gain and reduction of inter-trial variability. Improvement of the vergence was associated to a decrease of the disconjugacy of saccades during reading but also to shortening of fixation durations, to reduction of the number of regressive saccades and to a better correction of the intra-saccadic disconjugacy during the following fixation. The results corroborate the hypothesis of neuroplasticity based on saccade vergence interaction in young adults. It validates the clinical validity of the vergence double-step REMOBI method as a means to improve both, vergence and reading performances. It opens a new research approach on the link between fine binocular coordination of saccades, quality of the vergence response, attention, cognition and reading.
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Affiliation(s)
- François Daniel
- IRIS Group, Physiopathologie de la Vision et Motricité Binoculaire Centre National de la Recherche Scientifique FR3636 Université Paris Descartes Paris, France
| | - Aurélien Morize
- IRIS Group, Physiopathologie de la Vision et Motricité Binoculaire Centre National de la Recherche Scientifique FR3636 Université Paris Descartes Paris, France
| | - Dominique Brémond-Gignac
- IRIS Group, Physiopathologie de la Vision et Motricité Binoculaire Centre National de la Recherche Scientifique FR3636 Université Paris DescartesParis, France; Ophthalmology Service, Hôpital Necker - Enfants MaladesParis, France
| | - Zoï Kapoula
- IRIS Group, Physiopathologie de la Vision et Motricité Binoculaire Centre National de la Recherche Scientifique FR3636 Université Paris Descartes Paris, France
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Gerber S, Alzayady K, Burglen L, Brémond-Gignac D, Marchesin V, Roche O, Rio M, Funalot B, Calmon R, Durr A, Gil-da-Silva-Lopes V, Ribeiro Bittar M, Orssaud C, Héron B, Ayoub E, Berquin P, Bahi-Buisson N, Bole C, Masson C, Munnich A, Simons M, Delous M, Dollfus H, Boddaert N, Lyonnet S, Kaplan J, Calvas P, Yule D, Rozet JM, Fares Taie L. Recessive and Dominant De Novo ITPR1 Mutations Cause Gillespie Syndrome. Am J Hum Genet 2016; 98:971-980. [PMID: 27108797 DOI: 10.1016/j.ajhg.2016.03.004] [Citation(s) in RCA: 97] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Accepted: 03/07/2016] [Indexed: 12/01/2022] Open
Abstract
Gillespie syndrome (GS) is a rare variant form of aniridia characterized by non-progressive cerebellar ataxia, intellectual disability, and iris hypoplasia. Unlike the more common dominant and sporadic forms of aniridia, there has been no significant association with PAX6 mutations in individuals with GS and the mode of inheritance of the disease had long been regarded as uncertain. Using a combination of trio-based whole-exome sequencing and Sanger sequencing in five simplex GS-affected families, we found homozygous or compound heterozygous truncating mutations (c.4672C>T [p.Gln1558(∗)], c.2182C>T [p.Arg728(∗)], c.6366+3A>T [p.Gly2102Valfs5(∗)], and c.6664+5G>T [p.Ala2221Valfs23(∗)]) and de novo heterozygous mutations (c.7687_7689del [p.Lys2563del] and c.7659T>G [p.Phe2553Leu]) in the inositol 1,4,5-trisphosphate receptor type 1 gene (ITPR1). ITPR1 encodes one of the three members of the IP3-receptors family that form Ca(2+) release channels localized predominantly in membranes of endoplasmic reticulum Ca(2+) stores. The truncation mutants, which encompass the IP3-binding domain and varying lengths of the modulatory domain, did not form functional channels when produced in a heterologous cell system. Furthermore, ITPR1 p.Lys2563del mutant did not form IP3-induced Ca(2+) channels but exerted a negative effect when co-produced with wild-type ITPR1 channel activity. In total, these results demonstrate biallelic and monoallelic ITPR1 mutations as the underlying genetic defects for Gillespie syndrome, further extending the spectrum of ITPR1-related diseases.
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Kapoula Z, Morize A, Daniel F, Jonqua F, Orssaud C, Brémond-Gignac D. Objective Evaluation of Vergence Disorders and a Research-Based Novel Method for Vergence Rehabilitation. Transl Vis Sci Technol 2016; 5:8. [PMID: 26981330 PMCID: PMC4790421 DOI: 10.1167/tvst.5.2.8] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 01/25/2016] [Indexed: 11/24/2022] Open
Abstract
Purpose We performed video-oculography to evaluate vergence eye movement abnormalities in students diagnosed clinically with vergence disorders. We tested the efficiency of a novel rehabilitation method and evaluated its benefits with video-oculography cross-correlated with clinical tests and symptomatology. Methods A total of 19 students (20–27 years old) underwent ophthalmologic, orthoptic examination, and a vergence test coupled with video-oculography. Eight patients were diagnosed with vergence disorders with a high symptomatology score (CISS) and performed a 5-week session of vergence rehabilitation. Vergence and rehabilitation tasks were performed with a trapezoid surface of light emitting diodes (LEDs) and adjacent buzzers (US 8851669). We used a novel Vergence double-step (Vd-s) protocol: the target stepped to a second position before the vergence movement completion. Afterward the vergence test was repeated 1 week and 1 month later. Results Abnormally increased intertrial variability was observed for many vergence parameters (gain, duration, and speed) for the subjects with vergence disorders. High CISS scores were correlated with variability and increased latency. After the Vd-s, variability of all parameters dropped to normal or better levels. Moreover, the convergence and divergence latency diminished significantly to levels better than normal; benefits were maintained 1 month after completion of Vd-s. CISS scores dropped to normal level, which was maintained up to 1 year. Conclusions and Translational Relevance: Intertrial variability is the major marker of vergence disorders. The Vd-s research-based method leads to normalization of vergence properties and lasting removal of symptoms. The efficiency of the method is due to the spatiotemporal parameters of repetitive trials that stimulate neural plasticity.
