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Castets S, Albarel F, Bachelot A, Brun G, Bouligand J, Briet C, Bui Quoc E, Cazabat C, Chabbert-Buffet C, Christin-Maitre S, Courtillot C, Cuny T, De Filippo G, Donadille B, Illouz F, Pellegrini I, Reznik Y, Saveanu A, Teissier N, Touraine P, Vantyghem MC, Vergier J, Léger J, Brue T, Reynaud R. Position statement on the diagnosis and management of congenital pituitary deficiency in adults: the French National Diagnosis and Treatment Protocol (NDTP). Ann Endocrinol (Paris) 2024:S0003-4266(24)00035-0. [PMID: 38452869 DOI: 10.1016/j.ando.2024.03.001] [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] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
Pituitary deficiency, or hypopituitarism, is a rare chronic disease. It is defined by insufficient synthesis of one or more pituitary hormones (growth hormone, TSH, ACTH, LH-FSH, prolactin), whether or not associated with arginine vasopressin deficiency (formerly known as diabetes insipidus). In adult patients, it is usually acquired (notably during childhood), but can also be congenital, due to abnormal pituitary development. The present study focuses on congenital pituitary deficiency in adults, from diagnosis to follow-up, including special situations such as pregnancy or the elderly. The clinical presentation is highly variable, ranging from isolated deficit to multiple deficits, which may be part of a syndromic form or not. Diagnosis is based on a combination of clinical, biological (assessment of all hormonal axes), radiological (brain and hypothalamic-pituitary MRI) and genetic factors. Treatment consists in hormonal replacement therapy, adapted according to the period of life and the deficits, which may be progressive. Comorbidities, risk of complications and acute decompensation, and the impact on fertility and quality of life all require adaptative multidisciplinary care and long-term monitoring.
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Affiliation(s)
- S Castets
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service de Pédiatrie multidisciplinaire, Hôpital de la Timone Enfants, Centre de Référence des Maladies Rares de l'hypophyse HYPO, 13005 Marseille, France.
| | - F Albarel
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service d'Endocrinologie, Hôpital de la Conception, Centre de Référence des Maladies Rares de l'hypophyse HYPO, 13005 Marseille, France
| | - A Bachelot
- AP-HP, IE3M, hôpital Pitié-Salpêtrière, department of endocrinology and reproductive medicine and Centre de référence des maladies endocriniennes rares de la croissance, center de référence des pathologies gynécologiques Rares, ICAN, Paris, France; Sorbonne Université, Paris, France
| | - G Brun
- Aix Marseille University, CNRS, CRMBM, Marseille, France
| | - J Bouligand
- Molecular Genetic, Pharmacogenetic and Hormonology, Paris-Saclay University, Kremlin Bicetre Hospital APHP, Le Kremlin Bicetre, France
| | - C Briet
- Assistance Publique-Hôpitaux de Paris, Hôpital de Bicêtre, Service d'Endocrinologie et des Maladies de la Reproduction, Centre de Référence des Maladies Rares de l'Hypophyse, F-94275 Le Kremlin Bicêtre, France; Institut MITOVASC, INSERM U1083, Université d'Angers, Département d'Endocrinologie, Diabétologie et Nutrition, Centre Hospitalier Universitaire d'Angers, F-49933 Angers, France
| | - E Bui Quoc
- Assistance Publique-Hôpitaux de Paris, Robert Debré University Hospital, Ophthalmology Department, Paris, France
| | - C Cazabat
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service de Pédiatrie multidisciplinaire, Hôpital de la Timone Enfants, Centre de Référence des Maladies Rares de l'hypophyse HYPO, 13005 Marseille, France
| | - C Chabbert-Buffet
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service de Pédiatrie multidisciplinaire, Hôpital de la Timone Enfants, Centre de Référence des Maladies Rares de l'hypophyse HYPO, 13005 Marseille, France
| | - S Christin-Maitre
- Sorbonne University, Department of Endocrinology, Diabetology and Reproductive Medicine, Hôpital Saint-Antoine, Assistance Publique-Hôpitaux de Paris, Centre de référence des maladies endocriniennes rares de la croissance et du développement (CMERC) Centre de compétence HYPO 184 rue du faubourg St Antoine, 75012 Paris, France
