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Niegowski LJ, Cohen SY, Crincoli E, Mehanna CJ, Souied EH. Cognitive bias evaluation on the choice of treatment in common retinal disorders among retina specialists in 2023. J Fr Ophtalmol 2024; 47:104177. [PMID: 38603895 DOI: 10.1016/j.jfo.2024.104177] [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: 07/26/2023] [Revised: 10/01/2023] [Accepted: 10/22/2023] [Indexed: 04/13/2024]
Abstract
PURPOSE The study aimed to discern the intent to treat with the therapeutic agents prescribed first or second line in the following eye conditions: neovascular age-related macular Degeneration (nAMD), diabetic macular edema (DME), retinal vein occlusion (RVO), and myopic maculopathy with choroidal neovascularization (MMNV). The study also aimed to distinguish the ophthalmologists' intended treatment for their patients from those that they would prescribe for themselves if they were affected by the above macular conditions. METHODS The study utilized an online survey of 243 French ophthalmologists practicing medical retina, with males accounting for 54.3% of the participants. Data was obtained using a questionnaire that focused on the ophthalmologists' experience with various agents as well as their first and second line choices for nAMD, DME, RVO, and MMNV. RESULTS The vast majority of French ophthalmologists (99%) had experience with the most widely used anti-vascular endothelial growth factors (anti-VEGFs); ranibizumab, bevacizumab, and aflibercept. Fewer than 8% reported experience with anti-VEGF drug reservoirs, biosimilars, or faricimab. The study findings also showed ranibizumab and aflibercept as the commonly prescribed first line choices for the above-mentioned ocular conditions. For the second line choice, the study showed that aflibercept and dexamethasone intravitreal implants were the most common across the four retinal conditions studied. The only difference in intent to treat for "patients" versus "yourself" was for biosimilars (0% to 0.8%, P=0.001). CONCLUSION The findings regarding the first and second line choices for the mentioned ocular disorders were found to agree with the findings of published literature currently used in practice, with a tendency to prefer ranibizumab as first line therapy for neovascular disorders and aflibercept as first line therapy for macular edema. In addition, there were no differences between choices for first and second line therapy for patients vs. ophthalmologists.
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Affiliation(s)
- L-J Niegowski
- Department of Ophthalmology, University of Paris Est-Creteil, Créteil, France
| | - S Y Cohen
- Department of Ophthalmology, University of Paris Est-Creteil, Créteil, France; Ophthalmology Center for Imaging and Laser, Paris, France
| | - E Crincoli
- Department of Ophthalmology, University of Paris Est-Creteil, Créteil, France
| | - C J Mehanna
- Department of Ophthalmology, University of Paris Est-Creteil, Créteil, France
| | - E H Souied
- Department of Ophthalmology, University of Paris Est-Creteil, Créteil, France.
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Torrell-Belzach N, Miere A, Souied EH, Gaudric A, Cohen SY. Hemorrhagic unilateral retinopathy: a report of multimodal imaging in three cases. Retin Cases Brief Rep 2024:01271216-990000000-00292. [PMID: 38427977 DOI: 10.1097/icb.0000000000001557] [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: 05/18/2023] [Accepted: 02/13/2024] [Indexed: 03/03/2024]
Abstract
PURPOSE To report three cases of hemorrhagic unilateral retinopathy, diagnosed by multimodal imaging. METHODS Case report of 3 patients, 2 women and one man, aged 51, 74, and 52, respectively. RESULTS Symptoms were acute floaters, blurred vision, or central scotoma, unilateral in all cases. The best-corrected visual acuity was 20/20 in the affected eye in 2 patients with a paracentral scotoma, and 20/160 in the third patient. Funduscopic examination revealed multiple unilateral posterior hemorrhages located in the Henle fiber layer in the macula and beneath the internal limiting membrane around the optic disc on spectral-domain optical coherence tomography (SD-OCT). Fluorescein angiography and indocyanine green angiography (ICGA) did not show any vascular abnormalities. SD-OCT angiography (SD-OCT-A) did not show any capillary drop-out or choroidal abnormalities. In all patients, the visual symptoms completely disappeared within a few weeks, with spontaneous regression of the hemorrhages. CONCLUSION Hemorrhagic unilateral retinopathy is a rarely reported and poorly understood disorder. ICGA and SD-OCT-A did not allow better understanding the condition. No etiology has been associated with this entity so far. The spontaneous resolution of the present cases confirmed the favorable visual prognosis of the condition.
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Affiliation(s)
| | - Alexandra Miere
- the Department of Ophthalmology, Intercity Hospital, Creteil
| | - Eric H Souied
- the Department of Ophthalmology, Intercity Hospital, Creteil
| | - Alain Gaudric
- the Ophthalmic Center for Imaging and Laser, Paris, France
| | - Salomon Y Cohen
- the Department of Ophthalmology, Intercity Hospital, Creteil
- the Ophthalmic Center for Imaging and Laser, Paris, France
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3
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Wakabayashi T, Yonekawa Y, Ohno-Matsui K, Cohen SY, Rowland C, Pulido JS. RIDGE-SHAPED PERIPAPILLA. Retin Cases Brief Rep 2024; 18:11-14. [PMID: 36007179 DOI: 10.1097/icb.0000000000001308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Accepted: 07/25/2022] [Indexed: 06/15/2023]
Abstract
PURPOSE To report a case of peripapillary subretinal fluid associated with a ridge-shaped morphology surrounding the optic disk, which we termed ridge-shaped peripapilla. METHODS Case report. RESULTS A 6-year-old girl with mild-to-moderate myopia was referred for an abnormal fundus appearance of the left eye. Fundus examination of the left eye showed a vertical whitish elevation just temporal to the disk with pigment clumping. Spectral domain optical coherence tomography of the left eye showed an elevation of the fundus at the temporal edge of the disk with thinning of the choroid overlying the thickened scleral protrusion and a serous subretinal fluid. Fluorescein angiography of the left eye showed a hyperfluorescent area without leakage at the temporal edge of the disk, indicative of retinal pigment epithelium atrophy. There was no sign of choroidal neovascularization. Based on the fluorescein angiography and optical coherence tomography findings, the protrusion of the sclera seemed to result in overlying choroidal thinning with choroidal blood flow disturbances, and consequent retinal pigment epithelium atrophy, leading to the subretinal fluid. CONCLUSION This case highlights an unusual presentation of ridge-shaped peripapilla, characterized by inward convexity of the peripapillary area with a ridge-shaped morphology and localized thickening of the peripapillary sclera, in eyes with myopia.
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Affiliation(s)
- Taku Wakabayashi
- Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Yoshihiro Yonekawa
- Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Kyoko Ohno-Matsui
- Department of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan; and
| | - Salomon Y Cohen
- Ophthalmic Center for Imaging and Laser, Paris and University of Paris Est, Creteil, France
| | - Christina Rowland
- Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Jose S Pulido
- Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, Pennsylvania
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4
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Nghiem-Buffet S, Sibilia L, Cohen SY. Tilted disc in eyes with fovea plana. Graefes Arch Clin Exp Ophthalmol 2023; 261:3159-3164. [PMID: 37351645 DOI: 10.1007/s00417-023-06161-7] [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: 04/04/2023] [Revised: 05/16/2023] [Accepted: 06/15/2023] [Indexed: 06/24/2023] Open
Abstract
PURPOSE To report the association of tilted disc (TD) with fovea plana. METHODS Monocentric retrospective study of consecutive eyes diagnosed with fovea plana, assessed by spectral-domain optical coherence tomography. Analysis of the medical charts and imaging findings of patients to collect demographics, the visual acuity, and the clinical context. The presence of associated conditions was checked by two independent readers in order to classify fovea plana as isolated or part of other conditions. RESULTS Twenty-one patients, 9 men and 12 women, aged 12 to 91 years, were included. Fovea plana was isolated and asymptomatic in 10 (47.6%) patients. In 6 (28.5%) patients, fovea plana was associated with ocular albinism and/or nystagmus. In 6 (28.5%) patients, fovea plana was associated with an obliquity of the optic disc typical of TD, isolated (5 cases), or associated with nystagmus (1 case). CONCLUSION An association between TD and fovea plana had been reported only once in the literature and had been considered likely coincidental. However, this association could be more common than initially reported and suggests a common pathological process in eye development during embryogenesis.
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Affiliation(s)
- Sylvia Nghiem-Buffet
- Ophthalmology Center for Imaging and Laser, 11 rue Antoine Bourdelle, 75015, Paris, France
| | - Lise Sibilia
- Ophthalmology Center for Imaging and Laser, 11 rue Antoine Bourdelle, 75015, Paris, France
| | - Salomon Y Cohen
- Ophthalmology Center for Imaging and Laser, 11 rue Antoine Bourdelle, 75015, Paris, France.
- Department of Ophthalmology, Intercity Hospital and Paris Est University, 40 Avenue de Verdun, 94010, Creteil, France.
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van Dijk EHC, Ossewaarde-van Norel J, Vingerling JR, Cohen SY, Boon CJF. Serous Maculopathy Due to Aspecific Choroidopathy (SMACH). Asia Pac J Ophthalmol (Phila) 2023; 12:496-498. [PMID: 36454234 DOI: 10.1097/apo.0000000000000550] [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: 12/03/2022] Open
Affiliation(s)
- Elon H C van Dijk
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
| | | | - Johannes R Vingerling
- Department of Ophthalmology, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Salomon Y Cohen
- Ophthalmic Center for Imaging and Laser, Paris, France
- Department of Ophthalmology, Intercity Hospital and University of Paris Est, Creteil, France
| | - Camiel J F Boon
- Department of Ophthalmology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Ophthalmology, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
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Rohart C, Le HM, Estrada-Walker J, Giocanti-Auregan A, Cohen SY. LONG-TERM PROGNOSIS OF CHOROIDAL NEOVASCULARIZATION COMPLICATING ANGIOID STREAKS. Retina 2023; 43:882-887. [PMID: 36727798 DOI: 10.1097/iae.0000000000003746] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PURPOSE To report the very long-term visual prognosis of choroidal neovascularization complicating angioid streaks in the antivascular endothelial growth factor era. METHODS Retrospective monocentric study aimed at analyzing patients' demographics, choroidal neovascularization features, angioid streak-associated conditions, and previous and current therapies for choroidal neovascularization. The main outcome measures were the quantitative measurement of central retinal pigment epithelial atrophy enlargement by comparing the ratio of pixels involved on automated infrared images acquired by spectral-domain optical coherence tomography and the changes in best-corrected visual acuity. The secondary outcome measures were the number of intravitreal injections and the changes in central choroidal thickness and central retinal thickness. Subgroup analyzes were performed to compare macular atrophy extent between eyes of patients with or without proven pseudoxanthoma elasticum ("PXE" or "no PXE") and between eyes previously treated or not with photodynamic therapy ("PDT" or "no PDT"). RESULTS Thirty-three eyes of 23 patients were included. The mean best-corrected visual acuity decreased significantly from 66 ± 19 Early Treatment Diabetic Retinopathy Study letters at the time of the first antivascular endothelial growth factor injection to 52 ± 23 Early Treatment Diabetic Retinopathy Study letters at the end of the follow-up (mean follow-up duration: 109 ± 42 months, range: 47-175 months). The ratio of central retinal pigment epithelial atrophy enlargement was 201%, 110%, 240%, and 111% in the PXE, no PXE, PDT, and no PDT groups, respectively. CONCLUSION Despite the use of antivascular endothelial growth factor agents, the very long-term prognosis appeared relatively poor, especially in patients with PXE. This study also suggests that PDT should be used with caution in the management of choroidal neovascularization in eyes with angioid streaks.