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Affiliation(s)
- Zoï Kapoula
- IRIS Team, Physiopathology of vision and binocular control, FR3636, CNRS, University Paris Descartes, Paris, France
| | - Aurélien Morize
- IRIS Team, Physiopathology of vision and binocular control, FR3636, CNRS, University Paris Descartes, Paris, France
| | - François Daniel
- IRIS Team, Physiopathology of vision and binocular control, FR3636, CNRS, University Paris Descartes, Paris, France
| | - Fabienne Jonqua
- IRIS Team, Physiopathology of vision and binocular control, FR3636, CNRS, University Paris Descartes, Paris, France
| | - Christophe Orssaud
- Ophthalmology Department, APHP, European Hospital of Georges Pompidou, Paris, France
| | - Dominique Brémond-Gignac
- IRIS Team, Physiopathology of vision and binocular control, FR3636, CNRS, University Paris Descartes, Paris, France ; Ophthalmology Department, APHP, Necker-Enfants malades Hospital, Paris, France
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Brémond-Gignac D, Nischal KK, Mortemousque B, Gajdosova E, Granet DB, Chiambaretta F. Atopic Keratoconjunctivitis in Children: Clinical Features and Diagnosis. Ophthalmology 2015; 123:435-437. [PMID: 26278858 DOI: 10.1016/j.ophtha.2015.07.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 07/06/2015] [Accepted: 07/08/2015] [Indexed: 11/16/2022] Open
Affiliation(s)
- Dominique Brémond-Gignac
- Pediatric Ophthalmology Department, University Hospital Necker-Enfants Malades, Paris, France; CNRS Unit FR3636, Paris V University, Paris, France.
| | - Ken K Nischal
- Clinical and Academic Department of Ophthalmology, Great Ormond Street Hospital for Children, London, UK; Pediatric Ophthalmology, Strabismus and Adult Motility UPMC Eye Center, Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania
| | - Bruno Mortemousque
- Ophthalmology Department, University Hospital of Pontchaillou, Rennes, France
| | - Eva Gajdosova
- Clinical and Academic Department of Ophthalmology, Great Ormond Street Hospital for Children, London, UK
| | - David B Granet
- Ratner Children's Eye Center and Shiley Eye Center, University of California, San Diego, California
| | - Frédéric Chiambaretta
- Ophthalmology Department, University Hospital Gabriel Montpied, Clermont-Ferrand, France
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21
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Morin G, Bruechle NO, Singh AR, Knopp C, Jedraszak G, Elbracht M, Brémond-Gignac D, Hartmann K, Sevestre H, Deutz P, Hérent D, Nürnberg P, Roméo B, Konrad K, Mathieu-Dramard M, Oldenburg J, Bourges-Petit E, Shen Y, Zerres K, Ouadid-Ahidouch H, Rochette J. Gain-of-Function Mutation in STIM1 (P.R304W) Is Associated with Stormorken Syndrome. Hum Mutat 2015; 35:1221-32. [PMID: 25044882 DOI: 10.1002/humu.22621] [Citation(s) in RCA: 86] [Impact Index Per Article: 9.6] [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: 02/14/2014] [Accepted: 07/03/2014] [Indexed: 12/21/2022]
Abstract
Stormorken syndrome is a rare autosomal dominant disorder characterized by a phenotype that includes miosis, thrombocytopenia/thrombocytopathy with bleeding time diathesis, intellectual disability, mild hypocalcemia, muscle fatigue, asplenia, and ichthyosis. Using targeted sequencing and whole-exome sequencing, we identified the c.910C > T transition in a STIM1 allele (p.R304W) only in patients and not in their unaffected family members. STIM1 encodes stromal interaction molecule 1 protein (STIM1), which is a finely tuned endoplasmic reticulum Ca(2+) sensor. The effect of the mutation on the structure of STIM1 was investigated by molecular modeling, and its effect on function was explored by calcium imaging experiments. Results obtained from calcium imaging experiments using transfected cells together with fibroblasts from one patient are in agreement with impairment of calcium homeostasis. We show that the STIM1 p.R304W variant may affect the conformation of the inhibitory helix and unlock the inhibitory state of STIM1. The p.R304W mutation causes a gain of function effect associated with an increase in both resting Ca(2+) levels and store-operated calcium entry. Our study provides evidence that Stormorken syndrome may result from a single-gene defect, which is consistent with Mendelian-dominant inheritance.
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Affiliation(s)
- Gilles Morin
- Department of Molecular and Clinical Genetics, EA 4666, CHU d'Amiens, Université de Picardie Jules Verne, Amiens, France
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22
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Morin G, Bruechle NO, Singh AR, Knopp C, Jedraszak G, Elbracht M, Brémond-Gignac D, Hartmann K, Sevestre H, Deutz P, Hérent D, Nürnberg P, Roméo B, Konrad K, Mathieu-Dramard M, Oldenburg J, Bourges-Petit E, Shen Y, Zerres K, Ouadid-Ahidouch H, Rochette J. Gain-of-Function Mutation in STIM1 (P.R304W) Is Associated with Stormorken Syndrome. Hum Mutat 2014. [DOI: 10.1002/humu.22722] [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] [Indexed: 11/11/2022]
Affiliation(s)
- Gilles Morin
- Department of Molecular and Clinical Genetics, EA 4666, CHU d'Amiens; Université de Picardie Jules Verne; Amiens France
| | | | - Amrathlal Rabbind Singh
- Department of Molecular and Clinical Genetics, EA 4666, CHU d'Amiens; Université de Picardie Jules Verne; Amiens France
| | - Cordula Knopp
- Department of Human Genetics; RWTH University Hospital; Aachen Germany
| | - Guillaume Jedraszak
- Department of Molecular and Clinical Genetics, EA 4666, CHU d'Amiens; Université de Picardie Jules Verne; Amiens France
| | - Miriam Elbracht
- Department of Human Genetics; RWTH University Hospital; Aachen Germany
| | | | - Kathi Hartmann
- Department of Ophthalmology; RWTH University Hospital; Aachen Germany
| | - Henri Sevestre
- Department of Pathology; EA4667 CHU d'Amiens Amiens France
| | - Peter Deutz
- Department of Pediatrics; RWTH University Hospital; Aachen Germany
| | - Didier Hérent
- Department of Molecular and Clinical Genetics, EA 4666, CHU d'Amiens; Université de Picardie Jules Verne; Amiens France
| | - Peter Nürnberg
- Cologne Center for Genomics (CCG); University of Cologne; Cologne Germany
| | - Bernard Roméo
- Department of Paediatric Pneumology; CHU d'Amiens Amiens France
| | - Kerstin Konrad
- Child Neuropsychology Section, Department of Child and Adolescent Psychiatry and Psychotherapy; RWTH University Hospital; Aachen Germany
| | - Michèle Mathieu-Dramard
- Department of Molecular and Clinical Genetics, EA 4666, CHU d'Amiens; Université de Picardie Jules Verne; Amiens France
| | - Johannes Oldenburg
- Institute of Experimental Haematology and Transfusion Medicine; University Clinic Bonn; Bonn Germany
| | | | - Yuequan Shen
- Collaborative Innovation Center of Chemical Science and Engineering (Tianjin) and College of Life Sciences; Nankai University; Tianjin China
| | - Klaus Zerres
- Department of Human Genetics; RWTH University Hospital; Aachen Germany
| | - Halima Ouadid-Ahidouch
- Laboratory of Cellular and Molecular Physiology, EA 4667; UFR of Sciences; Amiens France
| | - Jacques Rochette
- Department of Molecular and Clinical Genetics, EA 4666, CHU d'Amiens; Université de Picardie Jules Verne; Amiens France
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Cretu I, Brémond-Gignac D, Milazzo S, Jany B, Ikoli JF, Copin H, Sevestre H. [Groenouw type II macular corneal dystrophy: case report]. J Fr Ophtalmol 2012; 35:786-91. [PMID: 23026701 DOI: 10.1016/j.jfo.2011.11.014] [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: 09/09/2011] [Revised: 11/14/2011] [Accepted: 11/17/2011] [Indexed: 11/17/2022]
Abstract
Corneal dystrophies are relatively rare diseases of the young adult. We report a case of a Groenouw type II macular corneal dystrophy. A 34-year-old woman with no prior history was referred by her ophthalmologist for bilateral corneal dystrophy developing for several years. Physical examination revealed decreased visual acuity related to bilateral rounded corneal deposits. The patient underwent penetrating keratoplasty. The diagnosis of Groenouw type II macular corneal dystrophy was confirmed by pathological examination of the recipient cornea. The clinical, pathologic and therapeutic features are discussed.
