1
|
Tsiropoulos GN, Vallee R, Gallo Castro D, Ambresin A. The importance of monitoring wet age-related macular degeneration patients during Coronavirus disease 19 pandemic: A retrospective study of assessment of functional and structural outcomes. J Fr Ophtalmol 2022; 45:852-859. [PMID: 35908993 PMCID: PMC9257228 DOI: 10.1016/j.jfo.2022.05.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 04/27/2022] [Accepted: 05/05/2022] [Indexed: 11/24/2022]
Abstract
Objectives Intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections are the gold standard treatment for wet age-related macular degeneration (wet AMD). Coronavirus disease 2019 (COVID-19) has led to the cancellation of many scheduled intravitreal anti-VEGF injection visits. We compared the functional and structural visual outcomes of wet AMD patients who did not adhere to their planned intervals (group 1) with those who did (group 2). Methods Wet AMD patients of Swiss Visio Montchoisi and RétinElysée were included. Best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) changes between their first visit after the end of the first national lockdown in Switzerland (27 April 2020, first post-lockdown visit) and their last visit before the beginning of the first national lockdown in Switzerland (13 March 2020, last pre-lockdown visit) were assessed. The BCVA outcome was defined as unfavorable when there was a loss of ≥ 5 ETDRS letters in the first post-lockdown visit compared to the BCVA at last pre-lockdown visit. The OCT outcome was defined as unfavorable when there was an increase in at least one of the parameters, intraretinal fluid (IRF), subretinal fluid (SRF), or pigment epithelial detachment (PED), at the first post-lockdown visit compared to the last pre-lockdown visit. Main results Group 1 (89 patients, 109 eyes) had a 13.41% greater rate of unfavorable BCVA outcomes and a 38.27% greater rate of unfavorable OCT outcomes than group 2 (96 patients, 122 eyes) (P = 0.04, P < 0.0001, respectively). Multivariate analysis showed that the more the patients deviated from their programmed injections and the higher the BCVA pre-lockdown, the higher the rate of unfavorable BCVA outcomes (P = 0.03 and P = 0.02, respectively). OCT outcomes were not a predictive factor for an unfavorable BCVA outcome. Conclusions The cancellation of many intravitreal anti-VEGF injection appointments resulted in worse functional and structural outcomes in wet AMD patients. The COVID-19 pandemic led many patients to refrain from their routine intravitreal anti-VEGF injection appointments, allowing us to analyze the role of designated intervals in the treatment of wet AMD. During any future lockdown due to COVID-19 or similar circumstances, continuity of care for wet AMD patients should be maintained.
Collapse
Affiliation(s)
- G N Tsiropoulos
- Swiss Visio Montchoisi, avenue du Servan 38, 1006 Lausanne, Switzerland; RétinElysée, Ophthalmology Center, avenue d'Ouchy 14, 1006 Lausanne, Switzerland; Aristotle University of Thessaloniki (A.U.Th), Department of Health Sciences, Medical School, Thessaloniki, Greece
| | - R Vallee
- Swiss Visio Montchoisi, avenue du Servan 38, 1006 Lausanne, Switzerland; Laboratory of Mathematics and Applications (LMA) CNRS 7348, Data Analysis and Computations Through Imaging Modeling Mathematics (DACTIM team) University of Poitiers, 15, rue de l'Hôtel-Dieu, TSA 71117, 86000 Poitiers, France
| | - D Gallo Castro
- Swiss Visio Montchoisi, avenue du Servan 38, 1006 Lausanne, Switzerland; RétinElysée, Ophthalmology Center, avenue d'Ouchy 14, 1006 Lausanne, Switzerland
| | - A Ambresin
- Swiss Visio Montchoisi, avenue du Servan 38, 1006 Lausanne, Switzerland; RétinElysée, Ophthalmology Center, avenue d'Ouchy 14, 1006 Lausanne, Switzerland; University of Lausanne (UNIL), Faculty of Biology and Medicine, 1015 Lausanne, Switzerland.
| |
Collapse
|
2
|
Moret E, Ambresin A, Gianniou C, Bijon J, Besse-Hayat C, Bogiatzi S, Hohl D, Spertini F, Mantel I. Non-immediate drug hypersensitivity reactions secondary to intravitreal anti-vascular endothelial growth factors. Graefes Arch Clin Exp Ophthalmol 2021; 260:1005-1014. [PMID: 34529134 PMCID: PMC8850288 DOI: 10.1007/s00417-021-05353-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 07/21/2021] [Accepted: 07/27/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose To describe a series of non-immediate drug hypersensitivity reactions after intravitreal anti-vascular endothelial growth factors (anti-VEGFs). Patients and methods Retrospective report of 6 patients with cutaneous non-immediate drug hypersensitivity reactions following intravitreal anti-VEGF injections, 4 after ranibizumab, 1 after bevacizumab and 1 after aflibercept. Results Clinical manifestations ranged from mild maculopapular rash, purpura to severe generalized erythroderma, with or without systemic involvement such as microscopic hematuria and proteinuria or fever. In two out of the six patients, reintroduction of either the same or an alternative anti-VEGF drug did induce a recurrence of the drug hypersensitivity reaction, while 4 patients showed no recurrence. Conclusion Cutaneous non-immediate drug hypersensitivity reactions secondary to intravitreal anti-VEGF may occur. Continuation of the same drug or switch to another anti-VEGF may either induce recurrence or be well supported by the patient. The decision of drug discontinuation should be guided by the severity of the disease.