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Affiliation(s)
- Charlotte Rohart
- Ophthalmology Center for Imaging and Laser, Paris
- Department of Ophthalmology, Ophtalmopôle Hôpital Cochin, APHP, and University of Paris, Paris, France
- Department of Ophthalmology, Clinique Beausoleil, Montpellier, France
| | - Hoang-Mai Le
- Department of Ophthalmology, University of Paris-Est Creteil, France; and
| | | | | | - Salomon Y Cohen
- Ophthalmology Center for Imaging and Laser, Paris
- Department of Ophthalmology, University of Paris-Est Creteil, France; and
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de Laage de Meux P, Mosbah H, Cotton-Viard A, Cohen SY. Fovea Plana and Fundus Hypopigmentation in Prader-Willi Syndrome. Retin Cases Brief Rep 2023; Publish Ahead of Print:01271216-990000000-00176. [PMID: 37267630 DOI: 10.1097/icb.0000000000001441] [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: 06/04/2023]
Abstract
PURPOSE To report a case of fovea plana with fundus hypopigmentation in a patient with Prader-Willi syndrome (PWS). CASE REPORT During a routine examination, fovea plana and fundus hypopigmentation were observed in both eyes in a 34-year-old male patient with PWS, and documented with fundus photography, spectral-domain optical coherence tomography (SD-OCT) and OCT-angiography. CONCLUSION Fovea plana and fundus hypopigmentation may be associated with PWS. Indeed, both PWS and oculocutaneous albinism (OCA) may be explained by the deletion of the same genomic region on chromosome 15. The present case of a PWS patient with fundus hypopigmentation supports the genetic and clinical overlap between PWS and OCA.
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Affiliation(s)
- Priscille de Laage de Meux
- Ophthalmology Center for Imaging and Laser, 11 rue Antoine Bourdelle, 75015 Paris, France
- Department of Ophthalmology, Intercity Hospital and University Paris Est, 40 Avenue de Verdun, 94010, Creteil, France
| | - Héléna Mosbah
- Department of Nutrition and Rare Diseases Referral Center PRADORT, Pitié-Salpêtrière Hospital, AP-HP and Sorbonne University, 47-83 Boulevard de l'Hôpital, 75671 Paris Cedex 13, France
| | | | - Salomon Y Cohen
- Ophthalmology Center for Imaging and Laser, 11 rue Antoine Bourdelle, 75015 Paris, France
- Department of Ophthalmology, Intercity Hospital and University Paris Est, 40 Avenue de Verdun, 94010, Creteil, France
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8
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Herda N, Semoun O, Srour M, Amoroso F, Baker M, Capuano V, Colantuono D, Cohen SY, Querques G, Souied EH. Atypical case of perifoveal exudative vascular anomalous complex associated with pachychoroid pigment epitheliopathy. Am J Ophthalmol Case Rep 2022; 28:101691. [PMID: 36090303 PMCID: PMC9449734 DOI: 10.1016/j.ajoc.2022.101691] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Revised: 07/09/2022] [Accepted: 08/22/2022] [Indexed: 11/16/2022] Open
Abstract
Purpose Observations Conclusion and importance
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Affiliation(s)
- Nabil Herda
- Department of Ophthalmology, University of Paris Est-Creteil, Créteil, France
- Corresponding author. Hopital intercommunal de Créteil, Department of Ophtalmology, 40 Avenue de Verdun, 94000, Créteil, France.
| | - Oudy Semoun
- Department of Ophthalmology, University of Paris Est-Creteil, Créteil, France
| | - Mayer Srour
- Department of Ophthalmology, University of Paris Est-Creteil, Créteil, France
| | - Francesca Amoroso
- Department of Ophthalmology, University of Paris Est-Creteil, Créteil, France
| | - May Baker
- Department of Ophthalmology, University of Paris Est-Creteil, Créteil, France
| | - Vittorio Capuano
- Department of Ophthalmology, University of Paris Est-Creteil, Créteil, France
| | - Donato Colantuono
- Department of Ophthalmology, University of Paris Est-Creteil, Créteil, France
| | - Salomon Y. Cohen
- Department of Ophthalmology, University of Paris Est-Creteil, Créteil, France
| | - Giuseppe Querques
- Department of Ophthalmology, University of Paris Est-Creteil, Créteil, France
- Department of Ophthalmology, IRCCS Ospedale San Raffaele, Vita-Salute University, Milan, Italy
| | - Eric H. Souied
- Department of Ophthalmology, University of Paris Est-Creteil, Créteil, France
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Torrell-Belzach N, Miere A, Souied E, Cohen SY. Long-Term Resolution of Perifoveal Exudative Vascular Anomalous Complex after Intravitreal Injections of Anti-Vascular Endothelial Growth Factor. Case Rep Ophthalmol 2022; 13:936-942. [PMID: 36466064 PMCID: PMC9710424 DOI: 10.1159/000526991] [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: 07/05/2022] [Accepted: 08/05/2022] [Indexed: 08/30/2023] Open
Abstract
Perifoveal exudative vascular anomalous complex (PEVAC) is a perifoveal aneurysmal vascular lesion found in healthy subjects. A 68-year-old woman was diagnosed with a typical unilateral and unifocal PEVAC lesion after extensive multimodal imaging and was treated with three-monthly intravitreal injections of ranibizumab. An immediate and complete resolution of the intraretinal fluid was observed. Visual acuity returned to 20/20 without any recurrence of the exudative signs along the 5 years of follow-up. Therefore, an initial anti-VEGF treatment with three-monthly intravitreal injections may be considered as a first-line treatment in PEVAC lesions and may result in long-term preservation of visual acuity.
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Affiliation(s)
| | - Alexandra Miere
- Department of Ophthalmology, University of Paris Est-Creteil, Créteil, France
| | - Eric Souied
- Department of Ophthalmology, University of Paris Est-Creteil, Créteil, France
| | - Salomon Y. Cohen
- Department of Ophthalmology, University of Paris Est-Creteil, Créteil, France
- Centre Ophtalmologique d'Imagerie et de Laser, Paris, France
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10
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Bellamy JP, Cohen SY. Congenital Hypertrophy of the Retinal Pigment Epithelium Complicated by Choroidal Neovascularization. Ophthalmol Retina 2022; 6:511. [PMID: 35680236 DOI: 10.1016/j.oret.2022.02.005] [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: 02/11/2022] [Revised: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 06/15/2023]
Affiliation(s)
| | - Salomon Y Cohen
- Centre Ophtalmologique d'Imagerie et de Laser, Paris, France; Department of Ophthalmology, University of Paris Est - Créteil, Créteil, France
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Le HM, Mrejen S, Sibilia L, Cohen SY. Correction to: Optical coherence tomography angiography quantification of choriocapillaris blood-flow after half-fluence photodynamic therapy for chronic central serous chorioretinopathy. Graefes Arch Clin Exp Ophthalmol 2022; 260:2391. [PMID: 35488910 DOI: 10.1007/s00417-022-05677-8] [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: 11/04/2022] Open
Affiliation(s)
- Hoang Mai Le
- Department of Ophthalmology, Intercity Hospital, University Paris Est Créteil, Créteil, France
| | - Sarah Mrejen
- Ophthalmic Center for Imagery and Laser, Paris, France
| | - Lise Sibilia
- Ophthalmic Center for Imagery and Laser, Paris, France
| | - Salomon Y Cohen
- Department of Ophthalmology, Intercity Hospital, University Paris Est Créteil, Créteil, France. .,Ophthalmic Center for Imagery and Laser, Paris, France. .,Centre Ophtalmologique d'Imagerie Et de Laser, 11 Rue, Antoine Bourdelle, 75015, Paris, France.
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Abstract
BACKGROUND AND PURPOSE To the best of our knowledge, there is no study of patients with central serous chorioretinopathy associated with chorioretinal folds, since a short mention in Gass' stereoscopic atlas. We report here six cases with this association. METHODS Six patients with both conditions were examined in our institution and underwent fluorescein angiography and optical coherence tomography. RESULTS Patients were 3 men and 3 women, aged 44 years to 82 years. All patients were hyperopic and two received corticosteroids. Fluorescein angiography showed pigmentary changes, diffuse leakage areas typical of chronic central serous chorioretinopathy, and chorioretinal folds mainly located in the upper temporal part of the fundus. Enhanced depth imaging optical coherence tomography was performed in 5 cases and revealed a thick choroid in all cases (mean subfoveal choroidal thickness: 381 µm, range: 280-510 µm). CONCLUSION Although possibly coincidental, the presence of chorioretinal folds in hyperopic central serous chorioretinopathy eyes could be due to the excessive thickness of the choroid in eyes with hyperopia related to short axial length.
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Affiliation(s)
- Salomon Y Cohen
- Ophthalmology Center for Imaging and Laser, Paris, France
- Department of Ophthalmology, University of Paris Est, Creteil, France
| | | | - Alain Gaudric
- Ophthalmology Center for Imaging and Laser, Paris, France
- Department of Ophthalmology, Lariboisière Hospital, APHP and University of Paris-Sorbonne, Paris, France; and
| | - Sarah Mrejen
- Ophthalmology Center for Imaging and Laser, Paris, France
- National Hospital of XV-XX, Paris, France
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Cohen SY, Mrejen S, Nghiem-Buffet S, Dubois L, Fajnkuchen F, Gaudric A. Outer Foveal Microdefects. ACTA ACUST UNITED AC 2021; 5:553-561. [DOI: 10.1016/j.oret.2020.09.018] [Citation(s) in RCA: 1] [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: 05/25/2020] [Revised: 08/19/2020] [Accepted: 09/14/2020] [Indexed: 12/28/2022]
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14
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Ansary MF, Amoroso F, Forte R, Cohen SY, Miere A, Souied EH. Swept-Source OCTA Imaging of a Presumed Solitary Circumscribed Retinal Astrocytic Proliferation. Ophthalmic Surg Lasers Imaging Retina 2021; 52:232-235. [PMID: 34039189 DOI: 10.3928/23258160-20210330-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Presumed solitary circumscribed retinal astrocytic proliferation (pSCRAP) is a rare, benign retinal tumor, typically presenting as a yellow-white, well-defined lesion. It was first qualified as astrocytic, but thanks to the development of optical coherence tomography (OCT), the lesion was identified as a deep glial lesion, as the nerve fiber layer appeared to be spared. Herein, the authors report the case of a 90-year-old man with inferopapillary pSCRAP who benefited from swept-source OCT angiography images. [Ophthalmic Surg Lasers Imaging Retina. 2021;52:232-235.].