| | - C Courtillot
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service de Pédiatrie multidisciplinaire, Hôpital de la Timone Enfants, Centre de Référence des Maladies Rares de l'hypophyse HYPO, 13005 Marseille, France
| | - T Cuny
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service de Pédiatrie multidisciplinaire, Hôpital de la Timone Enfants, Centre de Référence des Maladies Rares de l'hypophyse HYPO, 13005 Marseille, France
| | - G De Filippo
- Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Hôpital universitaire Robert Debré, Service d'Endocrinologie et Diabétologie Pédiatrique, Centre de Référence des Maladies Endocriniennes de la Croissance et du Développement, Paris, France
| | - B Donadille
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service de Pédiatrie multidisciplinaire, Hôpital de la Timone Enfants, Centre de Référence des Maladies Rares de l'hypophyse HYPO, 13005 Marseille, France
| | - F Illouz
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service de Pédiatrie multidisciplinaire, Hôpital de la Timone Enfants, Centre de Référence des Maladies Rares de l'hypophyse HYPO, 13005 Marseille, France
| | - I Pellegrini
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service de Pédiatrie multidisciplinaire, Hôpital de la Timone Enfants, Centre de Référence des Maladies Rares de l'hypophyse HYPO, 13005 Marseille, France
| | - Y Reznik
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service de Pédiatrie multidisciplinaire, Hôpital de la Timone Enfants, Centre de Référence des Maladies Rares de l'hypophyse HYPO, 13005 Marseille, France
| | - A Saveanu
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service de Pédiatrie multidisciplinaire, Hôpital de la Timone Enfants, Centre de Référence des Maladies Rares de l'hypophyse HYPO, 13005 Marseille, France
| | - N Teissier
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service de Pédiatrie multidisciplinaire, Hôpital de la Timone Enfants, Centre de Référence des Maladies Rares de l'hypophyse HYPO, 13005 Marseille, France
| | - P Touraine
- Service d'endocrinologie et médecine de la reproduction, Sorbonne Université Médecine-Hôpital Pitié Salpêtrière; Centre de maladies endocrinennes rares de la croissance et du développement, Paris, France
| | - M C Vantyghem
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service de Pédiatrie multidisciplinaire, Hôpital de la Timone Enfants, Centre de Référence des Maladies Rares de l'hypophyse HYPO, 13005 Marseille, France
| | - J Vergier
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service de Pédiatrie multidisciplinaire, Hôpital de la Timone Enfants, Centre de Référence des Maladies Rares de l'hypophyse HYPO, 13005 Marseille, France
| | - J Léger
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service de Pédiatrie multidisciplinaire, Hôpital de la Timone Enfants, Centre de Référence des Maladies Rares de l'hypophyse HYPO, 13005 Marseille, France
| | - T Brue
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service de Pédiatrie multidisciplinaire, Hôpital de la Timone Enfants, Centre de Référence des Maladies Rares de l'hypophyse HYPO, 13005 Marseille, France; Aix Marseille Univ, APHM, INSERM, MMG, Laboratory of Molecular Biology Hospital La Conception, Marseille, France
| | - R Reynaud
- Assistance Publique-Hôpitaux de Marseille (AP-HM), Service de Pédiatrie multidisciplinaire, Hôpital de la Timone Enfants, Centre de Référence des Maladies Rares de l'hypophyse HYPO, 13005 Marseille, France; Aix Marseille Univ, APHM, INSERM, MMG, Laboratory of Molecular Biology Hospital La Conception, Marseille, France
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Bui Quoc E. [Phenotype of an autosomal dominant congenital cataract in siblings]. J Fr Ophtalmol 2023; 46:966-967. [PMID: 37481451 DOI: 10.1016/j.jfo.2023.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 03/04/2023] [Indexed: 07/24/2023]
Affiliation(s)
- E Bui Quoc
- Hôpital universitaire Robert-Debré, AP-HP, Paris, France.
