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Ferreira de Moura T, Chemla C, Arndt C, Denoyer A. Multimodal imaging in a case of microsporidial keratoconjunctivitis in an immunocompetent woman. J Fr Ophtalmol 2024; 47:103917. [PMID: 37620198 DOI: 10.1016/j.jfo.2023.03.031] [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: 03/16/2023] [Revised: 03/24/2023] [Accepted: 03/27/2023] [Indexed: 08/26/2023]
Affiliation(s)
- T Ferreira de Moura
- Service d'ophtalmologie, hôpital Robert-Debré, centre hospitalier universitaire de Reims, rue du Général Koenig, 51100 Reims, France; EA4684, CARDIOVIR, université Reims Champagne-Ardenne, 51100 Reims, France.
| | - C Chemla
- Laboratoire de parasitologie, pôle de biologie de l'hôpital Robert-Debré, centre hospitalier universitaire de Reims, rue du Général Koenig, 51100 Reims, France; EA7510, ESCAPE, université Reims Champagne-Ardenne, 51100 Reims, France
| | - C Arndt
- Service d'ophtalmologie, hôpital Robert-Debré, centre hospitalier universitaire de Reims, rue du Général Koenig, 51100 Reims, France
| | - A Denoyer
- Service d'ophtalmologie, hôpital Robert-Debré, centre hospitalier universitaire de Reims, rue du Général Koenig, 51100 Reims, France; EA4684, CARDIOVIR, université Reims Champagne-Ardenne, 51100 Reims, France
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Razlog E, Denoyer A, Baillif S, Arndt C, Dubernard X, Caujolle JP, Nahon-Esteve S, Martel A. Revisiting the Use of Deep Temporalis Fascia Grafts in Ophthalmology. Semin Ophthalmol 2024:1-9. [PMID: 38661124 DOI: 10.1080/08820538.2024.2346756] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Accepted: 04/20/2024] [Indexed: 04/26/2024]
Abstract
PURPOSE To report new indications for deep temporalis fascia (DTF) grafts in the ophthalmic field. METHODS Monocentric retrospective interventional case series study. All the patients who underwent a DTF graft in an unpublished new indication over the study period (May 2020-October 2023) were included. For each patient, gender, age, graft indication, outcomes, complications, and follow-up duration were collected. In most cases, the DTF graft was covered by a vascularized flap. RESULTS Eight patients underwent a DTF graft over the study period. The indications were: radiotherapy-induced scleral necrosis in three cases, tendinoplasty to replace the inferior rectus muscle tendon invaded by a locally advanced conjunctival carcinoma in one case, Ahmed glaucoma valve tube exposure in one case, intraocular lens with scleral fixation exposure in one case, orbital cerebrospinal fluid fistula (orbitorrhea) in one case, and post-traumatic complete corneal graft loss in one case. The DTF graft was successful in 87.5% of cases after a mean follow-up of 11.4 months. No complications were observed. CONCLUSIONS DTF graft is a highly versatile graft that can be easily harvested. New indications for DTF grafts may include the repair of radiotherapy-induced scleral necrosis, the creation of oculomotor tendon and the temporary packing of large ocular tissue loss in an emergency context. Further studies with a longer follow-up are needed to confirm our preliminary results.
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Affiliation(s)
- Elena Razlog
- Ophthalmology Department, Robert Debre University Hospital, Reims, France
| | - Alexandre Denoyer
- Ophthalmology Department, Robert Debre University Hospital, Reims, France
| | - Stephanie Baillif
- Ophthalmology Department, Pasteur 2 University Hospital, Nice, France
| | - Carl Arndt
- Ophthalmology Department, Robert Debre University Hospital, Reims, France
| | | | | | | | - Arnaud Martel
- Ophthalmology Department, Pasteur 2 University Hospital, Nice, France
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Razlog E, Gire J, Arndt C, Denoyer A, Lassalle S, Baillif S, Martel A. Giant conjunctival inclusion cyst mimicking an orbital tumor. J Fr Ophtalmol 2023; 46:e274-e275. [PMID: 37085366 DOI: 10.1016/j.jfo.2022.12.041] [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: 11/09/2022] [Revised: 12/23/2022] [Accepted: 12/26/2022] [Indexed: 04/23/2023]
Affiliation(s)
- E Razlog
- Service d'ophtalmologie, CHU de Robert-Debré de Reims, université Reims - Champagne-Ardenne, rue du Général Koenig, 51100 Reims, France.