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Weber M, Kodjikian L, Coscas F, Faure C, Aubry I, Dufour I, Cohen SY. Impact of intravitreal aflibercept dosing regimens in treatment-naïve patients with neovascular age-related macular degeneration in routine clinical practice in France: results from the RAINBOW study. BMJ Open Ophthalmol 2020; 5:e000377. [PMID: 32518833 PMCID: PMC7254134 DOI: 10.1136/bmjophth-2019-000377] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 08/09/2019] [Revised: 01/28/2020] [Accepted: 02/13/2020] [Indexed: 12/03/2022] Open
Abstract
Objective To evaluate 12-month outcomes in treatment-naïve patients with neovascular (wet) age-related macular degeneration (AMD) stratified by intravitreal aflibercept (IVT-AFL) regimen. Methods and analysis Patients included in the 12-month interim analysis of Real life of intravitreal Aflibercept In FraNce: oBservatiOnal Study in Wet AMD (RAINBOW), a 4-year, ongoing observational study conducted in France, were stratified by IVT-AFL dosing regimen. Safety (n=593) and effectiveness (n=428) data were analysed. Regimens included a regular cohort (three initial monthly IVT-AFL injections and ≥6 injections) and irregular cohorts (<6 injections) with and without three initial monthly injections. The main outcome measure was mean gain in best-corrected visual acuity (BCVA) at 12 months. Results Mean number of IVT-AFL injections was 6.0 (all patients, n=513), 7.2 (regular cohort, n=102), 6.1 (irregular cohort with three initial monthly injections, n=266) and 5.2 (irregular cohort without three initial monthly injections, n=60). Overall mean gain in BCVA at 12 months was 5 letters; +7.1 letters (regular cohort) and +5.6 letters (irregular cohort with three initial monthly injections), both p<0.001 versus baseline, and –1.1 letters (irregular cohort without three initial monthly injections), p=0.669. Improvements in BCVA were also significantly greater in the regular cohort (p<0.001) and irregular cohort with three initial monthly injections (p=0.003) compared with the irregular cohort without three initial monthly injections. Ocular and non-ocular adverse events were reported in 14.7% and 17.4% of all patients, respectively. Conclusion Treatment-naïve patients with neovascular AMD receiving three initial monthly injections followed by regular or irregular injections over 12 months experienced better visual acuity outcomes than those receiving irregular treatment without three initial monthly injections. Trial registration number NCT02279537.
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Affiliation(s)
| | | | | | - Céline Faure
- Clinique Saint-Martin, Ramsay Générale de Santé, Caen, France
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16
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Nghiem-Buffet S, Gaudric A, Cohen SY. Solar retinal phototoxicity masquerading as self-inflicted handheld laser-induced lesions. Am J Ophthalmol Case Rep 2020; 17:100578. [PMID: 31909293 PMCID: PMC6939100 DOI: 10.1016/j.ajoc.2019.100578] [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] [Received: 12/18/2018] [Revised: 06/04/2019] [Accepted: 12/11/2019] [Indexed: 11/20/2022] Open
Abstract
PURPOSE To report multimodal imaging of lesions due to the unprotected observation of the sun with an astronomical telescope, mimicking self-inflicted handheld laser-induced macular lesions. OBSERVATION A 44-year old man was diagnosed with chronic central serous chorioretinopathy leaving a relative scotoma in his left eye, with visual acuity limited to 20/40. He complained of a sudden visual loss to 20/400. Fundus examination showed a yellowish discoloration of the fovea. Fundus autofluorescence pictures showed hyper-autofluorescent spots that were hyperfluorescent both on fluorescein and indocyanine-green angiography. Spectral-domain optical coherence tomography (SD-OCT) showed hyper-reflective foveal outer layers, and OCT-angiography showed dark areas at the choriocapillaris. Multimodal imaging was highly suggestive of self-inflicted handheld laser-induced lesions that were ruled out by the patient. He remembered having observed the sun during an astronomical session, looking for solar winds. The main astronomical telescope was protected by a specific filter, but the aiming side-telescope was incidentally not protected by any filter. CONCLUSION AND IMPORTANCE The unprotected observation of the sun with an astronomical telescope may result in visual loss due to macular burns that may mimic self-inflicted handheld laser-induced lesions. This hypothesis should be searched before concluding denied self-injuries.
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Affiliation(s)
- Sylvia Nghiem-Buffet
- Ophthalmology Center for Imaging and Laser, 11 Rue Antoine Bourdelle, 75015, Paris, France
- Department of Ophthalmology, University of Paris 13, Avicenne Hospital, 125 Route de Stalingrad, 93000, Bobigny, France
| | - Alain Gaudric
- Ophthalmology Center for Imaging and Laser, 11 Rue Antoine Bourdelle, 75015, Paris, France
- Department of Ophthalmology, Lariboisière Hospital, AP-HP and University Paris 7, 2 Rue Ambroise Paré, 75010, Paris, France
| | - Salomon Y. Cohen
- Ophthalmology Center for Imaging and Laser, 11 Rue Antoine Bourdelle, 75015, Paris, France
- Department of Ophthalmology, Intercity Hospital and University Paris Est, 40 Avenue de Verdun, 94010, Creteil, France
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Spaide RF, Jaffe GJ, Sarraf D, Freund KB, Sadda SR, Staurenghi G, Waheed NK, Chakravarthy U, Rosenfeld PJ, Holz FG, Souied EH, Cohen SY, Querques G, Ohno-Matsui K, Boyer D, Gaudric A, Blodi B, Baumal CR, Li X, Coscas GJ, Brucker A, Singerman L, Luthert P, Schmitz-Valckenberg S, Schmidt-Erfurth U, Grossniklaus HE, Wilson DJ, Guymer R, Yannuzzi LA, Chew EY, Csaky K, Monés JM, Pauleikhoff D, Tadayoni R, Fujimoto J. Consensus Nomenclature for Reporting Neovascular Age-Related Macular Degeneration Data: Consensus on Neovascular Age-Related Macular Degeneration Nomenclature Study Group. Ophthalmology 2019; 127:616-636. [PMID: 31864668 DOI: 10.1016/j.ophtha.2019.11.004] [Citation(s) in RCA: 362] [Impact Index Per Article: 72.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 11/03/2019] [Accepted: 11/06/2019] [Indexed: 12/30/2022] Open
Abstract
PURPOSE To establish a process to evaluate and standardize a state-of-the-art nomenclature for reporting neovascular age-related macular degeneration (AMD) data. DESIGN Consensus meeting. PARTICIPANTS An international panel of retina specialists, imaging and image reading center experts, and ocular pathologists. METHODS During several meetings organized under the auspices of the Macula Society, an international study group discussed and codified a set nomenclature framework for classifying the subtypes of neovascular AMD and associated lesion components. MAIN OUTCOME MEASURES A consensus classification of neovascular AMD. RESULTS The study group created a standardized working definition of AMD. The components of neovascular AMD were defined and subclassified. Disease consequences of macular neovascularization were delineated. CONCLUSIONS The framework of a consensus nomenclature system, a definition of AMD, and a delineation of the subtypes of neovascular AMD were developed. Establishing a uniform set of definitions will facilitate comparison of diverse patient groups and different studies. The framework presented is modified and updated readily, processes that are anticipated to occur on a periodic basis. The study group suggests that the consensus standards outlined in this article be used in future reported studies of neovascular AMD and clinical practice.
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Affiliation(s)
- Richard F Spaide
- Vitreous Retina Macula Consultants of New York, New York, New York.
| | - Glenn J Jaffe
- Department of Ophthalmology, Duke University, Durham, North Carolina
| | - David Sarraf
- Doheny Eye Institute, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California
| | - K Bailey Freund
- Vitreous Retina Macula Consultants of New York, New York, New York
| | - Srinivas R Sadda
- Doheny Eye Institute, David Geffen School of Medicine, University of California-Los Angeles, Los Angeles, California
| | | | - Nadia K Waheed
- New England Eye Center, Tufts University, Boston, Massachusetts
| | - Usha Chakravarthy
- Center for Public Health, The Queen's University of Belfast, Belfast, United Kingdom
| | - Philip J Rosenfeld
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida
| | - Frank G Holz
- Department of Ophthalmology, University of Bonn, Bonn, Germany
| | - Eric H Souied
- Department of Ophthalmology, Université Paris-Est Créteil, Paris, France
| | | | - Giuseppe Querques
- IRCCS San Raffaele Hospital, University Vita-Salute San Raffele, Milan, Italy
| | - Kyoko Ohno-Matsui
- Department of Ophthalmology, Tokyo Medical and Dental University, Tokyo, Japan
| | - David Boyer
- Retina-Vitreous Associates Medical Group, Los Angeles, California
| | - Alain Gaudric
- Department of Ophthalmology, Hôpital Lariboisière, AP-HP, Université de Paris, Paris, France
| | - Barbara Blodi
- Department of Ophthalmology and Visual Sciences, Fundus Photograph Reading Center, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | | | - Xiaoxin Li
- Department of Ophthalmology, People's Eye Center of People's Hospital of Beijing University, Beijing, China
| | - Gabriel J Coscas
- Department of Ophthalmology, University of Paris XII, Paris, France
| | - Alexander Brucker
- Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Lawrence Singerman
- Department of Ophthalmology, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Phil Luthert
- Institute of Ophthalmology, University College London, London, United Kingdom
| | | | | | | | | | - Robyn Guymer
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Department of Surgery (Ophthalmology), University of Melbourne, Melbourne, Australia
| | | | - Emily Y Chew
- National Eye Institute, National Institutes of Health, Bethesda, Maryland
| | | | - Jordi M Monés
- Institut de la Màcula and Barcelona Macula Foundation, Barcelona, Spain
| | | | - Ramin Tadayoni
- Department of Ophthalmology, Hôpital Lariboisière, AP-HP, Université de Paris, Paris, France
| | - James Fujimoto
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, Massachusetts
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18
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Blautain B, Souied EH, Cohen SY. Bilateral yellowish prefoveal dots in autoimmune hemolytic anemia secondary to myelodysplastic syndrome: Case report. J Fr Ophtalmol 2019; 42:e475-e477. [PMID: 31229323 DOI: 10.1016/j.jfo.2019.05.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 05/10/2019] [Accepted: 05/16/2019] [Indexed: 11/24/2022]
Affiliation(s)
- B Blautain
- Department of Ophthalmology, Intercity Hospital, University Paris-Est, 94010 Creteil, France
| | - E H Souied
- Department of Ophthalmology, Intercity Hospital, University Paris-Est, 94010 Creteil, France
| | - S Y Cohen
- Ophthalmology Center for Imaging and Laser, 75015 Paris, France.