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Tomietto P, Marciano E, Bui Quoc E. Prédictibilité du choix de l’implant, résultats visuels à 1 an et complications de la chirurgie de cataracte chez l’enfant. J Fr Ophtalmol 2022; 45:323-330. [DOI: 10.1016/j.jfo.2021.08.006] [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: 04/28/2021] [Revised: 07/26/2021] [Accepted: 08/09/2021] [Indexed: 11/27/2022]
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Peyre H, Gérard CL, Dupong Vanderhorst I, Larger S, Lemoussu C, Vesta J, Bui Quoc E, Gouleme N, Delorme R, Bucci M. Rééducation oculomotrice informatisée dans la dyslexie : essai clinique randomisé en crossover en population pédiatrique. Encephale 2018; 44:247-255. [DOI: 10.1016/j.encep.2017.03.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 03/11/2017] [Accepted: 03/13/2017] [Indexed: 11/16/2022]
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Vera L, Lambert N, Sommet J, Boulkedid R, Alberti C, Bui Quoc E. Visual outcomes and complications of cataract surgery with primary implantation in infants. J Fr Ophtalmol 2017; 40:386-393. [DOI: 10.1016/j.jfo.2016.12.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2016] [Revised: 12/22/2016] [Accepted: 12/29/2016] [Indexed: 10/19/2022]
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Bui Quoc E, Guilmin Crepon S, Tinguely S, Lavallee G, Busquet G, Angot M, Vera L. Comparaison de la réfraction avec ou sans cycloplégie au Retinomax® vs Plusoptix®. J Fr Ophtalmol 2017; 40:209-214. [DOI: 10.1016/j.jfo.2016.10.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Revised: 10/24/2016] [Accepted: 10/26/2016] [Indexed: 10/19/2022]
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Lions C, Colleville L, Bui Quoc E, Bucci MP. Importance de l’influx visuel selon l’œil fixateur sur le contrôle postural chez l’enfant strabique. Neurophysiol Clin 2015. [DOI: 10.1016/j.neucli.2015.10.062] [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: 10/22/2022] Open
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Bui Quoc E. The origins of strabismus and loss of binocular vision. Implication of the corpus callosum. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.0057] [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]
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Lions C, Ezane MD, Bui Quoc E, Milleret C, Bucci M. Analyse temporelle et spatiale du déplacement du centre des pressions chez l’enfant strabique. Neurophysiol Clin 2014. [DOI: 10.1016/j.neucli.2014.09.024] [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: 10/24/2022] Open
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Bui Quoc E, Bonnet D, Bajolle F. Cécité secondaire à un surdosage en antivitamine K chez l’enfant : un argument pour l’éducation thérapeutique. Arch Pediatr 2012; 19:22-6. [DOI: 10.1016/j.arcped.2011.10.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2011] [Revised: 04/29/2011] [Accepted: 10/03/2011] [Indexed: 11/26/2022]
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Quoc EB, Delepine B, Tran THC. [Thickness of retinal nerve fiber layer and macular volume in children and adults with strabismic and anisometropic amblyopia]. J Fr Ophtalmol 2009; 32:488-95. [PMID: 19660831 DOI: 10.1016/j.jfo.2009.06.002] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2008] [Accepted: 06/04/2009] [Indexed: 10/20/2022]
Abstract
PURPOSE To compare the thickness of the retinal nerve fiber layer (RNFL) and the macular volume and of normal and amblyopic eyes between children and adults who had strabismic or anisometropic amblyopia. PATIENTS AND METHODS Patients with unilateral amblyopia were consecutively included from June 2006 to June 2007. The macular volume and the RNFL thickness were measured using OCT and compared depending on the type of amblyopia, either strabismic or anisometropic, and the age of the patients, either children (3-10 years old) or adults (18 years old or older). RESULTS Fifty-six patients were included. In the child group (n=27), there was no significant difference in RNFL thickness and macular volume between amblyopic and normal eyes in