Collapse
Affiliation(s)
- E Moret
- Department of Ophthalmology, Jules-Gonin Eye Hospital, University of Lausanne, Foundation Asile des Aveugles, Lausanne, Switzerland
| | - A Ambresin
- Department of Ophthalmology, Jules-Gonin Eye Hospital, University of Lausanne, Foundation Asile des Aveugles, Lausanne, Switzerland
| | - C Gianniou
- Department of Ophthalmology, Jules-Gonin Eye Hospital, University of Lausanne, Foundation Asile des Aveugles, Lausanne, Switzerland
| | - J Bijon
- Department of Ophthalmology, Jules-Gonin Eye Hospital, University of Lausanne, Foundation Asile des Aveugles, Lausanne, Switzerland
| | - C Besse-Hayat
- Department of Ophthalmology, Jules-Gonin Eye Hospital, University of Lausanne, Foundation Asile des Aveugles, Lausanne, Switzerland
| | - S Bogiatzi
- Department of Medicine, Division of Dermatology and Venereology, Lausanne University Hospital CHUV, Lausanne, Switzerland
| | - D Hohl
- Department of Medicine, Division of Dermatology and Venereology, Lausanne University Hospital CHUV, Lausanne, Switzerland
| | - F Spertini
- Department of Medicine, Division of Immunology and Allergy, Lausanne University Hospital CHUV, Lausanne, Switzerland
| | - I Mantel
- Department of Ophthalmology, Jules-Gonin Eye Hospital, University of Lausanne, Foundation Asile des Aveugles, Lausanne, Switzerland.
| |
Collapse
|
3
|
Kuonen A, Bergin C, Ambresin A. Perifoveal capillary changes in diabetic patients and association between severity and type of diabetes, visual acuity, and enlargement of non-flow area in the retinal capillary plexuses. J Fr Ophtalmol 2021; 44:367-375. [PMID: 33494976 DOI: 10.1016/j.jfo.2020.09.005] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 09/02/2020] [Accepted: 09/03/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND The goal of this study was to evaluate the perifoveal capillary bed and to analyze areas of non-flow using optical coherence tomography angiography (OCT-A) in patients presenting with diabetic retinopathy (DR), correlating them to the severity of DR, type of diabetes and visual acuity (VA). PATIENTS AND METHODS The non-flow area (NFA) and foveal avascular zone (FAZ) in the superficial (SCP) and deep capillary plexus (DCP) were calculated using OCT-A imaging of patients with DR followed between July 2015 and March 2016 at the Jules Gonin Eye Hospital (Lausanne, Switzerland). Disease severity was classified using the Early Treatment Diabetic Retinopathy Study (ETDRS) classification. Analysis of variance was used to correct for correlation between eyes. RESULTS Seventy-eight eyes of 53 patients were included (29 men; 44 right eyes). There were 45 eyes with non-proliferative DR (NPDR; stage 1 [n=14], stage 2 [n=7], and stage 3 [n=24]) and 33 with proliferative DR (PDR; stage 1 [n=17], stage 2 [n=16]) included, among which 26 had type I diabetes and 52 type II diabetes. The mean Best Corrected Visual Acuity (BCVA) was 78.5 letters. The mean NFA in the SCP differed according to diabetes type and stage of DR (type 1 diabetes: NPDR, 0.76±0.3, PDR, 1.24±0.7; type 2 diabetes: NPDR, 1.46±0.7, PDR, 1.57±0.7). CONCLUSION The NFA, measured by OCTA, may be a useful indicator of DR severity, especially in the superficial capillary plexus. Loss of visual acuity might be correlated with increasing NFA (excluding the FAZ or not), primarily among patients with type II diabetes and NPDR.
Collapse
Affiliation(s)
- A Kuonen
- Department of Ophthalmology, University of Lausanne, Medical Retina Unit, Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, Lausanne, Switzerland
| | - C Bergin
- Department of Ophthalmology, University of Lausanne, Medical Retina Unit, Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, Lausanne, Switzerland
| | - A Ambresin
- Department of Ophthalmology, University of Lausanne, Medical Retina Unit, Jules-Gonin Eye Hospital, Fondation Asile des Aveugles, Lausanne, Switzerland; RétinElysée, 14 Avenue d'Ouchy, CH-1006 Lausanne, Switzerland.