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19
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Weber M, Velasque L, Coscas F, Faure C, Aubry I, Cohen SY. Effectiveness and safety of intravitreal aflibercept in patients with wet age-related macular degeneration treated in routine clinical practices across France: 12-month outcomes of the RAINBOW study. BMJ Open Ophthalmol 2019; 4:e000109. [PMID: 31179386 PMCID: PMC6528760 DOI: 10.1136/bmjophth-2017-000109] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [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: 08/21/2017] [Revised: 03/26/2018] [Accepted: 07/01/2018] [Indexed: 11/08/2022] Open
Abstract
Background/aims To monitor treatment-naïve patients with wet age-related macular degeneration (wet AMD) receiving intravitreal aflibercept (IVT-AFL) in France. Methods RAINBOW (Real life use of intravitreal Aflibercept In FraNce - oBservatiOnal study in Wet age-related macular degeneration) is an ongoing, observational, retrospective and prospective 4-year study to assess visual (primary), anatomical and safety outcomes following IVT-AFL treatment in wet AMD patients. We report the interim 12-month outcomes in patients who have already been enrolled. Results Safety data were analysed from 586 patients (safety analysis set); and effectiveness data were analysed from 502 patients with at least one follow-up (full-analysis set) and from 353 patients with visual acuity data at baseline and month 12. The mean (SD) best-corrected visual acuity (BCVA) was 56.7 (18.2) letters and the mean (SD) central retinal thickness (CRT) was 395.6 (140.5)µm at baseline. Most patients (76.9%) received a loading dose (first three injections within 90 days). The mean (SD) number of IVT-AFL injections over 12 months was 6.0 (2.1) and 6.6 (1.8) (patients who received a loading dose). The mean (SD) change in BCVA was 5.5 (15.0) letters and 6.8 (14.5) letters (patients who received a loading dose) at month 12 (p<0.001 vs baseline). The mean (SD) CRT reduction was –108.7 (146.8)µm and –116.4 (150.4)µm (loading dose) at month 12 (p<0.001 vs baseline). Overall, 118 (20.1%) patients experienced at least one treatment-emergent adverse event (TEAE), 1.2% experienced ocular TEAEs and 3.9% experienced serious AEs. Conclusion This 12-month interim analysis showed that IVT-AFL was associated with sustained improvements in a real-world setting. The RAINBOW results are consistent with the VIEW clinical studies. Trial registration number NCT02279537 Pre-results.
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Affiliation(s)
| | | | - Florence Coscas
- Centre d'exploration ophtalmologique de l'Odéon, Paris, France.,Department of Ophthalmology, Centre Hospitalier Intercommunal de Créteil, Creteil, France
| | - Céline Faure
- Hôpital privé Saint Martin, Ramsay Générale de Santé, Caen, France
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20
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Fajnkuchen F, Pieramici D, Hrarat L, Best AL, Cohen SY, Delahaye-Mazza C, Grenet T, Nghiem-Buffet S, Quentel G, Bodaghi B, Giocanti-Aurégan A. Impact of ranibizumab on visual impairment in patients with bilateral diabetic macular edema. Acta Diabetol 2019; 56:67-71. [PMID: 30167869 DOI: 10.1007/s00592-018-1210-3] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Accepted: 08/09/2018] [Indexed: 10/28/2022]
Abstract
AIMS Diabetic macular edema (DME) frequently presents bilaterally. In case of bilateral retinal disease, the visual impairment (VI) and the visual acuity (VA) are strongly correlated to the better eye. The aim of this study was to assess the impact of ranibizumab intravitreal injections (IVR) on VI in patients with simultaneous VA loss due to DME. METHODS This was a retrospective two-center study including consecutive DME patients with visual loss treated with ranibizumab since November 2011 and with a minimum follow-up of 6 months. Patients with bilateral visual decrease from DME undergoing IVR within 6 months of each other were included. RESULTS Twenty-nine DME patients who received bilateral IVR within a 6-month interval in the second eye were included. At baseline, 82.8% (n = 24) of patients had a VA < 20/40 in their better eye versus 44.8% (n = 13) of patients at the end of follow-up, i.e. a reduction by 45.9% of VI. In the better eye, the mean VA was 57.3, 65.0 and 65.5 ETDRS letters, respectively, at baseline, month 3 and month 6 (mean VA gain +8.2 letters). In the worse eye, the mean VA was 44.2, 53.5 and 53.8 ETDRS letters, respectively, at baseline, M3 and M6 (mean VA gain +9.6 letters). CONCLUSIONS In patients with bilateral DME, subsequent ranibizumab IVR reduced VI frequency.
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Affiliation(s)
- Franck Fajnkuchen
- Ophthalmology, Centre d'Imagerie et de Laser, Paris, France
- Ophthalmology Department, Avicenne Hospital, Bobigny, France
| | - Dante Pieramici
- Partner California Retina Consultants, Director California Retina Research Foundation, Santa Barbara, USA
| | - Linda Hrarat
- Ophthalmology Department, Avicenne Hospital, Bobigny, France
| | | | - Salomon Y Cohen
- Ophthalmology, Centre d'Imagerie et de Laser, Paris, France
- Centre Hospitalier Intercommunal Créteil, Créteil, France
| | | | - Typhaine Grenet
- Ophthalmology, Centre d'Imagerie et de Laser, Paris, France
- Ophthalmology Department, Avicenne Hospital, Bobigny, France
| | - Sylvia Nghiem-Buffet
- Ophthalmology, Centre d'Imagerie et de Laser, Paris, France
- Ophthalmology Department, Avicenne Hospital, Bobigny, France
| | | | - Bahram Bodaghi
- Ophthalmology Department, Avicenne Hospital, Bobigny, France
- Ophthalmology Department, Pitié Salpétrière Hospital, Paris, France
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21
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Cohen SY, Tabary S, El Ameen A, Mrejen S, Quentel G, Giocanti-Auregan A. Vascular remodeling of choroidal neovascularization in older myopic patients treated with ranibizumab. Graefes Arch Clin Exp Ophthalmol 2018; 257:485-493. [PMID: 30535969 DOI: 10.1007/s00417-018-04205-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 06/05/2018] [Revised: 10/19/2018] [Accepted: 11/28/2018] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To investigate morphological changes in myopic choroidal neovascularization (mCNV) using optical coherence tomography-angiography (OCT-A) after treatment with ranibizumab. METHODS Retrospective analysis of consecutive patients over a 24-month period. All treatment-naïve mCNV were imaged at baseline with color pictures, spectral-domain OCT and OCT-A, and fluorescein angiography in selected cases. CNV morphology was classified at baseline and at 6 months. The CNV lesion surface was also compared. RESULTS Twenty-nine patients with a mean age of 70.3 ± 10.1 years were included. They received a mean number of 2.65 injections over 6 months. Best-corrected visual acuity improved from 62.2 to 68.5 letters (p = 0.004), with regression of exudation in 24 eyes (82.7%). Baseline CNV was classified into tree-in-bud (16 eyes), medusa (9 eyes), or sea-fan (4 eyes) pattern. At 6 months, no abnormal blood flow was observed in CNV in 13 eyes. Eyes with complete regression or evolution towards an indistinct pattern showed more often a complete regression of exudation than eyes with unchanged pattern (p = 0.007). The mean CNV surface significantly decreased from 0.19 to 0.08 mm2 (p < 0.0001). CONCLUSION An unchanged pattern was more often associated with exudation persistence, while a complete regression or evolution towards indistinct pattern was always associated with vascular inactivity. However, variable changes in mCNV were observed after anti-VEGF. Thus, OCT-A could be more useful in the diagnosis than in the follow-up of mCNV.
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Affiliation(s)
- Salomon Y Cohen
- Ophthalmology Center for Imaging and Laser, 11 rue Antoine Bourdelle, 75015, Paris, France.
- Department of Ophthalmology, Paris Est University, Creteil, France.
| | - Sandrine Tabary
- Ophthalmology Center for Imaging and Laser, 11 rue Antoine Bourdelle, 75015, Paris, France
| | - Ala El Ameen
- Department of Ophthalmology, Paris Est University, Creteil, France
| | - Sarah Mrejen
- Ophthalmology Center for Imaging and Laser, 11 rue Antoine Bourdelle, 75015, Paris, France
| | - Gabriel Quentel
- Ophthalmology Center for Imaging and Laser, 11 rue Antoine Bourdelle, 75015, Paris, France
| | - Audrey Giocanti-Auregan
- Department of Ophthalmology, Hôpital Avicenne, AP-HP and Paris 13 University, Bobigny, France
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22
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Lanzetta P, Cruess AF, Cohen SY, Slakter JS, Katz T, Sowade O, Zeitz O, Ahlers C, Mitchell P. Predictors of visual outcomes in patients with neovascular age-related macular degeneration treated with anti-vascular endothelial growth factor therapy: post hoc analysis of the VIEW studies. Acta Ophthalmol 2018; 96:e911-e918. [PMID: 29659183 DOI: 10.1111/aos.13751] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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: 09/14/2017] [Accepted: 02/08/2018] [Indexed: 12/29/2022]
Abstract
PURPOSE Identify predictors for response to anti-vascular endothelial growth factor (VEGF) therapy in patients with neovascular (wet) age-related macular degeneration (nAMD). METHODS Retrospective, post hoc analysis of VIEW 1/2. Patients were randomized 1:1:1:1 to 0.5 mg intravitreal aflibercept (IVT-AFL) injection every 4 weeks (0.5q4); 2 mg IVT-AFL every 4 weeks (2q4); 2 mg IVT-AFL every 8 weeks (2q8) after an initial three injections at weeks 0, 4 and 8 or 0.5 mg intravitreal ranibizumab every 4 weeks (0.5q4). RESULTS 1815 patients [IVT-AFL 2q4 (n = 613); IVT-AFL 2q8 (n = 607); ranibizumab 0.5q4 (n = 595)] were included. Baseline demographics/characteristics were evenly balanced. Younger age (49-69 years), lower visual acuity (VA) [10.0-≤45.0 Early Treatment Diabetic Retinopathy Study (ETDRS) letters] and smaller choroidal neovascularization (CNV) size [0.0-≤3.1 disc areas (DA)] at baseline were associated with the most vision gain (≥15 letters) over 52 weeks (all nominal p < 0.0001).Younger age, higher baseline VA (>64.0-≤83.0 letters) and smaller CNV size were associated with a VA ≥20/40 at week 52. Predominantly classic CNV at baseline (nominal p = 0.0007), older age (≥90 years), lower baseline VA (10.0-≤ 45.0 ETDRS letters) and larger CNV size (>10.1-≤32.6 DA) were all associated with a VA ≤20/200 at week 52 (all nominal p < 0.0001). Along with treatment (nominal p < 0.0001), lower VA (p = 0.0166) and smaller central retinal thickness (both nominal p = 0.0190) were predictors for dry retina development. CONCLUSION Younger age, lower VA and smaller CNV size at baseline were all associated with greater vision gains over 52 weeks while younger age, higher VA and smaller CNV size at treatment start were more likely to achieve best-corrected VA 20/40 or better after a year's treatment, suggesting the benefit of early anti-VEGF treatment.
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Affiliation(s)
- Paolo Lanzetta
- Department of Medicine - Ophthalmology; University of Udine; Udine Italy
| | - Alan F. Cruess
- Department of Ophthalmology & Visual Sciences; Dalhousie University; Halifax Nova Scotia Canada
| | | | - Jason S. Slakter
- Vitreous Retina Macula Consultants of New York; New York New York USA
| | - Todd Katz
- Bayer US LLC; Whippany New Jersey USA
| | | | | | | | - Paul Mitchell
- Department of Ophthalmology; Westmead Institute; University of Sydney; Sydney New South Wales Australia
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Tick S, Cornut PL, De Bats F, Wolf B, Souied EH, Cohen SY. [Update from France Macula Federation: Treatment of Wet AMD]. J Fr Ophtalmol 2018; 41:862-867. [PMID: 30361178 DOI: 10.1016/j.jfo.2018.06.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Revised: 06/26/2018] [Accepted: 06/27/2018] [Indexed: 01/08/2023]
Abstract
PURPOSE To update the recommendations of the France Macula Federation for treatment of wet age-related macular degeneration (AMD). METHODS Analysis of literature and expert opinion. RESULTS The FFM recommends initiating anti-VEGF therapy as soon as possible after diagnosis of exudative AMD. There has been no major change in the last several years concerning the procedure of intravitreal injection itself. However, the litigious points are discussed: simultaneous bilateral injection; antibiotic therapy; medico-legal aspects. All anti-VEGF strategies possess advantages and limitations. The strategy should be left to the ophthalmologists' preference. However, the chosen strategy should be explained to patients and strictly followed. CONCLUSION The treatment of wet-AMD is more precisely codified than before. However, various strategies still coexist.