both anisometropic and strabismic amblyopia. In the adult group (n=29), the RNFL was statistically thicker in amblyopic eyes only in the subgroup of anisometropic amblyopia (114+/-10.3mum in the amblyopic eyes versus 103+/-9.8mum in the normal eyes, p=0.02). No difference was found in RNFL thickness and macular volume in strabismic amblyopia. When anisometropic amblyopic eyes in children were compared to those of adults, the spherical equivalence was more positive (p=0.03) and RNFL was thicker (p=0.02) in the adult group, whereas visual acuity was not significantly different between the two groups. In strabismic amblyopia, no difference was found in spherical equivalence, RNFL thickness, and macular volume, whereas visual acuity was better in children's amblyopic eyes as compared to those of adults (p=0.05). CONCLUSION The difference in RNFL thickness is related to the difference of refraction between normal and amblyopic eyes, and between children and adults, independently of visual acuity and the mechanism of amblyopia.
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Affiliation(s)
- E Bui Quoc
- Service d'Ophtalmologie, Hôpital Robert Debré, Paris, France
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Dethorey G, Bui Quoc E. 365 Prise en charge de la cataracte infantile associée à une aniridie. J Fr Ophtalmol 2009. [DOI: 10.1016/s0181-5512(09)73489-8] [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: 10/20/2022]
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Ingster Moati I, Bui Quoc E, Orssaud C, Creux C, Crochet M, Le Neindre P, Schmitt D, Roche O, Dufier J. 273 Délégation de tâches pour les examens électrophysiologiques visuels. J Fr Ophtalmol 2009. [DOI: 10.1016/s0181-5512(09)73400-x] [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: 10/20/2022]
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Allali J, Couturier A, Khechine Martinez R, Boumendil J, Roche O, Bui Quoc E, Orssaud C, Constantin Martinet N, Rahmoun J, Meneghel M, Al Quatani A, Dufier J. 645 Chirurgie des malformations palpébrales au cours des fentes orbito-faciales. J Fr Ophtalmol 2009. [DOI: 10.1016/s0181-5512(09)73769-6] [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: 11/17/2022]
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Bui Quoc E, Allali J, Rothschild P, Bajolle F, Ingstermoati I, Sidi D, Dufier J, Roche O. 117 Cécité consécutive à un hématome orbitaire par surdosage en anti-vitamine K. J Fr Ophtalmol 2008. [DOI: 10.1016/s0181-5512(08)70713-7] [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: 10/22/2022]
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Allali J, Couturier A, Roche O, Orssaud C, Khechine Martinez R, Bui Quoc E, Martinet Constantin N, Chayesthemer S, Abitbol M, Meneghel M, Dufier J. 113 Chirurgie reconstructrice des microphtalmies et anophtalmies. J Fr Ophtalmol 2008. [DOI: 10.1016/s0181-5512(08)70709-5] [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: 12/01/2022]
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Orssaud C, Roche O, Chayestemehr S, Bui Quoc E, Ingster Moati I, Allali J, Constantin N, Lavergne T, Dufier J. 164 Faut-il demander un ECG systématique chez des patients porteurs d’une neuropathie optique de Leber ? J Fr Ophtalmol 2008. [DOI: 10.1016/s0181-5512(08)70760-5] [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: 10/22/2022]
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Ingster Moati I, Bui Quoc E, Orssaud C, Schmitt D, Le Neindre P, Dury S, Dufier J, Roche O. 121 Surveillance des patients de plus de 65 ans sous hydroxychloroquine au long cours et ERG multifocal. J Fr Ophtalmol 2008. [DOI: 10.1016/s0181-5512(08)70717-4] [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: 10/22/2022]
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Abstract