| |
Collapse
|
4
|
Sanchis Zozaya J, Bodenmann P, Blaser J, Côté M, Pahud-Vermeulen B, Monnat M, Nsengywumva C, Hunziker B, Rojas-Urrego A, Ambresin A, Faucherre F, Gehri M. 2.11-P11The public health response for greater efficiency in the treatment of unaccompanied refugee minors in Switzerland. Eur J Public Health 2018. [DOI: 10.1093/eurpub/cky048.083] [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: 11/14/2022] Open
Affiliation(s)
- J Sanchis Zozaya
- Department of Ambulatory Care and Community Medicine (Policlinique Médicale Universitaire - PMU), Lausanne, Switzerland
| | - P Bodenmann
- Department of Ambulatory Care and Community Medicine (Policlinique Médicale Universitaire - PMU), Lausanne, Switzerland
| | - J Blaser
- Department of Ambulatory Care and Community Medicine (Policlinique Médicale Universitaire - PMU), Lausanne, Switzerland
| | - M Côté
- Department of Ambulatory Care and Community Medicine (Policlinique Médicale Universitaire - PMU), Lausanne, Switzerland
| | - B Pahud-Vermeulen
- Department of Ambulatory Care and Community Medicine (Policlinique Médicale Universitaire - PMU), Lausanne, Switzerland
| | - M Monnat
- Service of Public Health, Lausanne, Switzerland
| | - C Nsengywumva
- Foster Home Services for Asylum Seekers - Etablissement Vaudois d'Accueil des Migrants (EVAM), Lausanne, Switzerland
| | - B Hunziker
- Child Psychiatry Department - SUPEA/DP-CHUV), Lausanne, Switzerland
| | - A Rojas-Urrego
- Child Psychiatry Department (SPPEA/Fondation de Nant), Vevey, Switzerland
| | - A Ambresin
- Interdisciplinary division for adolescent health (DISA/CHUV), Lausanne, Switzerland
| | - F Faucherre
- Transcultural Psychiatry Unit (Unité Psy&Migrants/DP-CHUV), Lausanne, Switzerland
| | - M Gehri
- Department of Pediatrics, Children's Hospital (HeL/CHUV), Lausanne, Switzerland
| |
Collapse
|
5
|
Mantel I, Ambresin A, Zografos L. Retinal Angiomatous Proliferation Treated with a Combination of Intravitreal Triamcinolone Acetonide and Photodynamic Therapy with Verteporfin. Eur J Ophthalmol 2018; 16:705-10. [PMID: 17061221 DOI: 10.1177/112067210601600507] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose Retinal angiomatous proliferation (RAP) is a particularly aggressive form of exudative age-related macular degeneration. Response to laser photocoagulation or to photodynamic therapy (PDT) alone is often disappointing. The purpose of this study was to determine whether intravitreal triamcinolone acetonide (TA) injections followed by PDT in eyes with early stage RAP may be effective. Methods Prospective uncontrolled study, enrolling 11 patients (11 eyes) with stage 2 RAP, treated with intravitreal TA injection followed by PDT. Patients with large pigment epithelium detachment, RAP stage 3, or pre-existing glaucoma and known steroid responders were excluded. All patients underwent a complete ophthalmic examination including fluorescein and indocyanine green (ICG) angiography and optical coherence tomography (OCT-3) at baseline and at 1, 3, 6, and 12 months. Informed consent was obtained from all patients. Results Mean follow-up was 14.9 months (range 6–21 months). Mean age was 82 years. In four patients a small pigment epithelium detachment was found on tomography. Initial visual acuity (VA) ranged from 0.1 to 0.6 on the Snellen scale. After calculating the logarithmic values the authors found an initial mean VA of logMAR 0.61, which improved by 1.5, 0.9, and 0.9 log lines after 3, 6, and 12 months, respectively. Although the VA gain from baseline tended to decrease with time, only 2 patients (18%) had an actual loss of acuity (≥3 lines). Retreatment was required in 5 eyes. Conclusions In this prospective pilot study examining the use of intravitreal TA followed by PDT with verteporfin in eyes with stage 2 RAP, without a large pigment epithelium detachment, the authors found a potential benefit in terms of stabilization or even improvement of vision.
Collapse
Affiliation(s)
- I Mantel
- University Eye Clinic, Hôpital Jules Gonin, Lausanne, Switzerland.
| | | | | |
Collapse
|
6
|
Affiliation(s)
- A. Ambresin
- Medical Retina Unit; Jules-Gonin Eye Hospital; Lausanne Switzerland
| |
Collapse
|
7
|
Ambresin A. OCT and OCTA: new technology, new terminology. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.03131] [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: 12/01/2022]
Affiliation(s)
- A. Ambresin
- Medical Retina Unit; Jules-Gonin Eye Hospital; Lausanne Switzerland
| |
Collapse
|
8
|
Ambresin A, Mantel I, Bergin C, Naso S. Structural Bscan OCT correlation with OCT angiography biomarkers of activity in neovascular age related macular degeneration. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.01514] [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: 11/28/2022]
Affiliation(s)
- A. Ambresin
- Medical and Surgical Retina; RetinElysée; Lausanne Switzerland
- Medical Retina; Jules-Gonin Eye Hospital; Lausanne Switzerland
| | - I. Mantel
- Medical Retina; Jules-Gonin Eye Hospital; Lausanne Switzerland
| | - C. Bergin
- Medical Retina; Jules-Gonin Eye Hospital; Lausanne Switzerland
| | - S. Naso
- Medical Retina; Jules-Gonin Eye Hospital; Lausanne Switzerland
| |
Collapse
|
9
|
Ambresin A. OCT-A and FA findings in ocular Drepanocytosis. Acta Ophthalmol 2016. [DOI: 10.1111/j.1755-3768.2016.0213] [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: 11/28/2022]
|
10
|
de Massougnes S, Borruat FX, Ambresin A. Peripheral Bilateral Telangiectasiae in Multiple Sclerosis Patients Treated with Interferon B1a. Klin Monbl Augenheilkd 2016; 233:438-40. [PMID: 27116503 DOI: 10.1055/s-0041-111803] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- S de Massougnes
- Department of Ophthalmology, University of Lausanne, Lausanne, Switzerland
| | - F-X Borruat
- Department of Ophthalmology, University of Lausanne, Lausanne, Switzerland
| | - A Ambresin
- Department of Ophthalmology, University of Lausanne, Lausanne, Switzerland
| |
Collapse
|
11
|
Dirani A, Mantel I, Ambresin A. Recurrent Macular Edema in Central Retinal Vein Occlusion Treated with Intravitreal Ranibizumab using a Modified Treat and Extend Regimen. Klin Monbl Augenheilkd 2015; 232:538-41. [PMID: 25902116 DOI: 10.1055/s-0035-1545746] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the stability over time of the individually defined interval of intravitreal ranibizumab injection (IVR) for the treatment of recurrent macular edema (ME) in central retinal vein occlusion (CRVO). PATIENTS AND METHODS A case series of treatment naïve patients followed in the Jules Gonin Eye Hospital for macular edema due to central retinal vein occlusion is presented. Patients were treated monthly with IVR until complete absence of fluid on qualitative SD-OCT with a minimum of 5 monthly IVR. Thereafter, they were followed according to a modified treat and extend regimen (mTER). RESULTS Twelve eyes (12 patients) with ME due to CRVO were included. The mean follow-up period was 31.3 months. Analysis showed that best corrected visual acuity (BCVA), central macular thickness and qualitative spectral domain optical coherence tomography (SD-OCT) showed comparable results under monthly interval, after titration of an individualized interval and when performed in a series. 78% of treating intervals were within ±2 weeks of the first individually adjusted interval. The mean first defined interval was 4.3 weeks and the mean interval over time was 5.5 weeks (p=0.003). There was a trend towards longer interval over time. CONCLUSION The adjusted interval of retreatment of patients with ME due to CRVO showed a high stability with a trend toward longer duration over time. An mTER regimen seems to be valuable to follow patients with ME with good stabilization of VA.