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Affiliation(s)
- S Tick
- Centre hospitalier national d'ophtalmologie des XV-XX, 28, rue de Charenton, 75012 Paris, France; Centre ophtalmologique Vincennes, 17, bis rue des Meuniers, 94300 Vincennes, France
| | - P-L Cornut
- Centre pôle vision, clinique du Val d'Ouest, Croix rousse, 39, chemin de la Vernique, 69130 Écully, France
| | - F De Bats
- Centre pôle vision, clinique du Val d'Ouest, Croix rousse, 39, chemin de la Vernique, 69130 Écully, France; Hôpital de la Croix-Rousse, 103 grande rue de la Croix-Rousse, 69004 Lyon, France
| | - B Wolf
- Centre ophtalmologique de la maison rouge, 6, rue de l'Église, 67000 Strasbourg, France
| | - E H Souied
- Service d'ophtalmologie et université Paris Est, 61, avenue du Général de Gaulle, 94000 Créteil, France
| | - S Y Cohen
- Service d'ophtalmologie et université Paris Est, 61, avenue du Général de Gaulle, 94000 Créteil, France; Centre ophthalmologique d'imagerie et de laser, 11, rue Antoine Bourdelle, 75015 Paris, France.
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24
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Wolff B, De Bats F, Tick S, Cornut PL, Souied É, Cohen SY. [Update from France Macula Federation: Diagnosis of wet AMD]. J Fr Ophtalmol 2018; 41:857-861. [PMID: 30348597 DOI: 10.1016/j.jfo.2018.05.004] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 05/09/2018] [Indexed: 11/24/2022]
Abstract
PURPOSE To update the recommendations of the France Macula Federation for the diagnosis of wet age-related macular degeneration (AMD). METHODS Analysis of literature and expert opinion. RESULTS The FMF recommends diagnosing wet AMD by combining the results of fundus examination (or color or monochromatic fundus photographs), optical coherence tomography (OCT) showing exudative signs, and morphological visualization of the neovascular membrane, which may be obtained non-invasively (OCT-angiography) or invasively (fluorescein and/or indocyanine green angiography). Under optimal conditions in which all these tools are available, the FMF recommends using non-invasive methods as first-line tools and resorting to dye angiography if diagnostic doubt remains. CONCLUSION As observed in other fields of medical imaging, non-invasive methods are preferred to invasive methods for the diagnosis of wet AMD, while the latter are reserved for more difficult cases.
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Affiliation(s)
- B Wolff
- Centre ophtalmologique de la maison rouge, 6, rue de l'Église, 67000 Strasbourg, France
| | - F De Bats
- Centre Ophtalmologique pôle vision, 69130 Ecully, France; Hôpital de la Croix-Rousse, 69004 Lyon, France
| | - S Tick
- Centre hospitalier national d'ophtalmologie des XV-XX, 28, rue de Charenton, 75012 Paris, France
| | - P-L Cornut
- Centre Ophtalmologique pôle vision, 69130 Ecully, France
| | - É Souied
- Service d'ophtalmologie, université Paris Est, 94000 Créteil, France
| | - S Y Cohen
- Centre hospitalier national d'ophtalmologie des XV-XX, 28, rue de Charenton, 75012 Paris, France; Centre ophthalmologique d'imagerie et de laser, 11, rue Antoine-Bourdelle, 75015 Paris, France.
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25
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Introini U, Casalino G, Dhrami-Gavazi E, Mukkamala SK, Mrejen S, Schubert H, Cohen SY, Azzolini C, Bandello F, Chang S, Yannuzzi LA. Clinical course of acute zonal occult outer retinopathy complicated by choroidal neovascularization. Int J Retina Vitreous 2018; 4:32. [PMID: 30181904 PMCID: PMC6114516 DOI: 10.1186/s40942-018-0134-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: 05/07/2018] [Accepted: 07/23/2018] [Indexed: 12/22/2022] Open
Abstract
Purpose To report the clinical course and multimodal imaging features of acute zonal occult outer retinopathy (AZOOR) complicated by choroidal neovascularization (CNV) treated with anti-vascular endothelial growth factor (VEGF) treatment or photodynamic therapy (PDT). Methods Observational case series. Retrospective analysis of patients presenting to different institutions with evidence of AZOOR and neovascular lesions. Diagnosis of AZOOR was made on the basis of clinical presentation and multimodal imaging. All patients underwent a comprehensive ophthalmic evaluation and multimodal retinal imaging, including color fundus photos, fundus autofluorescence, fundus fluorescein angiography and spectral-domain optical coherence tomography. Results Four patients (three males, mean age 53.5 years) were included in the study. Mean follow-up was 5.1 years. Presentation of AZOOR was unilateral in two patients and bilateral in the remainder two patients. One of the patients presenting with unilateral AZOOR developed zonal lesions in the fellow eye during follow-up. All patients presented with unilateral type 2 (subretinal) CNV. Three patients underwent intravitreal anti-VEGF injections and one patient underwent a single PDT. Multimodal retinal imaging showed zonal or multizonal progression during treatment. After treatment, visual acuity and CNV stabilization was observed in all patients. Conclusions The presence of CNV expands the clinical spectrum of AZOOR. CNV complicating AZOOR may be effectively treated with intravitreal injections of anti-VEGF, despite progression of the zonal lesions. Further studies are required to define the role of treatment in the progression of the zonal lesions.
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Affiliation(s)
- Ugo Introini
- 1Department of Ophthalmology, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
| | - Giuseppe Casalino
- 1Department of Ophthalmology, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy.,2Moorfields Eye Hospital, NHS Foundation Trust, London, UK
| | - Elona Dhrami-Gavazi
- Vitreous Retina Macula Consultants of New York, New York, USA.,4Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University College of Physicians and Surgeons, New York, USA
| | - Sri Krishna Mukkamala
- Vitreous Retina Macula Consultants of New York, New York, USA.,4Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University College of Physicians and Surgeons, New York, USA
| | - Sarah Mrejen
- Ophthalmic Center for Imaging and Laser, Paris, France
| | - Hermann Schubert
- 4Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University College of Physicians and Surgeons, New York, USA
| | | | - Claudio Azzolini
- 6Department of Surgical Sciences, Ophthalmology Section, University of Insubria Ospedale di Circolo, Varèse, Italy
| | - Francesco Bandello
- 1Department of Ophthalmology, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
| | - Stanley Chang
- 4Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University College of Physicians and Surgeons, New York, USA
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Giocanti-Auregan A, Gaudric A, Buffon F, Mine M, Delahaye-Mazza C, Cohen SY, Erginay A, Chabriat H, Lasserve ET, Krivosic V. Optical Coherence Tomography Angiography of Familial Retinal Arteriolar Tortuosity. Ophthalmic Surg Lasers Imaging Retina 2018; 49:397-401. [DOI: 10.3928/23258160-20180601-03] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 11/01/2017] [Indexed: 01/03/2023]
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Cohen SY, Miere A, Nghiem-Buffet S, Fajnkuchen F, Souied EH, Mrejen S. Clinical applications of optical coherence tomography angiography: What we have learnt in the first 3 years. Eur J Ophthalmol 2018; 28:491-502. [PMID: 29554812 DOI: 10.1177/1120672117753704] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
A review of the literature from 2014 to 2016 was conducted, focusing on the results of optical coherence tomography angiography in different chorioretinal diseases. In only 3 years, optical coherence tomography angiography has been shown to be an effective tool for diagnosing choroidal neovascularization complicating age-related macular degeneration, pathologic myopia, and inflammatory conditions. The technique has sometimes been considered superior to conventional multimodal imaging, for example, in choroidal neovascularization associated with chronic central serous chorioretinopathy or multifocal choroiditis. In retinal vascular diseases, optical coherence tomography angiography has helped to understand the condition described as paracentral acute middle maculopathy and has been considered highly effective for the analysis of retinal vascular macular changes secondary to retinal vein occlusion or macular telangiectasia. Changes in the foveal avascular zone, also reported in diabetic maculopathy, have been shown to occur before any angiographic signs. A reduction in capillary vascular density has been reported in the fovea of eyes with malignant melanoma, but not in eyes with choroidal nevus. However, optical coherence tomography angiography is a recent technique that probably needs refinements and further studies. Nevertheless, the first 3 years of optical coherence tomography angiography use suggest its clinical relevance and useful applications in daily clinical practice.
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Affiliation(s)
- Salomon Y Cohen
- 1 Ophthalmological Center for Imaging and Laser, Paris, France.,2 Department of Ophthalmology, University of Paris-Est, Creteil, France
| | - Alexandra Miere
- 2 Department of Ophthalmology, University of Paris-Est, Creteil, France
| | | | | | - Eric H Souied
- 2 Department of Ophthalmology, University of Paris-Est, Creteil, France
| | - Sarah Mrejen
- 1 Ophthalmological Center for Imaging and Laser, Paris, France
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Abstract
PURPOSE To report the case of a 44-year-old woman with acute transient visual loss likely because of idiopathic pulmonary arterial hypertension. METHODS Case report imaged with fundus photographs, spectral-domain optical coherence tomography, fundus autofluorescence, and fluorescein and indocyanine green angiographies. RESULTS The patient complained of unilateral vision loss with metamorphopsia. Fundus examination of the right eye showed serous macular detachment and retinal folds. Fluorescein angiography and indocyanine green angiography showed delayed choroidal filling with multiple choroidal perfusion defects and dye leakage from areas of multiple pigment epithelial detachments. Spectral-domain optical coherence tomography showed a thick choroid. Medical history included idiopathic pulmonary arterial hypertension treated with tadalafil. Ocular signs regressed spontaneously within 1 week. CONCLUSION Transient severe choroidal filling defects with subretinal exudation may be observed in idiopathic pulmonary arterial hypertension. The present case raised the questions of the triggering factor of the acute decompensation of the blood-retinal barrier and the cause of its spontaneous regression.
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Affiliation(s)
- David Martiano
- *Department of Ophthalmology, Centre Hospitalier Intercommunal de Créteil, Université Paris Est, Paris, France; and †The Centre Ophtalmologique d'Imagerie et de Laser, Paris, France
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Abstract
PURPOSE To report a case of subfoveal acquired vitelliform detachment in a patient with multiple myeloma. METHODS Case report. RESULTS A 65-year-old man was referred for treatment of a serous macular detachment considered to be caused from chronic central serous chorioretinopathy or adult pseudovitelliform macular dystrophy. His medical history revealed an untreated multiple myeloma. Systemic chemotherapy was undertaken and resulted in a rapid resolution of the detachment. CONCLUSION Multiple myeloma may be considered as a possible cause of vitelliform macular detachment.