BACKGROUND Wilson's disease is an autosomal recessive genetic disorder resulting from an abnormality of copper metabolism. The excessive accumulation of copper in the brain induces an extrapyramidal syndrome. Oculomotor abnormalities occur in most extrapyramidal disorders but have rarely been studied in Wilson's disease. OBJECTIVE To evaluate the ocular motility manifestations of Wilson's disease. METHODS A prospective study of 34 patients affected by Wilson's disease who were recruited and their ocular motility recorded by electro-oculography (EOG). RESULTS Vertical smooth pursuit was abnormal in 29 patients (85%). Vertical optokinetic nystagmus and horizontal smooth pursuit were impaired in 41% and 41% of patients, respectively. No MRI abnormality was found in the lenticular nuclei of seven patients who manifested ocular motility abnormalities. CONCLUSION Vertical eye movements, in particular vertical pursuits, are impaired in Wilson's disease, more often than vertical optokinetic nystagmus and vertical saccades. EOG abnormalities can be found in patients who do not yet exhibit anatomical lesions on MRI.
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Affiliation(s)
- I Ingster-Moati
- Université Paris 7 Diderot, Assistance Publique-Hôpitaux de Paris, Hôpital Necker, Department of Ophthalmology, INSERM, U669, Paris, France.
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Roche O, Orssaud C, Allali J, Bui Quoc E, Dufier J. 386 Répartition et intérêt des stéréo-isomères du pigment maculaire. De la lutéine à la méso-zéaxanthine. J Fr Ophtalmol 2007. [DOI: 10.1016/s0181-5512(07)80199-9] [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: 10/21/2022]
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Khechine-Martinez R, Dufay Dupar B, Bui Quoc E, Abitbol M, Humbert A, Dufier J, Allali J. 108 Ptosis de l’enfant révélant une tumeur maligne extraorbitaire. J Fr Ophtalmol 2007. [DOI: 10.1016/s0181-5512(07)79920-5] [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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Bui Quoc E, Majzoub S, Ingster-Moati I, Orssaud C, Roche O, Dufier J. 650 Intoxications aux APS en 2007 : intérêt de l’électrorétinogramme multifocal. J Fr Ophtalmol 2007. [DOI: 10.1016/s0181-5512(07)80463-3] [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: 11/25/2022]
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Roche O, Orssaud C, Allali J, Bui Quoc E, Dufier J. 257 DMLA, dépistage des sujets à risque et prévention. J Fr Ophtalmol 2007. [DOI: 10.1016/s0181-5512(07)80069-6] [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: 11/16/2022]
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Bui Quoc E, Bernard A, Azan F, Renard G, Chauvaud D. [Results of treating rhegmatogenous retinal detachment with vitrectomy and silicone oil tamponade]. J Fr Ophtalmol 2007; 28:944-52. [PMID: 16395220 DOI: 10.1016/s0181-5512(05)81119-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Silicone oil is used in the treatment of rhegmatogenous retinal detachment when there is a high risk of postoperative proliferative vitreoretinopathy (PVR). This type of internal tamponade can be responsible for serious side effects. Removal of silicone oil is necessary to ensure a long-lasting functional result. The purpose of this study was to evaluate the results of using a transient internal tamponade with silicone oil. PATIENTS AND METHODS A retrospective review of cases of rhegmatogenous retinal detachment treated with internal tamponade with silicone oil for the first time in a 1-year period (January 2001 to December 2001) was conducted. We studied the type of retinal detachment, treatment before vitrectomy and silicone oil tamponade, indication for silicone oil tamponade, surgical steps and their results, causes of recurrent retinal detachment, and final visual acuity. Anatomical success was defined as a reattached retina after silicone oil removal. RESULTS Ninety-three patients were included. Anatomical success was achieved, after one or several procedures, in 71 patients (76.3%). The mean total number of surgical procedures was 2.6. After initial surgery, recurrence of retinal detachment after removal of silicone oil occurred in 17.0% of the cases. Recurrence of retinal detachment under silicone oil occurred in 45.1% of the cases; the cause of the recurrence was PVR in 97.6% of those patients. No serious complication of silicone oil tamponade occurred. The