Collapse
Affiliation(s)
- A Dirani
- Department of Ophthalmology, University of Lausanne, Jules Gonin Eye Hospital, Fondation Asile des Aveugles, Medical Retina Unit, Lausanne, Switzerland
| | - I Mantel
- Department of Ophthalmology, University of Lausanne, Jules Gonin Eye Hospital, Fondation Asile des Aveugles, Medical Retina Unit, Lausanne, Switzerland
| | - A Ambresin
- Department of Ophthalmology, University of Lausanne, Jules Gonin Eye Hospital, Fondation Asile des Aveugles, Medical Retina Unit, Lausanne, Switzerland
| |
Collapse
|
12
|
Meier PG, Ambresin A, Thirkill CE, Borruat FX, Schalenbourg A. Paraneoplastic vitelliform retinopathy secondary to metastatic melanoma. Klin Monbl Augenheilkd 2015; 232:587-9. [PMID: 25902133 DOI: 10.1055/s-0035-1545754] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- P G Meier
- Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, FAA, Lausanne, Switzerland (Chair: Prof. Francine Behar-Cohen)
| | - A Ambresin
- Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, FAA, Lausanne, Switzerland (Chair: Prof. Francine Behar-Cohen)
| | - C E Thirkill
- Eye Research Center, Davis Medical Center, University of California, Sacramento, CA, USA (Chair: Prof. Mark Mannis)
| | - F-X Borruat
- Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, FAA, Lausanne, Switzerland (Chair: Prof. Francine Behar-Cohen)
| | - A Schalenbourg
- Department of Ophthalmology, University of Lausanne, Jules-Gonin Eye Hospital, FAA, Lausanne, Switzerland (Chair: Prof. Francine Behar-Cohen)
| |
Collapse
|
13
|
Abstract
BACKGROUND Proliferative retinopathy is an important cause of vision loss in diabetic patients. Incomplete panretinal photocoagulation (PRP) can lead to recurrent proliferation of new vessels. PATIENTS AND METHODS We retrospectively analysed the outcome of patients with high risk proliferative diabetic retinopathy (PDR) previously treated with slit lamp PRP who underwent indirect fill in argon laser treatment with scleral indentation under anesthesia for persistent neovascular proliferation. RESULTS Seventeen eyes of ten patients were included. The mean age at diabetes onset was 17.3 years SD 16.2 (range 2-44). All patients reported long standing poor glycemic control (mean HbA1c: 8.5% SD 1.3 range 5.9-10.2). The area of retinal ischemia decreased significantly from 15±7.5 disk areas (DA) before fill-in laser to 3.2±4.2 DA after fill-in laser (p=0.001). The new vessels also regressed significantly after laser treatment 8.6±6.1 DA before treatment versus 6.5±6.4 DA after laser treatment, (p=0.044). Quiescent PDR was reached in 10 eyes (58.8%) at the last visit. CONCLUSIONS Fill-in indirect argon laser under general anesthesia should be considered to achieve further new vessels regression in high risk PDR patients. Scleral indentation and absence of pain may allow for more extensive laser application.
Collapse
Affiliation(s)
- A Ambresin
- Department of Ophthalmology, University of Lausanne, Jules Gonin Eye Hospital, Fondation Asile des Aveugles, Medical Retina Unit, Lausanne, Switzerland
| | - V Strueven
- Department of Ophthalmology, University of Lausanne, Jules Gonin Eye Hospital, Fondation Asile des Aveugles, Medical Retina Unit, Lausanne, Switzerland
| | - J-A C Pournaras
- Department of Ophthalmology, University of Lausanne, Jules Gonin Eye Hospital, Fondation Asile des Aveugles, Medical Retina Unit, Lausanne, Switzerland
| |
Collapse
|
14
|
Lehmann-Clarke L, Dirani A, Mantel I, Ambresin A. The effect of switching ranibizumab to aflibercept in refractory cases of macular edema secondary to ischemic central vein occlusion. Klin Monbl Augenheilkd 2015; 232:552-5. [PMID: 25902119 DOI: 10.1055/s-0035-1545783] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Macular edema resulting from central retinal vein occlusion is effectively treated with anti-vascular endothelial growth factor injections. However, some patients need monthly retreatment and still show frequent recurrences. The purpose of this study was to evaluate the visual and anatomic outcomes of refractory macular edema resulting from ischemic central retinal vein occlusion in patients switched from ranibizumab to aflibercept intravitreal injections. PATIENTS AND METHODS We describe a retrospective series of patients followed in the Medical Retina Unit of the Jules Gonin Eye Hospital for macular edema due to ischemic central retinal vein occlusion, refractory to monthly retreatment with ranibizumab, and changed to aflibercept. Refractory macular edema was defined as persistence of any fluid at each visit one month after last injection during at least 6 months. All patients had to have undergone pan-retinal laser scan. RESULTS Six patients were identified, one of whom had a very short-term follow-up (excluded from statistics). Mean age was 57±12 years. The mean changes in visual acuity and central macular thickness from baseline to switch were +20.6±20.3 ETDRS letters and -316.4±276.6 µm, respectively. The additional changes from before to after the switch were +9.2±9.5 ETDRS letters and -248.0±248.7 µm, respectively. The injection intervals could often be lengthened after the switch. CONCLUSIONS Intravitreal aflibercept seems to be a promising alternative treatment for macular edema refractory to ranibizumab in ischemic central retinal vein occlusion.