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Affiliation(s)
- Alaa El Ameen
- *Department of Ophthalmology, Paris-Est Créteil University, Creteil; †Ophtalmology Center for Imaging and Laser, Paris; and ‡Department of Haematology, Limoges University Hospital, Limoges, France
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Sayadi J, Miere A, Souied EH, Cohen SY. Type 3 Neovascularization Associated with Retinitis Pigmentosa. Case Rep Ophthalmol 2017; 8:245-249. [PMID: 28512428 PMCID: PMC5422741 DOI: 10.1159/000471790] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 03/11/2017] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To report a case of type 3 neovascular lesion in a patient with retinitis pigmentosa (RP) complicated by macular edema. CASE REPORT A 78-year-old man with a long follow-up for RP was referred for painless visual acuity decrease in the right eye. Best-corrected visual acuity was 20/125 in the right eye and 20/40 in the left. Fundus examination showed typical RP and macular edema in both eyes. In the right eye, spectral domain optical coherence tomography revealed a marked cystic macular edema associated with disruption of the Bruch membrane/retinal pigment epithelium complex overlying a pigmentary epithelium detachment, with a vascular structure which appeared to originate from the deep capillary plexus and to be connected with the subretinal pigment epithelium space. Optical coherence tomography angiography showed a high-flow vessel infiltrating the outer retinal layers in the deep capillary plexus segmentation, and a tuft-shaped, bright, high-flow network that seemed to be connected with the subretinal pigment epithelium space in the outer retinal layer segmentation. This presentation was consistent with an early type 3 neovascular lesion in the right eye. CONCLUSION Type 3 neovascularization may be considered a possible complication of RP.
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Affiliation(s)
- Jihene Sayadi
- aDepartment of Ophthalmology, Intercity Hospital and University Paris Est, Créteil, France
| | - Alexandra Miere
- aDepartment of Ophthalmology, Intercity Hospital and University Paris Est, Créteil, France
| | - Eric H Souied
- aDepartment of Ophthalmology, Intercity Hospital and University Paris Est, Créteil, France
| | - Salomon Y Cohen
- aDepartment of Ophthalmology, Intercity Hospital and University Paris Est, Créteil, France.,bOphthalmic Center for Imaging and Laser, Paris, France
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Martiano D, Caillaux V, Cohen SY, Querques G, Cochener B, Souied EH. Angioid streaks complicated by choroidal neovascularization in Paget's disease. J Fr Ophtalmol 2016; 39:e239-e240. [PMID: 27587348 DOI: 10.1016/j.jfo.2015.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 08/24/2015] [Indexed: 11/26/2022]
Affiliation(s)
- D Martiano
- Centre hospitalier intercommunal de Créteil, University Paris Est, 40, avenue de Verdun, 94000 Créteil, France; University Eye Department, centre hospitalier universitaire de Brest, 2, avenue Foch, 29200 Brest, France.
| | - V Caillaux
- Centre hospitalier intercommunal de Créteil, University Paris Est, 40, avenue de Verdun, 94000 Créteil, France
| | - S Y Cohen
- Centre hospitalier intercommunal de Créteil, University Paris Est, 40, avenue de Verdun, 94000 Créteil, France
| | - G Querques
- Centre hospitalier intercommunal de Créteil, University Paris Est, 40, avenue de Verdun, 94000 Créteil, France
| | - B Cochener
- University Eye Department, centre hospitalier universitaire de Brest, 2, avenue Foch, 29200 Brest, France
| | - E H Souied
- Centre hospitalier intercommunal de Créteil, University Paris Est, 40, avenue de Verdun, 94000 Créteil, France
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Giocanti-Auregan A, Tadayoni R, Grenet T, Fajnkuchen F, Nghiem-Buffet S, Delahaye-Mazza C, Quentel G, Cohen SY. Estimation of the need for bilateral intravitreal anti-VEGF injections in clinical practice. BMC Ophthalmol 2016; 16:142. [PMID: 27507298 PMCID: PMC4979182 DOI: 10.1186/s12886-016-0317-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Accepted: 08/01/2016] [Indexed: 12/15/2022] Open
Abstract
Background To estimate the need for bilateral intravitreal anti-VEGF injections in patients treated for neovascular age-related macular degeneration (nAMD), diabetic macular edema (DME), retinal vein occlusion, choroidal neovascularization (CNV) in high myopia, and other causes of CNV. Methods All consecutive patients treated with intravitreal anti-VEGF injection over a 1-month period were included in a prospective multicenter survey. The reason for intravitreal anti-VEGF injection and the involvement of the fellow eye in the pathology requiring a treatment with intravitreal anti-VEGF were recorded. A time interval between bilateral injections longer than 1 month, within a 1-month period, and same-day bilateral injections were recorded. Results A total of 1335 patients were included, corresponding to 1024 (76.7 %) patients treated for nAMD, 167 (12.5 %) for DME, and 144 (10.8 %) for other reasons. Four hundred and fifty-nine (34.4 %) patients were treated bilaterally with a time interval between injections longer than 1 month, 170 (12.7 %) were treated bilaterally within a 1-month interval, and 87 (6.6 %) had same-day bilateral injections. Bilateral injections were more frequent in diabetic patients than in nAMD patients (respectively 48 % vs. 36 %, p = 0.0033). Conclusions Patients with DME are more likely to be treated bilaterally with anti-VEGF injections. As the rate of second eye involvement requiring treatment increases progressively over time, a same-day bilateral injection strategy will become more common as it decreases the administrative burden on the healthcare system and treatment burden experienced by patients. Electronic supplementary material The online version of this article (doi:10.1186/s12886-016-0317-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Audrey Giocanti-Auregan
- Department of Ophthalmology, Hôpital Avicenne, AP-HP and University Paris 13-Bobigny, Seine Saint Denis, France.,Departement Hospitalo-Universitaire Vision et Handicaps, Paris, France
| | - Ramin Tadayoni
- Departement Hospitalo-Universitaire Vision et Handicaps, Paris, France.,Department of Ophthalmology, Hôpital Lariboisière, AP-HP and University Paris 7, Paris, France
| | - Typhaine Grenet
- Department of Ophthalmology, Hôpital Avicenne, AP-HP and University Paris 13-Bobigny, Seine Saint Denis, France.,Departement Hospitalo-Universitaire Vision et Handicaps, Paris, France.,Centre Ophtalmologique d'Imagerie et de Laser, 11 rue Antoine Bourdelle, 75015, Paris, France
| | - Franck Fajnkuchen
- Department of Ophthalmology, Hôpital Avicenne, AP-HP and University Paris 13-Bobigny, Seine Saint Denis, France.,Departement Hospitalo-Universitaire Vision et Handicaps, Paris, France.,Centre Ophtalmologique d'Imagerie et de Laser, 11 rue Antoine Bourdelle, 75015, Paris, France
| | - Sylvia Nghiem-Buffet
- Department of Ophthalmology, Hôpital Avicenne, AP-HP and University Paris 13-Bobigny, Seine Saint Denis, France.,Departement Hospitalo-Universitaire Vision et Handicaps, Paris, France.,Centre Ophtalmologique d'Imagerie et de Laser, 11 rue Antoine Bourdelle, 75015, Paris, France
| | - Corinne Delahaye-Mazza
- Centre Ophtalmologique d'Imagerie et de Laser, 11 rue Antoine Bourdelle, 75015, Paris, France
| | - Gabriel Quentel
- Centre Ophtalmologique d'Imagerie et de Laser, 11 rue Antoine Bourdelle, 75015, Paris, France
| | - Salomon Y Cohen
- Centre Ophtalmologique d'Imagerie et de Laser, 11 rue Antoine Bourdelle, 75015, Paris, France. .,Hôpital Intercommunal and University Paris-Est-Creteil, Creteil, France.
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Minvielle W, Caillaux V, Cohen SY, Chasset F, Zambrowski O, Miere A, Souied EH. Macular Microangiopathy in Sickle Cell Disease Using Optical Coherence Tomography Angiography. Am J Ophthalmol 2016; 164:137-44.e1. [PMID: 26748057 DOI: 10.1016/j.ajo.2015.12.023] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2015] [Revised: 12/14/2015] [Accepted: 12/14/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE To characterize the optical coherence tomography angiography (OCTA) appearance of the perifoveal macular microvasculature in visually asymptomatic patients with sickle cell disease, and to compare these findings with those of fluorescein angiography (FA). DESIGN Retrospective observational case series. METHODS Eighteen eyes of 9 consecutive patients with a median age of 41 years (range: 19-54 years) with electrophoretic confirmation of sickle cell disease were included and analyzed. A complete ophthalmologic examination was performed, including fundus examination, FA, and OCTA. Nine eyes of 5 healthy subjects were also analyzed with OCTA to serve as a control group. RESULTS OCTA demonstrated microvascular abnormalities in the perifoveal region of the macula in all eyes, whereas FA appeared normal in 9 of 18 eyes (50%). Most capillary abnormalities were located in the temporal juxtafoveal region and involved both the superficial and the deep capillary plexuses. The nonflow area (foveal avascular zone) was significantly larger in sickle cell disease patients than in the control group, both in the superficial and the deep capillary plexuses (P < .0001). The perifoveal vessel density was significantly lower in the sickle cell disease patients than in the control group in both the superficial (P = .0011) and the deep capillary plexuses (P = .0018). CONCLUSION OCTA provided detailed imaging of the perifoveal microvasculature in sickle cell disease. It appeared more sensitive than FA in detecting macular microangiopathy in asymptomatic patients. Microvascular abnormalities in sickle cell disease involved both the superficial and the deep capillary plexuses.