mean duration of the tamponade was 6.7 months. The best results were achieved among patients showing no recurrence with silicone oil: visual acuity above 4/200 in 84.6% of the patients, above 20/200 in 61.5% of the patients and above 80/200 in 20.5% of the patients. In case of recurrence with silicone oil treatment, visual acuity reached 4/200 in 70.4% of the patients and was above 20/200 in 25.9% of the patients. DISCUSSION AND CONCLUSION The results of this study are equivalent to those of studies in which analysis was made after removal of silicone oil. Proliferative vitreoretinopathy remains the only risk factor of retinal detachment recurrence with silicone oil (p<0.01). The number of previous surgeries is not a risk factor for postoperative PVR. Retinectomy is a surgical procedure that seems to improve the results in cases of severe PVR.
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Affiliation(s)
- E Bui Quoc
- Service d'Ophtalmologie, Hôtel-Dieu, 1, place du parvis Notre Dame, 75181 Paris Cedex 04, France.
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Abstract
INTRODUCTION Antimalarial drug-induced retinopathy was first described in the 1950s. Irreversible retinal damage still occurs 50 years later, despite knowledge of the phenomenon. This raises several questions: How aware are physicians of this problem and do they inform their patients? What efficient prevention strategies should be advocated and what are the legal aspects? We present four cases of severe chloroquine- and hydroxychloroquine-induced retinopathy to try to understand what led to these situations. CASE REPORTS The fist case, a male patient born in 1956, had chloroquine therapy for lupus initiated in 1987, at a dose ranging from 3 to 6 mg/kg per day. In 1992, no toxicity was clinically or electrophysiologically noted. In 1997, macular abnormalities were diagnosed; chloroquine treatment was nevertheless continued. In 2002, the electroretinogram and central visual field examinations were abnormal. Chloroquine treatment was discontinued. In 2005, abnormalities of full-field and multifocal electroretinograms, electro-oculogram, color vision, and visual field confirmed the maculopathy. The second case, a female patient, born in 1956, had chloroquine therapy for rheumatoid arthritis beginning in 1993, at a dose of 5 mg/kg per day. In 1999, 2000, and 2001, electroretinograms were reported as normal. Clinical maculopathy occurred in 2003 and treatment was continued. In January 2004, the central visual field was found abnormal; treatment was discontinued in July 2004. The third case, a female patient born in 1931, had chloroquine therapy for malaria prevention initiated in 1975, at a dose of 1.7 mg/kg per day. No exams were performed after 1983. In 2001, she complained of a left unilateral vision loss. Bilateral maculopathy was clinically found, and confirmed by full-field and multifocal electroretinograms. The fourth case, a female patient born in 1944, had hydroxychloroquine therapy for lupus initiated in 1982 at a dose of 6.9 mg/kg per day. In 2000 and 2002, full-field electroretinograms were reported as normal despite low amplitudes. In 2004, clinical examination was normal, whereas electroretinogram, electro-oculogram, color vision, and central visual field examinations proved severe damage; the treatment was discontinued. DISCUSSION Retinal damage in these cases was caused by several factors. Treatment was not stopped despite clinically obvious maculopathy in cases 1 and 2. In case 3, no ophthalmologic examinations were performed between 1983 and 2001. In case 4, despite a high cumulative dose, therapy was not discontinued, as also seen in cases 1 and 2, in which ophthalmologic monitoring was not increased. Higher doses than the maximal recommended daily dose occurred in cases 1, 2, and 4. CONCLUSION Antimalarial drug therapy still requires intensive monitoring to avoid severe retinal damage that can lead to legal blindness. Appropriate examinations should be performed regularly in order to decide whether to taper or stop when damage is still mild, preclinical, or reversible.