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Affiliation(s)
- I Cretu
- Clinique ophtalmologique Saint-Victor, CHU d'Amiens, 354, boulevard de Beauvillé, 80054 Amiens, France
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Kloss BAV, Reis LM, Brémond-Gignac D, Glaser T, Semina EV. Analysis of FOXD3 sequence variation in human ocular disease. Mol Vis 2012; 18:1740-9. [PMID: 22815627 PMCID: PMC3398501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Accepted: 06/23/2012] [Indexed: 11/23/2022] Open
Abstract
PURPOSE The migratory neural crest cell population makes a significant contribution to the anterior segment structures of the eye. Consequently, several anterior segment dysgenesis phenotypes are associated with mutations in genes expressed during neural crest development. The forkhead box D3 (FOXD3) gene encodes a forkhead transcription factor that plays an important role in neural crest specification in vertebrates and therefore may be involved in human eye disease. METHODS We screened 310 probands with developmental ocular conditions for variations in FOXD3. RESULTS Six nonsynonymous FOXD3 variants were identified. Four of these changes, c.47C>T (p.Thr16Met), c.359C>T (p.Pro120Leu), c.517A>C (p.Asn173His), and c.818_829dup (p.Arg273_Gly276dup), affected conserved regions and were observed primarily in probands with aniridia or Peters anomaly; out of these four variants, one, p.Arg273_Gly276dup, was not detected in control populations and two, p.Pro120Leu and p.Asn173His, were statistically enriched in cases with aniridia or Peters anomaly. The p.Arg273_Gly276dup variant was seen in a proband with aniridia as well as two additional unrelated probands affected with anophthalmia or congenital cataracts. The p.Asn173His variant affects Helix 2 of the DNA-binding domain and was observed in two unrelated patients with Peters anomaly or aniridia; in both cases, one parent carried the same allele. CONCLUSIONS FOXD3 variants increase the risk of anterior segment dysgenesis phenotypes in humans. The p.Asn173His mutation affects a residue in the forkhead domain that is 100% conserved among vertebrate orthologs and is predicted to participate in protein-protein interactions. Its phenotypic effects may be modulated by transcriptional cofactors which have yet to be identified.
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Affiliation(s)
- Bethany A. Volkmann Kloss
- Department of Pediatrics and Children’s Research Institute at the Medical College of Wisconsin and Children’s Hospital of Wisconsin, Milwaukee, WI,Department of Cell Biology, Neurobiology and Anatomy at the Medical College of Wisconsin, Milwaukee, WI
| | - Linda M. Reis
- Department of Pediatrics and Children’s Research Institute at the Medical College of Wisconsin and Children’s Hospital of Wisconsin, Milwaukee, WI
| | - Dominique Brémond-Gignac
- Department of Pediatric Ophthalmology, St Victor University Hospital of Amiens and Vision Institute, Picardie Jules Verne University, Amiens, France
| | - Tom Glaser
- Departments of Internal Medicine and Human Genetics, University of Michigan, Ann Arbor, MI
| | - Elena V. Semina
- Department of Pediatrics and Children’s Research Institute at the Medical College of Wisconsin and Children’s Hospital of Wisconsin, Milwaukee, WI,Department of Cell Biology, Neurobiology and Anatomy at the Medical College of Wisconsin, Milwaukee, WI
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Brémond-Gignac D, Milazzo S. Drusen du nerf optique de l’enfant et complications hémorragiques. J Fr Ophtalmol 2011; 34:679-82. [DOI: 10.1016/j.jfo.2011.02.013] [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: 02/03/2011] [Accepted: 02/03/2011] [Indexed: 11/16/2022]
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26
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Pluquet E, Brémond-Gignac D, Milazzo S, Mammeri H. Unusual acute endophthalmitis due to an as yet unclassified Acinetobacter gyllenbergii-like isolate. J Med Microbiol 2011; 60:1379-1382. [DOI: 10.1099/jmm.0.026609-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Emilie Pluquet
- Service de Bactériologie, Centre Hospitalo-Universitaire d'Amiens, Hôpital Nord, Faculté de Médecine d'Amiens, Université de Picardie Jules Verne, 80000 Amiens, France
| | - Dominique Brémond-Gignac
- Service d'Ophtalmologie, Centre Hospitalo-Universitaire d'Amiens, Centre Saint-Victor, Faculté de Médecine d'Amiens, Université de Picardie Jules Verne, 80000 Amiens, France
| | - Solange Milazzo
- Service d'Ophtalmologie, Centre Hospitalo-Universitaire d'Amiens, Centre Saint-Victor, Faculté de Médecine d'Amiens, Université de Picardie Jules Verne, 80000 Amiens, France
| | - Hedi Mammeri
- Service de Bactériologie, Centre Hospitalo-Universitaire d'Amiens, Hôpital Nord, Faculté de Médecine d'Amiens, Université de Picardie Jules Verne, 80000 Amiens, France
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Abstract
A rare lesion of secondary amyloidosis of the cornea caused by trichiasis is reported. A 33-year-old Asian woman presented with progressive decrease of visual acuity of the right eye evolving over several years, combined with the growth of a lower budding, gelatinous, pink corneal mass located next to an inferior lid trichiasis. The treatment consisted of eyelid surgery for trichiasis, followed by ablation of the corneal lesion by anterior keratectomy. After 14 months of follow-up, no recurrence was observed. Visual acuity is 9/10 P3 without correction. Pathological examination of the mass revealed secondary corneal amyloidosis, AL type (light chains), rarely reported in the literature (18 cases). No other organ involvement by amyloidosis was identified. Corneal amyloidosis is a rare complication of trichiasis. To avoid recurrence, this anomaly should be recognized as the cause and should be treated prior to removal of the corneal lesion.