Collapse
Affiliation(s)
- L Lehmann-Clarke
- Department of Ophthalmology, University of Lausanne, Jules Gonin Eye Hospital, Fondation Asile des Aveugles, Medical Retina Unit, Lausanne, Switzerland (Chairperson: Prof. Francine Behar-Cohen)
| | - A Dirani
- Department of Ophthalmology, University of Lausanne, Jules Gonin Eye Hospital, Fondation Asile des Aveugles, Medical Retina Unit, Lausanne, Switzerland (Chairperson: Prof. Francine Behar-Cohen)
| | - I Mantel
- Department of Ophthalmology, University of Lausanne, Jules Gonin Eye Hospital, Fondation Asile des Aveugles, Medical Retina Unit, Lausanne, Switzerland (Chairperson: Prof. Francine Behar-Cohen)
| | - A Ambresin
- Department of Ophthalmology, University of Lausanne, Jules Gonin Eye Hospital, Fondation Asile des Aveugles, Medical Retina Unit, Lausanne, Switzerland (Chairperson: Prof. Francine Behar-Cohen)
| |
Collapse
|
15
|
Ladaique M, Dirani A, Ambresin A. Long-term follow-up of choroidal neovascularization in pathological myopia treated with intravitreal ranibizumab. Klin Monbl Augenheilkd 2015; 232:542-7. [PMID: 25902117 DOI: 10.1055/s-0035-1545817] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND The purpose of this contribution is to report our functional results on the efficacy of intravitreal ranibizumab for submacular choroidal neovessels (CNV) in high myopia, and to compare the roles of optical coherence tomography (OCT), fluorescein angiography and visual acuity changes in the treatment decision prior to each injection. PATIENTS AND METHODS This is a retrospective study performed in Jules Gonin Eye Hospital. It included all patients with myopic CNV treated with intravitreal ranibizumab injections with a minimum follow-up of 24 months. After an induction dosing from 1 to 3 injections, the follow-up was based on a pro re nata regimen. Ophthalmic evaluation, best corrected visual acuity, and OCT were done at each visit, and fluorescein angiography at baseline and if neovascular activity was suspected. Retreatment criteria included metamorphopsia, visual loss of ≥5 ETDRS letters, any fluid on OCT and/or leakage on fluorescein angiography. RESULTS 24 eyes were included in the study. Mean follow-up was 49 months. Mean visual acuity improved significantly from 62.8±13.8 letters at baseline to 72.8±12.9 letters at last follow-up visit (p=0.001). The mean number of injections was 2.2 in the first year and below 1 for the following years. The sensitivities of fluorescein angiography, SD OCT, and visual acuity loss≥5 letters were 62.6%, 51.4%, and 40%, respectively. The fluorescein angiography showed a significantly higher sensitivity in treatment decision than OCT (p=0.007). CONCLUSION Our study has shown that ranibizumab injections provide a significant long-term visual benefit in myopic CNV with a small number of injections. Fluorescein angiography has a preponderant role in the treatment decision of active myopic CNV.
Collapse
Affiliation(s)
- M Ladaique
- Department of Ophthalmology, University of Lausanne, Jules Gonin Eye Hospital, Fondation Asile des Aveugles, Medical Retina Unit, Lausanne, Switzerland
| | - A Dirani
- Department of Ophthalmology, University of Lausanne, Jules Gonin Eye Hospital, Fondation Asile des Aveugles, Medical Retina Unit, Lausanne, Switzerland
| | - A Ambresin
- Department of Ophthalmology, University of Lausanne, Jules Gonin Eye Hospital, Fondation Asile des Aveugles, Medical Retina Unit, Lausanne, Switzerland
| |
Collapse
|
16
|
Gianniou C, Dirani A, Ferrini W, Marchionno L, Decugis D, Deli A, Ambresin A, Mantel I. Two-year outcome of an observe-and-plan regimen for neovascular age-related macular degeneration: how to alleviate the clinical burden with maintained functional results. Eye (Lond) 2014; 29:342-9. [PMID: 25359289 DOI: 10.1038/eye.2014.258] [Citation(s) in RCA: 20] [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] [Received: 05/10/2014] [Accepted: 10/06/2014] [Indexed: 10/24/2022] Open
Abstract
PURPOSE The purpose of this study was to report the 2-year outcome of an individually tailored 'observe-and-plan' treatment regimen for neovascular age-related macular degeneration (nAMD), and to investigate its clinical value in terms of functional outcome. This regimen aimed to reduce the clinical burden (visits) by employing individually fixed injection intervals, based on the predictability of an individual's need for retreatment. METHODS This prospective case series included 104 patients (115 eyes) with nAMD. Following three loading doses of ranibizumab, the disease recurrence interval was determined in monthly observation visits. Retreatment was applied in a series of three injections with individually fixed intervals (2 weeks shorter than the recurrence interval), combined with periodic adjustment of the intervals. The allowed injection intervals in treatment plans ranged from 1 to 3 months. If there was no recurrence at 3 months, the patient could change to monitoring alone. RESULTS Mean visual acuity (VA) improved by 8.7, 9.7, and 9.2 letters at months 3, 12, and 24, respectively. The mean number of injections was 7.8 and 5.8 during years 1 and 2, respectively, whereas the mean number of ophthalmic examinations was 4.0 and 2.9, respectively. The mean treatment interval (after the loading doses) was 2.0 months during year 1, and 2.2 months during year 2. CONCLUSION The observe-and-plan regimen significantly improved and maintained VA over the course of 2 years. This favourable functional outcome was achieved with fewer clinic visits compared with other regimens. Therefore, this observe-and-plan regimen has the potential to alleviate the clinical burden of nAMD treatment.