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Affiliation(s)
- I Ingster-Moati
- Hôpital Lariboisière, Assistance Publique-Hôpitaux de Paris, Paris, France.
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Bodaghi B, Bui Quoc E, Wechsler B, Tran THC, Cassoux N, Le Thi Huong D, Chosidow O, Herson S, Piette JC, LeHoang P. Therapeutic use of infliximab in sight threatening uveitis: retrospective analysis of efficacy, safety, and limiting factors. Ann Rheum Dis 2005; 64:962-4. [PMID: 15897316 PMCID: PMC1755514 DOI: 10.1136/ard.2004.025882] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Bui Quoc E, Ingster-Moati I, Rigolet MH, Chosidow O, Bodaghi B. Prévention ophtalmologique de l’intoxication rétinienne induite par les antipaludéens de synthèse. Ann Dermatol Venereol 2005; 132:329-37. [PMID: 15886559 DOI: 10.1016/s0151-9638(05)79277-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Antimalarial drugs induce severe retinal toxicity. The aims of this study were to evaluate the strategy of screening clinical and preclinical intoxication due to antimalarial agents in two centres of reference and to describe the results of ophthalmologic examination. PATIENTS AND METHODS Patients referred for ophthalmologic evaluation in connection with antimalarial agents therapy in the Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts from October 1999 to December 2000 and in the Hôpital Lariboisière from January 1995 to December 1998 were investigated. A retrospective review of results of ophthalmologic examination, electroretinogram, electro-oculogram, colour vision test and central visual field was conducted to assess retinal intoxication. RESULTS Among 705 patients recruited in the Centre des Quinze-Vingts, 10 out of 133 who were never treated had an electrophysiological contra-indication to the treatment. Among the 572 other patients, 31 presented with preclinical intoxication (5.4 p. 100) and 8 other patients presented with clinical intoxication. Among 925 patients recruited in the Hôpital Lariboisière, 37 presented with preclinical intoxication (4 p. 100) and four patients presented with clinical intoxication. DISCUSSION The antimalarial drugs clinical intoxication is rare but nevertheless real. Screening for preclinical intoxication can prevent the evolution toward irreversible retinal intoxication. Diagnosis of preclinical intoxication is established through the confrontation of results of different tests and their evolution. The multifocal electroretinogram remains to be evaluated. CONCLUSION Ophthalmologic monitoring including funduscopy, should be recommended at least once a year. Visual field seems to become interesting in the screening. Electroretinogram and electro-oculogram remain useful quantitative and obvious tests. A prospective study to assess the optimal way to prevent retinal intoxication is mandatory.