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Affiliation(s)
- A Mora
- Service d'ophtalmologie, centre Saint-Victor, clinique ophtalmologique Saint-Victor, CHU d'Amiens, université Picardie Jules-Verne, 354, boulevard de Beauvillé, 80054 Amiens cedex 1, France
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28
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Abstract
The cataract or opacification of the lens raises, in the child, two problems: of clinical diagnosis but especially of action to be taken therapeutic in particular surgical in front of a juvenille lens. This leads to a step and a therapeutic strategy, which must, individually, weigh the advantages and the disadvantages of the surgery. It is a frequent cause of visual handicap in the child. In the event of unilaterality, the major risks are the amblyopia and the aniseiconia. The elements to be analyzed are linked or the bilaterality, the type and the importance of opacity, local or general associated malformations, precocity diagnoses, and with regard to the treatment, the potential surgical complications, the quality of the optical correction, the postoperative assumption of responsibility and the cooperation of the parents. In all the cases, it will always be necessary to treat the functional part of the amblyopia.
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Affiliation(s)
- S Milazzo
- Clinique ophtalmologique Saint-Victor, 354, boulevard de Beauvillé, 80054 Amiens cedex 01, France.
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29
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Brémond-Gignac D, Copin H, Elmaleh M, Milazzo S. Anomalies oculaires fœtales : apport de l’imagerie anténatale en résonance magnétique. J Fr Ophtalmol 2010; 33:350-4. [DOI: 10.1016/j.jfo.2010.03.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2009] [Accepted: 03/03/2010] [Indexed: 11/29/2022]
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30
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Kapoula Z, Ganem R, Poncet S, Gintautas D, Eggert T, Brémond-Gignac D, Bucci MP. Free exploration of painting uncovers particularly loose yoking of saccades in dyslexics. Dyslexia 2009; 15:243-259. [PMID: 19003978 DOI: 10.1002/dys.377] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Binocular yoking of saccades is essential for single vision of words during reading. This study examines the quality of binocular coordination in individuals with dyslexia, independent of the process of reading. Fifteen dyslexia children (11.2+/-1.4 years) and 15 non-dyslexia individuals (8 children, aged 11.1+/-1.3 years, and 7 adults, 24+/-3 years) were studied. Eye movements were recorded in two conditions. In the control condition, participants made saccades to a single target where the saccade direction and magnitude were controlled. In the experimental condition saccades were allowed to move freely while viewing paintings. The results indicated that, compared with the non-dyslexia group, the dyslexia group showed a larger saccade amplitude difference between the two eyes, as well as a larger conjugate post-saccadic drift, during painting exploration than that for saccades to a single target. While both groups showed a larger disconjugate post-saccadic drift during painting exploration relative to the control condition, this showed a negative correlation with saccade disconjugacy (i.e. disconjugate drift reduced the disparity) only for the non-dyslexia group. These results indicate that individuals with dyslexia have problems of binocular coordination, both during the saccade and fixations, which are independent of the reading process. It is suggested that this reflects an immaturity of the normal oculomotor learning mechanisms.
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Affiliation(s)
- Zoï Kapoula
- IRIS FRE3154 CNRS, Service Ophtalmologie-ORL-Stomatologie, Hôpital Européen Georges Pompidou, Paris, France.
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Yang Q, Jurion F, Bucci MP, Lucek A, Wiener-Vacher S, Brémond-Gignac D, Orssaud C, Kapoula Z. Six Adult Cases with a Pseudo-Vestibular Syndrome Related to Vergence Abnormalities. Neuroophthalmology 2009. [DOI: 10.1080/01658100701501109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Bucci MP, Brémond-Gignac D, Kapoula Z. Speed and accuracy of saccades, vergence and combined eye movements in subjects with strabismus before and after eye surgery. Vision Res 2009; 49:460-9. [PMID: 19138698 DOI: 10.1016/j.visres.2008.12.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2008] [Revised: 12/04/2008] [Accepted: 12/08/2008] [Indexed: 11/27/2022]
Abstract
The purpose of the study was to examine spatio-temporal characteristics of horizontal eye movements in the natural space (saccade, vergence and combined movements) in young subjects with early onset convergent or divergent strabismus. Nine young subjects (8-20 years old) were tested: three with divergent strabismus, six with convergent strabismus. A standard paradigm was used to elicit pure horizontal saccades at far and at close viewing distance, pure vergence along the median plane (convergence and divergence) and saccades combined with vergence movements. Horizontal eye movements from both eyes were recorded by a photoelectric device. Eye movements were recorded before surgery, and, for the majority of the subjects, two times after surgery. Before surgery the accuracy of convergence and divergence movements in their pure or combined form was poor with respect to normal values. The mean velocity of convergence was also abnormally slow. Strabismus surgery improved significantly the accuracy of these types of eye movements. The speed of pure convergence and of divergence combined movements increased significantly after surgery. We concluded that poor vergence eye movement's performance, particularly those found for convergence in strabismic subjects could be due to impairment in the central structures related to sensory disparity inputs. Adaptive mechanisms promoted by the realignment of the eyes could be at the origin of the improvement in the vergence performances observed in our subjects after strabismus eye surgery.
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Affiliation(s)
- Maria Pia Bucci
- CNRS, Pôle chirurgie ORL-OPH, Hôpital Robert Debré, Paris, France.
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Bois C, Binot MC, Jonqua F, Guillemot G, Brémond-Gignac D. Dépistage des troubles visuels entre 3 et 5 ans : expérience du service départemental de la Protection Maternelle et Infantile dans les Hauts-de-Seine. J Fr Ophtalmol 2007; 30:570-6. [PMID: 17646745 DOI: 10.1016/s0181-5512(07)89660-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [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: 10/22/2022]
Abstract
INTRODUCTION Prevalence of visual impairment is estimated at 15% at the age of 5 years. Early visual screening is essential to prevent the risk of amblyopia and treat strabismus. The Maternal and Infant Welfare department of the Hauts-de-Seine district (France) organized a systematic visual screening during a routine health check-up in 3- to 4-year-old preschool children. In this population, 4% of children were wearing corrected lenses before check-up and 12% of children were referred to an ophthalmic consultant. The aim of this study was to document the performance and limitations of two visual acuity measurement tests: the Stycar test (separated presentation of letters) and Cadet letters test (grouped presentation). PATIENTS AND METHODS Twelve physicians conducting check-ups in 56 of the department's preschools constituted two random samples of representative children. The first sample of 201 children included 3- to 4-year-olds with a positive visual screening on the Cadet or Stycar test and the results and recommendations were collected. The second sample included 238 children who had a first negative visual screening at 3-4 years old with the Stycar test. We then conducted a second visual screening at 4-5 years-old with the Cadet letters test and collected results. RESULTS In the first sample of 201 children, 73 were lost to follow-up, 40 had a normal documented ophthalmic examination, 63 needed glasses and 25 needed follow-up. The positive predictive value (PPV) of the Stycar test was much higher than the PPV of the Cadet test (79% versus 48%, p<10-4). After this first screening, prevalence of visual impairment at 3-4 years old was estimated at 8%. In the second sample of 238 children, four children were recently lens adapted and 36 were referred to an ophthalmic consultant. Of these 36 children, 11 were lost to follow-up (of these children, two had a very low visual acuity (2/10 and 3/10), four had a normal ophthalmic examination, 13 needed glasses, and eight needed a follow-up. Of the total sample, 10.5% of the children had a documented visual insufficiency on the primary Stycar test screening. The PPV of the Cadet letters test was 84% (IC95%[70%; 98%]). Results of the Cadet letters test was independent of the delay between the two tests. CONCLUSION Although one-third of the children did not follow the recommendations for follow-up consultation, we demonstrate that visual acuity evaluation was insufficient at 3-4 years of age, and the problems were caught at 4-5 years of age with the Cadet test. Physicians must be aware of the difficulty of the Cadet test at 3-4 years of age but also that screening is inadequate when the Stycar test is normal. A second visual screening, taking into account separating problems on the Cadet test is justified at 4-5 years of age The Stycar test must be discontinued after 4-5 years of age when compliance and the predictive value of the Cadet letters test become excellent.