Collapse
Affiliation(s)
- C Gianniou
- Department of Ophthalmology, University of Lausanne, Jules Gonin Eye Hospital, Fondation Asile des aveugles, Lausanne, Switzerland
| | - A Dirani
- Department of Ophthalmology, University of Lausanne, Jules Gonin Eye Hospital, Fondation Asile des aveugles, Lausanne, Switzerland
| | - W Ferrini
- Department of Ophthalmology, University of Lausanne, Jules Gonin Eye Hospital, Fondation Asile des aveugles, Lausanne, Switzerland
| | - L Marchionno
- Department of Ophthalmology, University of Lausanne, Jules Gonin Eye Hospital, Fondation Asile des aveugles, Lausanne, Switzerland
| | - D Decugis
- Department of Ophthalmology, University of Lausanne, Jules Gonin Eye Hospital, Fondation Asile des aveugles, Lausanne, Switzerland
| | - A Deli
- Department of Ophthalmology, University of Lausanne, Jules Gonin Eye Hospital, Fondation Asile des aveugles, Lausanne, Switzerland
| | - A Ambresin
- Department of Ophthalmology, University of Lausanne, Jules Gonin Eye Hospital, Fondation Asile des aveugles, Lausanne, Switzerland
| | - I Mantel
- Department of Ophthalmology, University of Lausanne, Jules Gonin Eye Hospital, Fondation Asile des aveugles, Lausanne, Switzerland
| |
Collapse
|
17
|
Ferrini W, Ambresin A. Intravitreal dexamethasone implant for the treatment of macular edema after retinal vein occlusion in a clinical setting. Klin Monbl Augenheilkd 2013; 230:423-6. [PMID: 23629796 DOI: 10.1055/s-0032-1328388] [Citation(s) in RCA: 9] [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] [Indexed: 10/26/2022]
Abstract
BACKGROUND To study the efficacy and safety of a new intravitreal implant (sustained release of dexamethasone, Ozurdex®) recently approved in Switzerland for the treatment of macular edema secondary to retinal vein occlusion in a clinical setting. PATIENTS AND METHODS Prospective non-consecutive study of patients with macular edema secondary to central retinal vein occlusion or branch retinal vein occlusion treated with implant of dexamethasone 0.7 mg. Follow-up visits were performed at day 1, week 1 and monthly thereafter. ETDRS best corrected visual acuity, Goldmann tonometry and macular thickness on SD-OCT were registered. Retreatment was carried out on a pro re nata basis starting from month 3. RESULTS Fifteen eyes of 15 patients were included (8 branch retinal vein occlusions, 7 central retinal vein occlusions). 33% of the patients achieved 3 lines or more of vision gain. The central retinal vein occlusion subgroup showed a mean decline in visual acuity at month 3. A reduction of 36% of macular edema was already observed at day 1. All maculae were dry at month 1. The mean time of recurrence of macular edema for both groups was 4.6 months. A similar reduction of macular edema was obtained after a second implantation. An intraocular pressure increase of ≥ 20% was observed after the first implantation in 53% of patients. CONCLUSION Our study showed efficacy and safety of intravitreal dexamethasone implant in the treatment of macular edema due to retinal vein occlusion. Anatomical efficacy was observed at day 1 but seems to have shorter effect than previously published data. No serious side effects were observed.