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Giocanti-Auregan A, Tadayoni R, Fajnkuchen F, Dourmad P, Magazzeni S, Cohen SY. Predictive Value of Outer Retina En Face OCT Imaging for Geographic Atrophy Progression. ACTA ACUST UNITED AC 2015; 56:8325-30. [DOI: 10.1167/iovs.14-15480] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Audrey Giocanti-Auregan
- Department of Ophthalmology, Hôpital Avicenne, Assistance Publique des Hôpitaux de Paris (AP-HP), and Paris 13 University, Bobigny, France 2Département Hospitalo-Universitaire Vision et Handicaps, Paris, France
| | - Ramin Tadayoni
- Département Hospitalo-Universitaire Vision et Handicaps, Paris, France 3Department of Ophthalmology, Hôpital Lariboisière, AP-HP and Paris 7 University, Paris, France
| | - Franck Fajnkuchen
- Department of Ophthalmology, Hôpital Avicenne, Assistance Publique des Hôpitaux de Paris (AP-HP), and Paris 13 University, Bobigny, France 2Département Hospitalo-Universitaire Vision et Handicaps, Paris, France 4Centre Ophtalmologique d'Imagerie et de Las
| | - Pauline Dourmad
- Centre Ophtalmologique d'Imagerie et de Laser, Paris, France
| | | | - Salomon Y. Cohen
- Centre Ophtalmologique d'Imagerie et de Laser, Paris, France 6Department of Ophthalmology, Hôpital Intercommunal and University Paris-Est-Creteil, Creteil, France
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Despreaux R, Cohen SY, Semoun O, Zambrowski O, Jung C, Oubraham H, Souied EH. Short-term results of switchback from aflibercept to ranibizumab in neovascular age-related macular degeneration in clinical practice. Graefes Arch Clin Exp Ophthalmol 2015; 254:639-44. [PMID: 26092633 DOI: 10.1007/s00417-015-3084-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 05/17/2015] [Accepted: 06/03/2015] [Indexed: 12/13/2022] Open
Abstract
PURPOSE This work was undertaken to analyze the efficacy of switchback from aflibercept to ranibizumab in patients with neovascular age-related macular degeneration (nAMD) who had previously switched from ranibizumab to aflibercept. METHODS This retrospective double-center study included 45 patients with nAMD who were previously treated with ranibizumab, then aflibercept, and then ranibizumab again, regardless of the number of intravitreal injections received. The primary outcome was change in best-corrected visual acuity (BCVA) measured on the Early Treatment Diabetic Retinopathy Study ETDRS chart before (T0) and after (T1) the switch, and 3 months after the switchback (T2). Secondary outcomes included changes in central foveal thickness (CFT) measured at T0, T1, and T2, as analyzed on spectral-domain optical coherence tomography (SD-OCT), and the percentage of patients gaining five letters or better. RESULTS Forty-seven eyes of 45 patients were switched back from aflibercept to ranibizumab. The mean BCVA was 67.4 ± 13.4 at T0, 66.7 ± 14.4 at T1, and 68.2 ± 13.9 at T2. BCVA was significantly improved between T1 and T2 (p = 0.0230), but not between T0 and T1 (p = 0.5153) or between T0 and T2 (p = 0.4248). The mean CFT decreased from 317.8 μm ± 89.6 at T0 to 306.9 μm ±68.0 at T1, and to 291.2 μm ± 76.6 at T2. The decrease in CFT was not statistically significant between either T0 and T1 or T1 and T2, but was significant between T0 and T2, when compared before switch and after switchback (p = 0.0027). However, when considering eyes that received three or more consecutive intravitreal injections of aflibercept before switchback, the statistical significance between T1 and T2 was lost, although a trend towards significance remained (p = 0.06). Thirteen eyes (27.7 %) gained five letters or more (range, 5-15 letters) after switchback. CONCLUSIONS A short-term benefit of switchback from one anti-VEGF agent to another was observed in patients with nAMD who had shown no benefit from the initial switch.
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Affiliation(s)
- Raphaelle Despreaux
- Department of Ophthalmology, Hôpital Intercommunal de Créteil, Faculté de médecine Henri Mondor, Université Paris Est Créteil, 40 avenue de Verdun, 94000, Créteil, France
| | - Salomon Y Cohen
- Department of Ophthalmology, Hôpital Intercommunal de Créteil, Faculté de médecine Henri Mondor, Université Paris Est Créteil, 40 avenue de Verdun, 94000, Créteil, France. .,Centre Ophtalmologique d'Imagerie et de Laser, Paris, France.
| | - Oudy Semoun
- Department of Ophthalmology, Hôpital Intercommunal de Créteil, Faculté de médecine Henri Mondor, Université Paris Est Créteil, 40 avenue de Verdun, 94000, Créteil, France
| | - Olivia Zambrowski
- Department of Ophthalmology, Hôpital Intercommunal de Créteil, Faculté de médecine Henri Mondor, Université Paris Est Créteil, 40 avenue de Verdun, 94000, Créteil, France
| | - Camille Jung
- Centre de Recherche Clinique- Centre de Ressources Biologiques, Hôpital Intercommunal de Créteil, Faculté de médecine Henri Mondor, Université Paris Est Créteil, Créteil, France
| | - Hassiba Oubraham
- Department of Ophthalmology, Hôpital Intercommunal de Créteil, Faculté de médecine Henri Mondor, Université Paris Est Créteil, 40 avenue de Verdun, 94000, Créteil, France
| | - Eric H Souied
- Department of Ophthalmology, Hôpital Intercommunal de Créteil, Faculté de médecine Henri Mondor, Université Paris Est Créteil, 40 avenue de Verdun, 94000, Créteil, France.,Centre de Recherche Clinique- Centre de Ressources Biologiques, Hôpital Intercommunal de Créteil, Faculté de médecine Henri Mondor, Université Paris Est Créteil, Créteil, France
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Cohen SY, Nghiem-Buffet S, Grenet T, Dubois L, Ayrault S, Fajnkuchen F, Delahaye-Mazza C, Quentel G, Tadayoni R. Long-term variable outcome of myopic choroidal neovascularization treated with ranibizumab. Jpn J Ophthalmol 2014; 59:36-42. [DOI: 10.1007/s10384-014-0363-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2014] [Accepted: 10/14/2014] [Indexed: 01/21/2023]
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Nghiem-Buffet S, Fajnkuchen F, Buffet M, Ayrault S, Le Gloahec-Lorcy A, Grenet T, Delahaye-Mazza C, Quentel G, Cohen SY. Intravitreal Ranibizumab and/or Dexamethasone Implant for Macular Edema Secondary to Retinal Vein Occlusion. Ophthalmologica 2014; 232:216-22. [DOI: 10.1159/000365639] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2014] [Accepted: 06/28/2014] [Indexed: 11/19/2022]
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Leveziela N, Quaranta-El Maftouhib M, Lalloumc F, Souied É, Cohen SY. [Treatment of myopic choroidal neovascularization: recommendations of the Fédération France Macula]. J Fr Ophtalmol 2014; 37:320-8. [PMID: 24829953 DOI: 10.1016/j.jfo.2013.12.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Myopic choroidal neovascularization is a frequent cause of visual acuity loss that can affect young individuals. Through a group of experts belonging to the Fédération France Macula, we review the treatment of myopic choroidal neovascularization and provide recommendations related to the treatment of this complication.
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Cohen SY, Massin P, Souied E. [Anti-VEGF: one drug for different conditions?]. J Fr Ophtalmol 2013; 36:2-4. [PMID: 23290491 DOI: 10.1016/j.jfo.2012.11.001] [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: 10/23/2012] [Revised: 11/05/2012] [Accepted: 11/07/2012] [Indexed: 10/27/2022]
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Wolff B, Tick S, Cohen SY. Photocoagulation therapy of leaking archer's type 2 retinal arteriovenous communication. Retin Cases Brief Rep 2013; 7:95-97. [PMID: 25390534 DOI: 10.1097/icb.0b013e31826f0927] [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: 06/04/2023]
Abstract
PURPOSE Type 2 retinal arteriovenous communication is characterized by direct arteriovenous communication without an intervening arteriolar or capillary segment. It may be complicated by extravascular exudation. The successful results of low-intensity argon laser photocoagulation in two cases are reported. METHODS Case report of two patients. RESULTS Both cases were associated with a serous macular detachment, showing evidence of vascular leakage. Argon laser photocoagulation was performed. Visual improvement was observed in both cases, with disappearance of vascular leakage. CONCLUSION Type 2 arteriovenous communications lead to increased arterial flow through a low-resistance vein. The resulting high intraluminal pressure may explain the observed vascular ectasia and consequent fluid leakage. Spontaneous regression may occur. Nevertheless, direct argon laser photocoagulation may be considered a therapeutic option and lead to visual improvement.
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Affiliation(s)
- Benjamin Wolff
- *Department of Ophthalmology, Fondation Ophtalmologique Adolphe de Rothschild †Department of Ophthalmology, Centre National d'Ophtalmologie des XV-XX ‡Centre Ophtalmologique d'Imagerie et de Laser, Paris, France
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Zerbib J, Puche N, Richard F, Leveziel N, Cohen SY, Korobelnik JF, Sahel J, Munnich A, Kaplan J, Rozet JM, Souied EH. No association between the T280M polymorphism of the CX3CR1 gene and exudative AMD. Exp Eye Res 2011; 93:382-6. [PMID: 21621535 DOI: 10.1016/j.exer.2011.05.005] [Citation(s) in RCA: 11] [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: 11/25/2010] [Revised: 04/21/2011] [Accepted: 05/10/2011] [Indexed: 11/29/2022]
Abstract
Major genetic factors for age-related macular degeneration (AMD) have recently been identified as susceptibility risk factors. The CX3CR1 gene has been shown to be associated with AMD in some studies. Our purpose was to analyze the role of the T280M polymorphism of the CX3CR1 gene in a large French population, in a case-control study. 1093 patients with exudative AMD and 396 controls have been recruited and genotyped for the Y402H of CFH, rs10490924 of ARMS2 and T280M of the CX3CR1 gene. The distribution of the Y402H of CFH and of the rs10490924 of ARMS2 was significantly different between cases and controls (p < 0.0001). The distribution of the T280M genotypes was not significantly different in the AMD patients compared to controls (p = 0.99). The Odds Ratio compared to TT individuals was 1.0 (95% CI 0.8-1.3) for TM individuals and 1.0 (95% CI 0.5-2.1) for MM individuals. The M allele frequency was 0.157 in cases and 0.154 in controls (p = 0.87). Our study exclude an association between the T280M of the CX3CR1 gene and exudative AMD in a French population.
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Affiliation(s)
- Jennyfer Zerbib
- Department of Ophthalmology, Hopital Intercommunal de Creteil, University Paris Est Creteil, France
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Cohen SY, Dubois L, Tadayoni R, Quentel G. Age at occurrence of exudative age-related macular degeneration in a clinical setting: difference between 1986 and 2006. Ophthalmologica 2010; 225:76-80. [PMID: 20881441 DOI: 10.1159/000314707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2009] [Accepted: 02/19/2010] [Indexed: 11/19/2022]
Abstract
PURPOSE To our knowledge, there is no published study on the evolution of age of occurrence of exudative age-related macular degeneration (AMD). The present study was performed to test whether or not the average age of patients with newly diagnosed choroidal neovascularization (CNV) due to AMD has changed in a clinical setting during the past 20 years. METHODS Nonrandomized comparative case study. Charts and fluorescein angiograms of consecutive patients diagnosed in 1986 and 2006 in a tertiary care center were analyzed to identify differences in age, gender and type of CNV. Mann-Whitney's nonparametric test was used to compare the statistical distribution of the parameters. χ(2) or Fisher's exact test was used for categorical variables. RESULTS 357 patients with CNV due to AMD, 79 in 1986, and 278 in 2006 were included. The patients diagnosed in 2006 were 4.7 years older than those diagnosed in 1986 (80.1 ± 8.9 vs. 75.4 ± 6.7 years, p < 0.0001). The main increase was in the percentage of patients over 85 years: 11.39% in 1986 versus 26.98% in 2006. There was no significant difference between the two groups as regards gender or type of CNV. CONCLUSIONS In our clinical setting, the average age of patients with newly diagnosed exudative AMD increased significantly between 1986 and 2006. The fact that in the present series more than 1 out of 4 patients was over 85 may have a significant impact on the potential side effects of currently available treatments of exudative AMD.
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Affiliation(s)
- Salomon Y Cohen
- Centre Ophtalmologique d'Imagerie et de Laser, 11 rue Antoine-Bourdelle, Paris, France.