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Affiliation(s)
- C Bois
- Service Départemental de PMI, Conseil Général des Hauts-de-Seine, Nanterre, France
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Abstract
Aniridia consists in a congenital absence of the iris, with incidence varying from 1/64,000 to 1/96,000. This complex embryologic malformation involves the iris, trabecula, and cornea with limbal stem cell deficiency. Aniridia is a genetic haplo-insufficiency expression of the PAX6 gene located on chromosome 11p13. The associated clinical ocular signs could be congenital cataract, congenital glaucoma (the most common complication), keratopathy, ptosis, nystagmus, foveal aplasia, or microphthalmia. More than half of aniridic patients will develop glaucoma, so a regular complete tensional check-up is recommended. Central pachymetry is thicker than in the general population and overestimates ocular pressure if a corrective coefficient is not used. When glaucoma is diagnosed, medical or surgical treatment should be adapted to the child's age. In younger children, trabeculotomy is preferable to trabeculectomy in the first step if the cornea is clear enough. In older children or teenagers, a classical medical treatment must be initiated first, but surgical treatment will often be needed later. Trabeculectomy is the surgical procedure to choose for these older patients or can be combined with cataract surgery in adults. In severe glaucoma, after failure of trabeculectomy with or without mitomycin C, glaucoma surgery with drainage placement could be necessary to control ocular pressure and preserve vision. The outcome of glaucoma in aniridia is always severe and requires medical and surgical treatment adapted from infancy to adulthood.
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Affiliation(s)
- D Brémond-Gignac
- Service d'Ophtalmologie Pédiatrique, Hôpital Robert Debré, APHP, 48 boulevard Serrurier, 75019 Paris, France
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Keren B, Suzuki OT, Gérard-Blanluet M, Brémond-Gignac D, Elmaleh M, Titomanlio L, Delezoide AL, Passos-Bueno MR, Verloes A. CNS malformations in Knobloch syndrome with splice mutation inCOL18A1 gene. Am J Med Genet A 2007; 143A:1514-8. [PMID: 17546652 DOI: 10.1002/ajmg.a.31784] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Boris Keren
- Clinical Genetic Unit, Department of Medical Genetics, APHP, Robert Debré University Hospital, 48 boulevard Serurier, 75019 Paris, France
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Kapoula Z, Bucci MP, Jurion F, Ayoun J, Afkhami F, Brémond-Gignac D. Evidence for frequent divergence impairment in French dyslexic children: deficit of convergence relaxation or of divergence per se? Graefes Arch Clin Exp Ophthalmol 2006; 245:931-6. [PMID: 17186259 DOI: 10.1007/s00417-006-0490-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.4] [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: 05/23/2006] [Revised: 09/07/2006] [Accepted: 10/21/2006] [Indexed: 10/23/2022] Open
Abstract
AIM There is a controversy as to whether dyslexic children present visuo-motor disabilities such as vergence and accommodative problems assessed with orthoptic tests. The purpose of this study is to re-examine this issue in a large population of children. METHODS Extensive orthoptic evaluation was made in 57 dyslexic and 46 non-dyslexic ("normal") age-matched children. Convergence and divergence capacities were evaluated at two distances (30 cm and 400 cm). RESULTS Binocular vision measured with stereo-acuity tests was normal in dyslexics. In contrast, the near point of convergence was significantly more remote in dyslexics; most importantly, divergence at both far and near distance was significantly more reduced in dyslexics (median value 4 pD and 10 pD, respectively, at far and near) than in "normals" (median value 6 pD and 12 pD, at far and near). CONCLUSION The existence of the divergence deficit at far distance indicates the presence of deficit of divergence per se, independently from convergence and accommodation relaxation. This result is novel and corroborated by physiological studies indicating distinct control of convergence and divergence, both at the cortical and subcortical premotor level. We conclude that vergence deficits are frequently present in dyslexics, and that dyslexics should be re-educated; training should address distinctively convergence and divergence subsystems.
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Affiliation(s)
- Zoï Kapoula
- IRIS Group/LPPA UMR 7152, CNRS-College de France, 11 place M. Berthelot, 75005 Paris, France.
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Guilmin-Crépon S, Garel C, Baumann C, Brémond-Gignac D, Bailleul-Forestier I, Magnier S, Castanet M, Czernichow P, VAN DEN Abbeele T, Léger J. High proportion of pituitary abnormalities and other congenital defects in children with congenital nasal pyriform aperture stenosis. Pediatr Res 2006; 60:478-84. [PMID: 16940234 DOI: 10.1203/01.pdr.0000238380.03683.cb] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
We aimed to determine the occurrence of pituitary dysfunction and additional malformations in patients with congenital nasal pyriform aperture stenosis (CNPAS) and to predict which patients are at risk of pituitary dysfunction. Among the 40 studied patients, hypothalamo-pituitary (HP) axis abnormalities were found in 16 patients (40%), with endocrine dysfunction (n = 9) and/or abnormal HP MRI findings (n = 15). A normal HP axis on MRI was highly predictive of normal endocrine function. Of the 40 patients, 31 had additional abnormalities in the cranio-facial area (n = 26), the brain (n = 12), the vertebrae (n = 5), the limbs (n = 4), the heart (n = 7) and the kidney (n = 3). Six patients had syndromic associations: VACTERL (n = 4), CHARGE (n = 1) and RHYNS (n = 1) syndromes. Craniofacial and brain malformations were more common in patients with HP axis abnormalities than in patients with normal HP axis. Familial history of midline defects and/or consanguinity were found in 30% of patients. In conclusion, HP axis abnormalities are frequent in patients with CNPAS and justify MRI of the brain early in life and clinical evaluation to screen for patients with pituitary insufficiency. CNPAS may be a genetically heterogeneous condition with a large phenotypic variability that shares common etiological mechanisms with the various forms of the holoprosencephaly phenotype.