Collapse
Affiliation(s)
- W Ferrini
- Jules Gonin Eye Hospital, Medical Retina Unit, University of Lausanne, Switzerland
| | | |
Collapse
|
18
|
Deli A, Moetteli L, Ambresin A, Mantel I. Comparison of fundus autofluorescence images acquired by the confocal scanning laser ophthalmoscope (488 nm excitation) and the modified Topcon fundus camera (580 nm excitation). Int Ophthalmol 2013; 33:635-43. [PMID: 23468053 DOI: 10.1007/s10792-013-9749-z] [Citation(s) in RCA: 9] [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: 09/21/2012] [Accepted: 02/22/2013] [Indexed: 11/25/2022]
Abstract
To compare autofluorescence (AF) images obtained with the confocal scanning laser ophthalmoscope (using the Heidelberg retina angiograph; HRA) and the modified Topcon fundus camera, in a routine clinical setting. A prospective comparative study conducted at the Jules-Gonin Eye Hospital. Fifty-six patients from the medical retina clinic. All patients had complete ophthalmic slit-lamp and fundus examinations, colour and red-free fundus photography, AF imaging with both instruments, and fluorescein angiography. Cataract and fixation were graded clinically. AF patterns were analyzed for healthy and pathological features. Differences of image noise were analyzed by cataract grading and fixation. A total of 105 eyes were included. AF patterns discovered by the retina angiograph and the fundus camera images, respectively, were a dark optic disc in 72 % versus 15 %, a dark fovea in 92 % versus 4 %, sub- and intraretinal fluid visible as hyperautofluorescence on HRA images only, lipid exudates visible as hypoautofluorescence on HRA images only. The same autofluorescent pattern was found on both images for geographic atrophy, retinal pigment changes, drusen and haemorrhage. Image noise was significantly associated with the degree of cataract and/or poor fixation, favouring the fundus camera. Images acquired by the fundus camera before and after fluorescein angiography were identical. Fundus AF images differ according to the technical differences of the instruments used. Knowledge of these differences is important not only for correctly interpreting images, but also for selecting the most appropriate instrument for the clinical situation.
Collapse
Affiliation(s)
- A Deli
- Ophthalmology Department of the University of Lausanne, Jules-Gonin Eye Hospital, 15 Av. de France-Case postale 133, 1000, Lausanne 7, Switzerland
| | | | | | | |
Collapse
|
19
|
Konstantinidis L, Mantel I, Zografos L, Ambresin A. Intravitreal ranibizumab in the treatment of predominantly hemorrhagic lesions in exudative age-related macular degeneration. Klin Monbl Augenheilkd 2011; 228:288-92. [PMID: 21484631 DOI: 10.1055/s-0031-1273214] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Submacular hemorrhage is a manifestation of neovascular age-related macular degeneration (AMD) that has a very poor natural history leading to severe visual loss. We have evaluated the safety and efficacy of intravitreal ranibizumab in the treatment of predominantly hemorrhagic AMD. PATIENTS AND METHODS A retrospective study of patients with predominantly hemorrhagic AMD treated with intravitreal ranibizumab at the Jules Gonin Eye Hospital between December 2006 and December 2008 was undertaken. Baseline and monthly follow-up exams included visual acuity (VA), fundus exam and optical coherence tomography (OCT) while fluorescein and indocyanine green angiography were performed at least every three months. RESULTS The study included 8 eyes. The mean follow-up was 13 months (SD: 6.3). The mean number of intravitreal injections administered for each patient was 6.4 (SD: 2). 50 % of the patients demonstrated stable or improved VA. The size of hemorrhage at baseline was inversely correlated to the final VA (two-tailed p value = 0.038) and positively correlated to the final central macular thickness (two-tailed p value = 0.021). Anticoagulation treatment was inversely correlated to the time of hemorrhage resolution (two-tailed p value = 0.039). CONCLUSIONS Intravitreal ranibizumab may be an effective treatment for predominantly hemorrhagic lesions due to neovascular AMD.
Collapse
|
20
|
Moulin A, Bucher M, Pournaras J, Nguyen C, Ambresin A. Fluorescein and Indocyanine Green Angiography Findings in B Cell Lymphoblastic Leukemia Mimicking Acute Central Serous Chorioretinopathy. Klin Monbl Augenheilkd 2010; 227:342-4. [DOI: 10.1055/s-0029-1245251] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
21
|
Mameletzi E, Pournaras JA, Ambresin A, Nguyen C. Retinal Embolisation with Localised Retinal Detachment following Retrobulbar Anaesthesia. Klin Monbl Augenheilkd 2008; 225:476-8. [DOI: 10.1055/s-2008-1027268] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
22
|
Pournaras JA, Nguyen C, Vaudaux J, Konstantinidis L, Ambresin A, Wolfensberger T. Treatment of Central Retinal Vein Occlusion-Related Macular Edema with Intravitreal Bevacizumab (Avastin®): Preliminary Results. Klin Monbl Augenheilkd 2008; 225:397-400. [DOI: 10.1055/s-2008-1027258] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
23
|
Droz I, Mantel I, Ambresin A, Faouzi M, Schorderet DF, Munier FL. Genotype-phenotype correlation of age-related macular degeneration: influence of complement factor H polymorphism. Br J Ophthalmol 2008; 92:513-7. [PMID: 18211923 DOI: 10.1136/bjo.2007.127811] [Citation(s) in RCA: 29] [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: 11/03/2022]
Abstract
BACKGROUND/AIMS Complement factor H (CFH) Y402H polymorphism shows a strong association with age-related macular degeneration (AMD). Although the phenotypic concordance of AMD has been shown in sibling/twin studies, little is known about the genotype-phenotype association. In this study, we investigated whether CFH Y402H is associated with early phenotypic features. METHODS Statistical analysis was performed on 420 patients with AMD with complete clinical and genetic data (graded colour fundus photographs, according to the International Classification and Grading System for AMD and successful testing for CFH Y402H). RESULTS In this Swiss population, an OR of 2.95 was confirmed for AMD in the presence of at least one risk C allele and OR of 9.05 for the CC homozygotes, corrected for age and sex. No difference was found between the AMD stages. Patients homozygous for the risk allele showed significant association with peripheral drusen (p = 0.028) and for central drusen location (p = 0.049). No trend was found for other drusen criteria (size, total surface, location nasal to disc) and for pigmentary changes. CONCLUSIONS The CFH Y402H polymorphism showed a genotype-phenotype association for some drusen features. Additional genetic factors are likely to influence drusen phenotype.