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Cohen SY, Dubois L, Nghiem-Buffet S, Ayrault S, Fajnkuchen F, Guiberteau B, Delahaye-Mazza C, Quentel G, Tadayoni R. Retinal pseudocysts in age-related geographic atrophy. Am J Ophthalmol 2010; 150:211-217.e1. [PMID: 20537310 DOI: 10.1016/j.ajo.2010.02.019] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2009] [Revised: 02/19/2010] [Accepted: 02/19/2010] [Indexed: 11/26/2022]
Abstract
PURPOSE To report the presence of pseudocysts in retinal layers of eyes with geographic atrophy (GA) attributable to age-related macular degeneration (AMD) and to estimate their prevalence. DESIGN Retrospective study. METHODS setting: Clinical practice. patients: Consecutive patients with GA, assessed by spectral-domain optical coherence tomography (OCT). main outcome measures: Assessment of pseudocyst prevalence in retinal layers. Statistical analysis by the chi(2) test, Fisher exact test, Mann-Whitney U test, and Cramer test, performed to explore links between the presence of pseudocysts and demographic features and/or pattern of atrophy, ie, horseshoe, homogeneous area, homogeneous area or patchy atrophy with foveal sparing, and patchy atrophy. RESULTS Eighty-eight eyes of 68 GA patients aged between 61 and 94 years (mean: 79.8) were examined. In 20 patients, GA was bilateral. Twenty-four eyes (27.2%) exhibited pseudocysts corresponding to small cystoid spaces frequently located in the inner nuclear layer of the retina. There was no macular edema. Fluorescein angiography, performed in 71 eyes (80%), ruled out possible choroidal neovascularization. No correlation was found between 1) patients' age (P = .7) or gender (P > .99) and the presence of pseudocysts or 2) patterns of atrophy (Cramer test: V = 0.183) and the presence of pseudocysts. CONCLUSIONS Pseudocysts seemed to be frequent in atrophic AMD. They might correspond to Müller cell degeneration, as suspected in other degenerative retinal disorders like tamoxifen retinopathy or group 2A idiopathic juxtafoveolar retinal telangiectasis. The present results indicate that pseudocysts are frequently seen on OCT in eyes with atrophic AMD and their presence should not be considered as a manifestation of neovascular AMD that requires prompt treatment.
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Zerbib J, Richard F, Puche N, Leveziel N, Cohen SY, Korobelnik JF, Sahel J, Munnich A, Kaplan J, Rozet JM, Souied EH. R102G polymorphism of the C3 gene associated with exudative age-related macular degeneration in a French population. Mol Vis 2010; 16:1324-30. [PMID: 20664795 PMCID: PMC2905636] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2010] [Accepted: 07/08/2010] [Indexed: 10/25/2022] Open
Abstract
PURPOSE Major genetic factors for age-related macular degeneration (AMD) have recently been identified as susceptibility risk factors, underlying the role of the complement pathway in AMD. Our purpose was to analyze the role of the R102G polymorphism of the complement component (C3) gene in a French population, in a case-control study. METHODS A total of 1,080 patients with exudative AMD and 406 controls were recruited and genotyped for Y402H of complement factor H (CFH), rs10490924 of age-related maculopathy susceptibility 2 (ARMS2), and R102G of the C3 gene. RESULTS The distribution of the R102G genotypes was significantly different in the AMD patients compared to controls (p=0.02). The Odds Ratio compared to C/C individuals was 1.4 (95% CI 1.1-1.8) for C/G individuals and 1.4 (95% CI 0.8-2.4) for G/G individuals. In a dominant model, the adjusted Odds Ratio for carriers of the G allele is 1.4 (95% CI 1.0-1.9; p=0.03). CONCLUSIONS Our study shows C3 to be a moderate susceptibility gene for exudative AMD in the French population.
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Affiliation(s)
- Jennyfer Zerbib
- Department of Ophthalmology, Hopital Intercommunal de Creteil, University Paris 12, Creteil, France,Department of Genetics, INSERM U781, Necker Enfants Malades Hospital, Paris, France
| | - Florence Richard
- University Lille Nord of France, INSERM, UMR744, Institut Pasteur of Lille, Lille, France
| | - Nathalie Puche
- Department of Ophthalmology, Hopital Intercommunal de Creteil, University Paris 12, Creteil, France
| | - Nicolas Leveziel
- Department of Ophthalmology, Hopital Intercommunal de Creteil, University Paris 12, Creteil, France
| | | | | | - José Sahel
- Ophthalmology, Institut de la Vision, Inserm Pierre et Marie Curie University, Paris, France
| | - Arnold Munnich
- Department of Genetics, INSERM U781, Necker Enfants Malades Hospital, Paris, France
| | - Josseline Kaplan
- Department of Genetics, INSERM U781, Necker Enfants Malades Hospital, Paris, France
| | - Jean-Michel Rozet
- Department of Genetics, INSERM U781, Necker Enfants Malades Hospital, Paris, France
| | - Eric H. Souied
- Department of Ophthalmology, Hopital Intercommunal de Creteil, University Paris 12, Creteil, France,Unite Fonctionnelle de Recherche Clinique, Creteil, France
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Cohen SY, Levy-Gabriel C, Freund KB, Atebara NH. Diagnostic and therapeutic challenges. Retina 2010; 30:527-30. [PMID: 20216294 DOI: 10.1097/iae.0b013e3181cafc18] [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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Gaudric A, Cohen SY. When should anti-vascular endothelial growth factor treatment be stopped in age-related macular degeneration? Am J Ophthalmol 2010; 149:4-6. [PMID: 20103036 DOI: 10.1016/j.ajo.2009.08.039] [Citation(s) in RCA: 2] [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] [Received: 06/28/2009] [Revised: 08/28/2009] [Accepted: 08/31/2009] [Indexed: 12/12/2022]
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Leveziel N, Puche N, Richard F, Somner JEA, Zerbib J, Bastuji-Garin S, Cohen SY, Korobelnik JF, Sahel J, Soubrane G, Benlian P, Souied EH. Genotypic influences on severity of exudative age-related macular degeneration. Invest Ophthalmol Vis Sci 2009; 51:2620-5. [PMID: 20042647 DOI: 10.1167/iovs.09-4423] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [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 Major genetic risk factors have recently been identified for age-related macular degeneration (AMD), including the ARMS2/LOC387715 and CFH at-risk polymorphisms. The study was conducted to establish correlations between the AMD genotype and both the phenotype and severity of AMD. METHODS In a prospective cohort of 1216 AMD patients, four genotypic homozygous groups were identified (n = 264): double homozygous for wild-type alleles (group 1, n = 49), homozygous for the at-risk allele of ARMS2/LOC387715 only (group 2, n = 57), homozygous for the at-risk allele of CFH only (group 3, n = 106), and double homozygous for both at-risk alleles (group 4, n = 52). The phenotypic classification of exudative AMD was based on fluorescein angiography. RESULTS Mean age at presentation was significantly lower in group 4 than in group 1 (P < 0.014). Patients in group 4 presented more often with bilateral CNV and fibrovascular scars than did patients in group 1 (P < 0.001 and < 0.0031 respectively) and with significantly lower visual acuity (VA) in the first affected eye than did patients in group 1 (P < 0.02). Patients in group 2 presented with worse VA than did patients in group 3 (P < 0.003). Classic CNV was more commonly associated with the at-risk allele of the ARMS2/LOC387715 locus than with the at-risk allele of the CFH gene (P < 0.026). CONCLUSIONS This study demonstrates an association between the at-risk allele of the ARMS2/LOC387715 locus and classic CNV, fibrovascular lesions, and poor VA. Individuals double homozygous for both at-risk alleles had a higher risk of being affected with a severe form of AMD at an earlier age.
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Affiliation(s)
- Nicolas Leveziel
- Faculté de Médecine Henri Mondor, Department of Ophthalmology, APHP (Assistance Publique Hôpitaux Paris), Groupe Hospitalier Albert Chenevier-Henri Mondor, University Paris 12, Créteil, France
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Cohen SY, Dubois L, Tadayoni R, Fajnkuchen F, Nghiem-Buffet S, Delahaye-Mazza C, Guiberteau B, Quentel G. Results of one-year's treatment with ranibizumab for exudative age-related macular degeneration in a clinical setting. Am J Ophthalmol 2009; 148:409-13. [PMID: 19477713 DOI: 10.1016/j.ajo.2009.04.001] [Citation(s) in RCA: 112] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2009] [Revised: 03/31/2009] [Accepted: 04/01/2009] [Indexed: 10/20/2022]
Abstract
PURPOSE To evaluate the results of 1 year of treatment with intravitreal ranibizumab for exudative age-related macular degeneration (AMD) in a clinical setting. DESIGN Nonrandomized, single-center, retrospective, interventional case series. METHODS Retrospective analysis of consecutive charts and angiograms of patients with previously untreated exudative AMD, treated in one or both eyes with ranibizumab between January 2 and October 31, 2007. The following were recorded for each patient: age at presentation, gender, treated eye, type of choroidal neovascularization, visual acuity (VA) measured on an Early Treatment Diabetic Retinopathy Study chart at baseline and at 52 +/- 6 weeks, the number of performed intravitreal (IVT) injections, and follow-up examinations. RESULTS The 122 patients comprised 85 women (70%) and 37 men ranging in age from 56 to 91 years (mean +/- standard deviation, 78.3 +/- 7). In all, 124 eyes were treated on a pro re nata basis after 1 or 3 initial IVT injections. The mean number of IVT injections was 3.79 +/- 1.39 (range, 1 to 7). The mean number of follow-up visits was 8.07 +/- 1.44 (range, 4 to 12). Mean VA +/- standard deviation changed from 56.15 +/- 14 to 56.89 +/- 17 letters (VA gain, +0.7 letters). CONCLUSIONS The results showed that VA stabilized rather than improved and compared unfavorably with the gains found in randomized clinical trials and the Prospective Optical Coherence Tomography Imaging of Patients with Neovascular AMD Treated with intraOcular Ranibizumab (PrONTO) Study. However in this study, patients were examined less frequently and were treated far less frequently. The present results suggest that a long, regular follow-up is necessary for patients treated with ranibizumab to obtain and preserve significant visual gain, and not only to achieve visual stabilization.
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Weber M, Cohen SY, Tadayoni R, Coscas G, Creuzot-Garcher C, Devin F, Gaudric A, Mauget-Faysse M, Sahel JA, Soubrane G, Souied E, Korobelnik JF. [Evolving intravitreous injection technique]. J Fr Ophtalmol 2009; 31:625-9. [PMID: 18772818 DOI: 10.1016/s0181-5512(08)75468-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The technique of intravitreous injections has been well documented for several years. Recently, a descriptive article on the intravitreous injections procedure was published in the Journal Français d'Ophtalmologie, and the AFSSAPS (French agency for drug safety) released recommendations concerning this matter on the occasion of commercial launch of pegaptanib. Since that time, the number of intravitreal injections has considerably increased, because anti-VEGF drugs had been made available to ophthalmologists, and several teams have performed a large number of procedures, allowing them to better comprehend intravitreous injections. The present paper describes our current practice of intravitreous injections. Several specialists have exchanged their experiences and issued a common synthesis. Detailed modifications of the initial recommendations have been suggested, with such basic changes such as abandoning preoperative pupil dilatation and easing postsurgical monitoring. Follow-up examinations should be adapted to each patient rather than being systematic. The suggested modifications do not change the procedure of intravitreous injections substantially, but they simplify many steps and detail the various procedures when consensus is lacking.
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Affiliation(s)
- M Weber
- Service d'ophtalmologie, CHU Hôtel-Dieu, Nantes, France.
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