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Affiliation(s)
- Sophie Guilmin-Crépon
- Pediatric Endocrinology and Diabetes Unit, Centre de Référence Maladies Endocriniennes Rares de la Croissance, Hôpital Robert Debré, Assistance Publique-Hôpitaux de Paris, Paris VII University, 75019 Paris, France
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Mortemousque B, Fauquert JL, Chiambaretta F, Demoly P, Helleboid L, Creuzot-Garcher C, Brémond-Gignac D. Le test de provocation conjonctival : recommandations pratiques pour le diagnostic des conjonctivites allergiques. J Fr Ophtalmol 2006; 29:837-46. [PMID: 16988636 DOI: 10.1016/s0181-5512(06)73857-8] [Citation(s) in RCA: 18] [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] [Indexed: 11/26/2022]
Abstract
The diagnosis of ocular allergy, which has become a real public health problem occurring in 25% of the general population and continues to rise, requires allergic testing. Skin and blood tests combined with interviewing the patient demonstrate sensitivity to one or more antigens. However, while allergic testing and interviews generally reveal the cause of the symptoms, only the conjunctival provocation test (CPT) provides clear evidence of a functional relation between the conjunctival pathology and exposure to the antigen. Since there is still no validated consensus regarding the criteria for positivity of the CPT in routine practice, the working group attempted to establish the major guidelines for conducting the test, to standardize approaches and pinpoint areas of uncertainty. The group established a consensus regarding the conditions for using the test (patient selection, allergens to be tested, usable concentrations, the test protocol, the signs and symptoms to be assessed, interpretation of results, follow-up) and identified two distinct patient groups (outpatients and hospitalized patients) in whom test-taking conditions are different. The outpatient group includes patients suffering from benign forms of conjunctivitis (acute, seasonal, or chronic) and those sensitive to the usual allergens (mainly domestic and airborne). In these cases, the test is given in a medical setting with an allergologist or an ophthalmologist who instills the drops relatively rapidly. The criterion for positivity is the extent of the pruritus. On the other hand, in the hospital population, which is composed of patients suffering from vernal conjunctivitis, the attempt to establish the triggering factor requires a more elaborate protocol carried out in an ophthalmologic setting and based on the association of a range of clinical and biological factors. The deliberations of the working group should lead to the standardization of the CPT procedure for diagnostic purposes.
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Affiliation(s)
- B Mortemousque
- Service d'Ophtalmologie, Hôpital Pellegrin, CHU, Bordeaux
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Devogelaere T, Beresniak A, Raymaeckers A, Naacke H, Ssi Yan Kai I, Brémond-Gignac D. [Clinical study of Supranettes pads in the treatment of seasonal or perennial allergic conjunctivitis in children]. J Fr Ophtalmol 2006; 29:593-8. [PMID: 16885888 DOI: 10.1016/s0181-5512(06)73819-0] [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: 10/22/2022]
Abstract
PURPOSE Ocular allergy is a common disease that is on the rise. Seasonal and perennial conjunctivitis are the most common forms of ocular allergy. Itching, hyperemia, foreign body sensation, irritation, blurred vision or ocular dryness sensations, tearing, and photophobia are the clinical signs observed in patients. A topical antiallergic treatment is prescribed associated with ocular cleaning to contribute to an antigen washing of the ocular surface. Our study aimed to evaluate the use of Supranettes pads as supplementation treatment in children for seasonal or perennial conjunctivitis. MATERIAL AND METHODS Our prospective study was done in children with a diagnosis of seasonal or perennial clinical ocular allergy. Every symptom was rated from 0 to 4 according to the intensity described by the children and their parents. Twenty children (range, 4-10 years) presenting an ocular allergy were included in the study. A topical antiallergic treatment membrane stabilizer or antihistamine and Supranettes pads were prescribed for ocular cleaning of one randomized selected eye four times a day. Patients were seen in consultation 1 month later to evaluate the treatment. The ocular comfort of each eye, one treated with Supranettes pads and the other not treated by Supranettes pads, was evaluated by the child helped by parents on a graduated self-evaluation scale (range, 0-10). The Mann-Whitney statistical test was used to differentiate the two groups. RESULTS Of the 20 patients, eleven presented seasonal conjunctivitis and nine perennial conjunctivitis. Six of them presented conjunctivitis with a slight to moderate superficial punctuate keratitis. At the consultation on day 28+/-3, patients who were first treated showed clear improvement of clinical signs with the prescribed treatment. The statistical comparison of the two groups confirmed a significant difference (p<0.05) to the advantage of the group using the Supranettes pads. DISCUSSION Ocular washing is essential in the treatment of allergic conjunctivitis. The new galenic form of ocular cleaning by physiological serum-impregnated pads is simple to use for children. An objective significant difference is difficult to observe in 1 month. CONCLUSION This study underlines the importance of the comfort of Supranettes pads evaluated in the treatment of children's conjunctivitis. It confirms the advantage of developing evaluation studies including patient satisfaction and quality of life in ophthalmology.
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Affiliation(s)
- T Devogelaere
- Service d'Ophtalmologie, Hôpital Robert Debré, AP-HP, Paris, France
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Bucci MP, Kapoula Z, Brémond-Gignac D, Wiener-Vacher S. Binocular coordination of saccades in children with vertigo: dependency on the vergence state. Vision Res 2006; 46:3594-602. [PMID: 16837021 DOI: 10.1016/j.visres.2006.06.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [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: 01/09/2006] [Revised: 05/17/2006] [Accepted: 06/01/2006] [Indexed: 11/21/2022]
Abstract
The present study examines the quality of binocular coordination of saccades at far and near distance in 15 children with symptoms of vertigo headache and equilibrium disorders; these children show normal vestibular function but abnormal convergence eye movements (e.g., long time preparation, slow execution and poor accuracy, see ). The results show normal binocular saccade coordination at far distance, but large abnormal disconjugacy for saccades at near distance. During combined saccade-vergence movements (studied in six of these children), convergence remains abnormally slow. This supports the interpretation according to which poor binocular yoking of the saccades is linked to the reduced ability to produce fast convergence during the saccade; a learning mechanism based on rapid vergence would help to reduce the abducting-adducting asymmetry of the saccades. An alternative interpretation would be reduced learning ability for monocular adjustment of the saccade signals.
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Affiliation(s)
- Maria Pia Bucci
- IRIS Group/LPPA, UMR 7152 CNRS-College de France, 11, Place M Berthelot, Paris, France.