Collapse
Affiliation(s)
- I Droz
- University Eye Hospital Jules Gonin, 15, Av. de France - Case postale 133, CH - 1000 Lausanne 7, Switzerland
| | | | | | | | | | | |
Collapse
|
24
|
Mantel I, Ambresin A, Zografos L. 310 Ranibizumab pour la DMLA exsudative à prédominance occulte – les expériences de la première année en pratique clinique. J Fr Ophtalmol 2007. [DOI: 10.1016/s0181-5512(07)80122-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
25
|
De Haller R, Ambresin A, Zografos L, Mantel I. 309 Le Ranibizumab dans le traitement de la DMLA exsudative avec néovascularisation occulte et décollement de l’épithélium pigmentaire. J Fr Ophtalmol 2007. [DOI: 10.1016/s0181-5512(07)80121-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
26
|
Ambresin A, Mantel I, Zografos L. 417 Injection intravitréenne de ranibizumab pour prolifération angiomateuse rétinienne : résultats préliminaires. J Fr Ophtalmol 2007. [DOI: 10.1016/s0181-5512(07)80230-0] [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: 11/30/2022]
|
27
|
Nessi F, Guex-Crosier Y, Ambresin A, Zografos L. Photodynamic therapy with verteporfin for subfoveal choroidal neovascularization secondary to toxoplasmic chorioretinal scar. Klin Monbl Augenheilkd 2004; 221:371-3. [PMID: 15162283 DOI: 10.1055/s-2004-812860] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND To assess the effect of photodynamic therapy in the treatment of subfoveal choroidal neovascularization consecutive to a toxoplasmic chorioretinal scar. HISTORY AND SIGNS Three patients with a previous history of toxoplasmic chorioretinal scar noticed a decrease in visual acuity and metamorphopsia. Fundus examination and fluorescein angiography revealed the presence of subfoveal choroidal neovascularization at the edge of the toxoplasmic chorioretinal scar. THERAPY AND OUTCOME The first patient, aged 78, was treated by photodynamic therapy followed by three subsequent treatments of feeder vessel by laser photocoagulation. Visual acuity decreased during follow-up in the presence of recurrence of choroidal neovascularization and subretinal fibrosis. The second patient, a 20-year-old lady, was treated with three sessions of photodynamic therapy for a subfoveal choroidal neovascularization related to a toxoplasmic scar. Visual acuity was stabilized on the last follow-up visit at 0.3. The third patient, aged 53, received four treatments with photodynamic therapy at an interval of 3 - 4 months. choroidal neovascularization was stabilized and the last visual acuity was 0.2. CONCLUSIONS This preliminary report suggests that photodynamic therapy with verteporfine may be an effective therapeutic modality for subfoveal choroidal neovascularization related to a toxoplasmic chorioretinal scar. Further assessment is needed in order to confirm this preliminary findings.
Collapse
Affiliation(s)
- F Nessi
- Hôpital Ophtalmique Jules Gonin, Lausanne, Switzerland
| | | | | | | |
Collapse
|
28
|
Abstract
PURPOSE To determine the epidemiology of Behçet's disease in Western Switzerland and to study the characteristics of ocular disease. METHODS Patients newly diagnosed with Behçet's disease, seen from January 1990 to December 1998 at Hôpital Jules Gonin, La Source Eye Center, and the Division of Immunology and Allergy, University of Lausanne, were analyzed. The Japanese diagnostic criteria for Behçet's disease were used and both complete and incomplete forms were included. Incidence, proportion of cases with ocular involvement, and the characteristics of ocular disease were determined. RESULTS During the follow-up period, a total of 35 Behçet's patients were seen in the three study centers. Twenty-five of these patients had ocular involvement. The incidences of Behçet's disease and Behçet's ocular disease in the western part of Switzerland, with a referral population of roughly 600000 persons, were 0.65 and 0.46 per 100000 per year, respectively. The mean age of the group was 33.2 years, age at presentation was 25.8 years, and mean follow-up was 5.7 years. The most frequent sign was oral aphthous involvement (86%), followed by ocular manifestations (72%). The HLA-B51 antigen was present in 66% of the patients with ocular involvement. Panuveitis was present in 20/25 patients (80%), anterior uveitis in 3/25 patients, and posterior involvement in 2/25 patients. Twenty-two patients (88%) had systemic treatment that always included corticosteroids; it was associated with other treatments in 17/22 patients. Mean duration of treatment was 45.5 +/- 25.1 (SD) months. The mean recurrence-free period in the six patients in whom treatment could be interrupted was 18.0 +/- 8.8 (SD) months. Visual function was maintained at the end of the follow-up for the collective and visual outcome was correlated to visual function at presentation. CONCLUSIONS The incidence of Behçet's disease in Western Switzerland was comparable to that in other western nonendemic countries. With early diagnosis and appropriate therapy, the prognosis was favorable in our collective of patients.
Collapse
Affiliation(s)
- A Ambresin
- Department of Ophthalmology, Hôpital Ophtalmique Jules Gonin, Switzerland
| | | | | | | |
Collapse
|
29
|
Ambresin A, Borruat FX, Mermoud A. Recurrent transient visual loss after deep sclerectomy. Arch Ophthalmol 2001; 119:1213-5. [PMID: 11483096] [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] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
- A Ambresin
- Hôpital Ophtalmique Jules Gonin, Avenue de France 15, CH-1004 Lausanne, Switzerland.
| | | | | |
Collapse
|