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Affiliation(s)
- E Bui Quoc
- Laboratoire de Physiologie de la Perception et de l'Action, Collège de France, Paris
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Metzquer C, Bodaghi B, Bui Quoc E, Wechsler B, Tran T, Cassoux N, Le Thi Huong-Boutin D, Chosidow O, Piette J, Le Hoang P. 293 Utilisation thérapeutiqure de l’infliximab au cours des uvéites réfractaires: analyse rétrospective de l’efficacité, des effets indésirables et des limites. J Fr Ophtalmol 2005. [DOI: 10.1016/s0181-5512(05)74690-8] [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: 10/22/2022]
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Bui Quoc E, Quenech’du N, Milleret C. 009 Plasticité de l’intégration interhémisphérique visuelle via le corps calleux en cas de strabisme convergent unilatéral précoce. J Fr Ophtalmol 2005. [DOI: 10.1016/s0181-5512(05)74405-3] [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: 10/22/2022]
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Abstract
INTRODUCTION Retinopathy of prematurity is a complication of prematurity whose risk factors are well known. Its prognosis remains fearsome and its treatment is difficult. PATIENTS AND METHODS Fifty-four children were managed (108 eyes analyzed) for retinopathy of prematurity in the Ophthalmology Ward of Necker-Enfants-Malades Hospital between 1996 and 2002. A retrospective review of those cases was performed to describe their clinical features, their treatment and their outcome. RESULTS Mean gestational age was 26.75 weeks after the mother's last period (24-32.5 weeks) and mean birth weight was 842 g (530-2260 g). Stage zero occurred in ten eyes, stage 1 in two eyes, stage 2 in seven eyes, stage 3 in 42 eyes, stage 4 in ten eyes, stage 5 in 24 eyes, and after-effects stage in 13 eyes. Initial treatment (combined treatments possible) was abstention in 45 eyes, cryotherapy in 16 eyes, laser photocoagulation in 43 eyes, surgical treatment of 13 eyes (scleral buckling or vitrectomy). Cryotherapy was effective in 71.5% of cases, photocoagulation was effective in 77%, and scleral buckling was effective in 25%. Vitrectomy failed in the five eyes treated. Outcome was complicated by legal blindness in 33 eyes. DISCUSSION AND CONCLUSION The cases of retinopathy of prematurity that we manage are often severe, stage 3 or above, which explains the outcome of the patients. The 7-year experience reported herein shows how difficult it is to manage this condition, though the need for its detection, diagnosis criteria, and therapeutical indications are well known. Because younger and smaller premature newborns are successfully managed by pediatricians, retinopathy of prematurity is far from having vanished and its morbidity is considerable.
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Affiliation(s)
- E Bui Quoc
- Service d'Ophtalmologie, Hôpital Necker-Enfants-Malades, 149, rue de Sèvres, 75743 Paris 15.
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Bui Quoc E, Bodaghi B, Adam R, Burtin T, Cassoux N, Dreifuss S, Fardeau C, LeHoang P. [Intraocular pressure elevation after subtenon injection of triamcinolone acetonide during uveitis]. J Fr Ophtalmol 2002; 25:1048-56. [PMID: 12527830] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
INTRODUCTION New therapeutic concepts in the management of ocular inflammation have led to the development of periocular and intravitreal injections. Such treatment modalities can induce intraocular pressure elevation. PATIENTS AND METHODS Periocular injections have been given to patients suffering from strictly unilateral or bilateral but asymmetrical and noninfectious posterior uveitis. A history of corticosteroid-induced glaucoma was a contraindication to such treatment. A retrospective review of cases who were given subtenon triamcinolone acetonide injection between May and October 2001 was undertaken to evaluate the efficacy of the treatment and the risk of intraocular pressure elevation. Ocular pressure was measured before and after the injection and the efficacy of the treatment was evaluated by measurements of visual acuity and fluorescein angiography. RESULTS One or several injections were given to 61 patients. Intraocular pressure rose in 13 patients (21.3%). Medical treatment was unsuccessful in three cases and surgical excision of periocular corticosteroid deposit was required. Therefore, intraocular pressure was controlled with no other medication. Treatment was considered effective in 32 patients (52.45%): improvement of visual acuity (more than two lines) or control of inflammation on fluorescein angiography. DISCUSSION and conclusions: Periocular subtenon injection of triamcinolone acetonide in posterior noninfectious uveitis is a safe procedure. Intraocular pressure elevation is not frequent and can be controlled through medical treatment or surgical excision of a residual deposit, in which pharmacologically active triamcinolone can be present several months after the injection.
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Affiliation(s)
- E Bui Quoc
- Service d'Ophtalmologie, Groupe Hospitalier Pitié-Salpêtrière, 47-83, boulevard de l'hôpital, 75651 Paris cedex 13, France
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