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Bucci MP, Kapoula Z, Yang Q, Brémond-Gignac D. Latency of saccades, vergence, and combined movements in children with early onset convergent or divergent strabismus. Vision Res 2005; 46:1384-92. [PMID: 16126244 DOI: 10.1016/j.visres.2005.06.035] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [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: 03/29/2005] [Revised: 06/27/2005] [Accepted: 06/30/2005] [Indexed: 10/25/2022]
Abstract
The goal of this study was to examine latency of horizontal eye movements in the natural space (saccades, vergence, and combined saccade-vergence movements) in children with early onset convergent or divergent strabismus. Ten children were tested (8-11 years old): three with divergent strabismus, seven with convergent strabismus. A paradigm was used to elicit pure lateral saccades at far and near distance, pure vergence (convergence and divergence) and saccades combined with vergence movements. Horizontal eye movements from both eyes were recorded simultaneously by a photoelectric device (Oculometer, Dr. Bouis). The latency of saccades (at far and near distance), of vergence (convergence and divergence), and of combined movements greatly varies among subjects and has tendency to be longer than that observed in normal children of matched age, however, these differences reach significance in only a few cases. Children with divergent strabismus and residual gross binocular vision show abnormally longer vergence latencies than children with convergent strabismus without binocular vision. The initiation of combined movements does not show a dominant pattern, such as preceding vergence, as is found in normal children. Finally, strabismus surgery has no major effect on latencies. We conclude that there is no overall deficiency in latencies of eye movements in 3D space in children with early onset strabismus. Most likely, monocular visual input can be efficient as normal binocular vision for vergence movements. In a few subjects with divergent strabismus and fragile, intermittent binocular vision, latencies can be abnormally long, just because of the fragile binocular input and/or attention effort needs to use it. The absence of a pattern of initiation similar to normal children could be due to attention and fixation capabilities.
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Affiliation(s)
- Maria Pia Bucci
- IRIS Group, LPPA UMR 7152, CNRS-College de France 11, place M. Berthelot, 75005 Paris, France.
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Brémond-Gignac D, Gérard-Blanluet M, Copin H, Bitoun P, Baumann C, Crolla JA, Benzacken B, Verloes A. Three patients with hallucal polydactyly and WAGR syndrome, including discordant expression of Wilms tumor in MZ twins. Am J Med Genet A 2005; 134:422-5. [PMID: 15779023 DOI: 10.1002/ajmg.a.30646] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [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: 11/07/2022]
Abstract
The WAGR contiguous gene deletion syndrome is a combination of Wilms tumor, Aniridia, Genito-urinary abnormalities, and growth and mental retardation which is invariably associated with an 11p13 deletion. We report two monozygotic twins and a third, unrelated patient with WAGR syndrome and additional clinical features not usually associated with WAGR. Both twins had developmental delay, growth deficiency, severe ocular involvement (nystagmus, aniridia, cataracts), atrial septal defect and two uncommon findings: agenesis of the corpus callosum and duplication of the halluces. One twin developed Wilms tumors aged 19 months while her sister remained tumor free by the age of 6.5 years. The singleton patient showed typical WAGR syndrome and preaxial hallucal polydactyly. Molecular cytogenetic studies refined the identification of the extent of the deleted segments, which were not identical in the two families. The two deletions included the PAX6 and WT1 genes as previously reported in typical WAGR patients. The unusual anomalies described in this report, may represent the expression of low penetrant traits associated with haploinsufficency of one or more of the genes present in the deletion (PAX6 is expressed in CNS) or may indicate epistatic influences of modifier genes on the expression of gene(s) present in the WAGR region.
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Brémond-Gignac D, Crolla JA, Copin H, Guichet A, Bonneau D, Taine L, Lacombe D, Baumann C, Benzacken B, Verloes A. Combination of WAGR and Potocki–Shaffer contiguous deletion syndromes in a patient with an 11p11.2–p14 deletion. Eur J Hum Genet 2005; 13:409-13. [PMID: 15702131 DOI: 10.1038/sj.ejhg.5201358] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [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: 11/09/2022] Open
Abstract
Aniridia, Wilms tumor, genitourinary abnormalities, growth and mental retardation are the cardinal features of the WAGR 11p13 deletion syndrome. The Potocki-Schaffer syndrome or proximal 11p deletion syndrome (previously DEFECT11 syndrome) is a contiguous gene syndrome associated with deletions in 11p11.2, principal features of which are multiple exostoses and enlarged parietal foramina. Mental handicap, facial dysmorphism and craniosynostosis may also be associated. We report a patient with combined WAGR and Potocki-Shaffer syndromes, and obesity. She presented with aniridia, cataract, nystagmus, corneal ulcers and bilateral congenital ptosis. A left nephroblastoma was detected at 15 months. Other features included moderate developmental delay, growth deficiency, facial dysmorphism, multiple exostoses and cranial lacunae. High-resolution and molecular cytogenetics confirmed a del(11)(p11.2p14.1) deletion with a proximal breakpoint between the cosmid DO8153 and the BAC RP11-104M24 to a distal breakpoint between cosmids CO8160 (D11S151) and F1238 (D11S1446). The deletion therefore includes EXT2, ALX4, WT1 and PAX6. This case appears to be the second patient reported with this combined deletion syndrome and confirms the association of obesity in the WAGR spectrum, a feature previously reported in four cases, and for which the acronym WAGRO has been suggested. Molecular and follow-up data on the original WAGRO case are briefly presented.
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Affiliation(s)
- D Brémond-Gignac
- Service d'Ophtalmologie Pédiatrique, Hôpital Robert Debré, AP-HP, INSERM E9935, Paris, France
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45
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Affiliation(s)
- H Copin
- Laboratoire de Cytogénétique, Hôpital Lariboisière, AP-HP, Paris, France
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46
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Brémond-Gignac D. Oculoplastic surgery. J Fr Ophtalmol 2004. [DOI: 10.1016/s0181-5512(04)96162-1] [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: 11/15/2022]
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Bucci MP, Kapoula Z, Yang Q, Brémond-Gignac D, Wiener-Vacher S. Speed-accuracy of saccades, vergence and combined eye movements in children with vertigo. Exp Brain Res 2004; 157:286-95. [PMID: 15024539 DOI: 10.1007/s00221-004-1842-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [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: 07/07/2003] [Accepted: 12/22/2003] [Indexed: 10/26/2022]
Abstract
Vergence abnormalities could lead to inappropriate vestibulo-ocular reflex (VOR), causing vertigo and imbalance (Brandt 1999). Indeed, a recent study by Anoh-Tanon et al. (2000) reported the existence of a population of children with symptoms of vertigo in the absence of vestibular dysfunction but with abnormal vergence findings in orthoptic tests. The purpose of this study was to examine in such children the accuracy, duration and mean velocity of vergence and saccades; additionally, for a few subjects, the effect of orthoptic vergence training on these parameters was also investigated. LEDs were used to stimulate saccades, pure vergence along the median plane and combined saccade-vergence movements. Movements from both eyes were recorded with a photoelectric device (Bouis). The results show that children with vertigo perform saccades as normal subjects of comparable age. In contrast, vergence, particularly convergence, shows abnormalities: poor accuracy, long duration and low speed. During combined movements, the well known reciprocal interaction between the saccade and the vergence is present only for saccades combined with divergence; for saccades combined with convergence such interaction is abnormal: the saccade is slowed down by the convergence but the convergence is not accelerated by the saccade. Orthoptic training improves significantly the accuracy of all eye movements; such improvement was significant for all types of eye movements except for divergence (pure and combined). Furthermore, convergence remains abnormal and the lack of acceleration by the saccade persists. These specific convergence deficits could be of both subcortical and cortical origin. Orthoptic training improves the accuracy presumably via visual attentional mechanisms, but cannot completely override deficits related to subcortical deficiencies.
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Affiliation(s)
- Maria Pia Bucci
- Laboratoire de Physiologie de la Perception et de 1l'Action, LPPA, CNRS-College de France, 11 place M. Berthelot, 75005 Paris, France.
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Bucci MP, Kapoula Z, Yang Q, Wiener-Vacher S, Brémond-Gignac D. Abnormality of vergence latency in children with vertigo. J Neurol 2004; 251:204-13. [PMID: 14991356 DOI: 10.1007/s00415-004-0304-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [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: 03/11/2003] [Revised: 09/29/2003] [Accepted: 10/07/2003] [Indexed: 11/28/2022]
Abstract
It is well known that vergence movements are important for distance appreciation, depth vision and stereopsis. Moreover, vergence movements are very probably used by the CNS during head and body motion to adjust the gain of the vestibulo-ocular reflex (VOR) according to the viewing distance. A recent clinical study of Anoh-Tanon et al. suggested that vertigo in children with normal vestibular function could be associated with abnormal vergence clinically assessed. The purpose of this study was to test this hypothesis with objective vergence eye movement recordings. We examined the latency of vergence, saccades and combined movements in twelve children with the complaint of vertigo but without vestibular abnormality. Convergence and saccades combined with convergence or with divergence had abnormally long latencies (relative to normal children of matched age). In contrast, divergence and isolated saccades showed only mild latency increase relative to normals. Lengthening of latency could be due to impaired cortical control. Orthoptic vergence training reduced all latencies; however, even the reduced latency of vergence and of combined movements was still abnormal. The improvement after orthoptic vergence training could be due to increased visual attention, although such mechanism cannot eliminate completely the initiation deficit of vergence movements. Objective eye movement recordings are thus useful for a diagnosis and treatment of children with vertigo.
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Affiliation(s)
- Maria Pia Bucci
- Laboratoire de Physiologie de la Perception et de l'Action, UMR 9950 CNRS-College de France, 11, place Marcelin Berthelot, 75005, Paris, France.
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Lapeyraque AL, Haddad E, André JL, Brémond-Gignac D, Taylor CM, Rianthavorn P, Salusky IB, Loirat C. Sudden blindness caused by anterior ischemic optic neuropathy in 5 children on continuous peritoneal dialysis1 1Published partially (case 3) in abstract form in Arch Ped 7:437, 2000, and in Pediatr Nephrol 16:C4, 2001. Am J Kidney Dis 2003; 42:E3-9. [PMID: 14582071 DOI: 10.1016/j.ajkd.2003.07.009] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [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: 11/19/2022]
Abstract
The authors report the occurrence of sudden blindness in 5 children (mean age, 32 months; range, 11 to 60) during continuous peritoneal dialysis regimen. All children presented with loss of light perception, visual fixation and ocular pursuit, and bilateral mydriasis unreactive to bright light. Fundoscopic examination found signs of anterior ischemic optic neuropathy with disc swelling, edema, and hemorrhages. Whereas 1 patient was dehydrated, the 4 other patients appeared well and not dehydrated. Nevertheless, blood pressure was below the normal range in all of them. Therefore, hypovolemia is highly suspected to have been the cause of ischemic optic neuropathy in all cases. Treatment consisted of steroids (4 patients), anticoagulation or antiagregation drugs (3 patients), plasma or macromolecules infusions (2 patients), vasodilatators (2 patients), and transient dialysis interruption (1 patient). One child with hepatic cirrhosis died 4 days later of acute liver insufficiency owing to ischemic hepatic necrosis. The other children had only partial improvement of vision during the following months. Because the prognosis of ischemic optic neuropathy is very poor, diagnosis and treatment of chronic hypovolemia in children on continuous peritoneal dialysis is essential to prevent such a devastating complication.
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Affiliation(s)
- Anne-Laure Lapeyraque
- Service de Néphrologie and the Service d'Ophtalmologie, Hopital Robert Debré, Assistance Publique-Hopitaux de Paris, Paris, France
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Bucci MP, Kapoula Z, Yang Q, Wiener-Vacher S, Brémond-Gignac D. Saccades, vergence and combined eye movements in a young subject with Congenital Central Hypoventilation Syndrome (CCHS). Strabismus 2003; 11:95-107. [PMID: 12854017 DOI: 10.1076/stra.11.2.95.15103] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To study saccades, vergence and combined eye movements in a case of Congenital Central Hypoventilation Syndrome. METHODS A 16-year-old girl with congenital partial third cranial nerve palsy, with ptosis and divergent strabismus dependent on viewing distance, participated in this study. A first operation for her ptosis was done seven years ago and an operation for her strabismus was done four years ago. The day of our oculomotor test, the patient had a residual exotropia of 12 prism diopters, mild amblyopia of the left eye and no binocular vision. LEDs on a table placed at eye level were used to stimulate saccades, pure vergence along the median plane and combined saccade-vergence movements. Horizontal eye movements from both eyes were recorded simultaneously with a photoelectric device (Bouis Oculometer). RESULTS The binocular coordination of saccades in this subject was unstable and more variable than normal, and there was divergent post-saccadic drift, i.e., in the direction of her residual deviation. The patient had difficulty making movements in space, particularly vergence eye movements. Pure saccades and combined movements showed abnormally long latencies and marked hypometrias. The velocity of pure saccades was normal. In contrast, the velocity of saccades in the combined movements was abnormally slow. CONCLUSION The long latency and the low accuracy of the eye movements in natural space indicate a general deficit in the central circuitry that controls the initiation and programming of all these types of eye movements. The absence of pure vergence and the slowness of the saccades in the combined movements could be due to a brainstem deficit specific to the vergence oculomotor system.
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Affiliation(s)
- Maria Pia Bucci
- Laboratoire de Physiologie de la Perception et de l'Action, LPPA, CNRS-College de France, Paris, France.
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