| | - J Gire
- Centre de consultation ophtalmologique, 80, allée des Ormes, 06250 Mougins, France
| | - C Arndt
- Service d'ophtalmologie, CHU de Robert-Debré de Reims, université Reims - Champagne-Ardenne, rue du Général Koenig, 51100 Reims, France
| | - A Denoyer
- Service d'ophtalmologie, CHU de Robert-Debré de Reims, université Reims - Champagne-Ardenne, rue du Général Koenig, 51100 Reims, France
| | - S Lassalle
- Laboratoire d'anatomie pathologique, CHU de Nice, université Côte d'Azur, hôpital Pasteur, 30, voie Romaine, 06000 Nice, France
| | - S Baillif
- Service d'ophtalmologie, CHU de Nice, université Côte d'Azur, hôpital Pasteur, 30, voie Romaine, 06000 Nice, France
| | - A Martel
- Service d'ophtalmologie, CHU de Nice, université Côte d'Azur, hôpital Pasteur, 30, voie Romaine, 06000 Nice, France
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Ferreira de Moura T, Servettaz A, Henry A, Arndt C, Denoyer A. Roth spots in a Rendu-Osler-Weber syndrome. Retin Cases Brief Rep 2023:01271216-990000000-00213. [PMID: 37639637 DOI: 10.1097/icb.0000000000001479] [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: 08/31/2023]
Abstract
PURPOSE To describe the molecular diagnosis and atypical ocular presentation of a patient who suffered for a Rendu-Osler-Weber syndrome associated with juvenile polyposis (JP) syndrome. METHODS This is a case report of a patient that underwent fundus examen, brain Magnetic Resonance Imaging (MRI) and arteriography. Genetic testing was performed by next-generation-sequencing (NGS). RESULTS A 35-year-old woman presented with right hemiplegia with right homonymous lateral hemianopia and homolateral complete sensory deficit. She also had Roth spots in her left fundus. Genetic testing revealed a pathogenic variation in the heterozygous state in the SMAD-4 gene (c.1245_1248del). CONCLUSION Hereditary Hemorrhagic Telangiectasia (HTT) also known as Rendu-Osler-Weber syndrome is a rare autosomal dominant disease which reveals mostly with epistaxis and cutaneous telangiectasias. Our clinical case reports Roth spots in the context of HTT associated with juvenile polyposis syndrome. SMAD-4 mutation may explain the presence of a carotid-ophthalmic aneurysm which is not a lesion usually found in HTT.
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Affiliation(s)
- Thomas Ferreira de Moura
- Université Reims Champagne-Ardenne; service d'ophtalmologie, Centre Hospitalier Universitaire de Reims, rue du Général Koenig, 51100 Reims, France
- EA4684, CARDIOVIR, Université Reims Champagne-Ardenne, 51100 Reims, France
| | - Amélie Servettaz
- Université Reims Champagne-Ardenne; service de médecine interne, maladies infectieuses et immunologie clinique, Centre Hospitalier Universitaire de Reims, rue du Général Koenig, 51100 Reims, France
| | - Adrien Henry
- Université Reims Champagne-Ardenne; service d'ophtalmologie, Centre Hospitalier Universitaire de Reims, rue du Général Koenig, 51100 Reims, France
| | - Carl Arndt
- Université Reims Champagne-Ardenne; service d'ophtalmologie, Centre Hospitalier Universitaire de Reims, rue du Général Koenig, 51100 Reims, France
| | - Alexandre Denoyer
- Université Reims Champagne-Ardenne; service d'ophtalmologie, Centre Hospitalier Universitaire de Reims, rue du Général Koenig, 51100 Reims, France
- EA4684, CARDIOVIR, Université Reims Champagne-Ardenne, 51100 Reims, France
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Razlog E, Chammas J, Arndt C, Denoyer A. [Development of a chatbot (conversational app) for cataract surgery patients]. J Fr Ophtalmol 2023; 46:441-448. [PMID: 37061386 DOI: 10.1016/j.jfo.2022.07.023] [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: 05/30/2022] [Accepted: 07/25/2022] [Indexed: 04/17/2023]
Abstract
INTRODUCTION The goal of this study was to create and promote a type of chatbot or conversational app, for patients who need cataract surgery and to evaluate its acceptability. METHODS Multicentric prospective clinical study in two phases. Phase I : distribution of a questionnaire of 20 questions (evaluating patients' knowledge about cataracts and cataract surgery and their expectations in terms of patient education). Statistical analysis was performed through factorial analysis with factor rotation and Cronbach's alpha calculation. Phase II : creation of a chatbot with a repertoire of question-answer sets. An acceptability analysis was performed using a second questionnaire inspired by the « SUS Score ». RESULTS One hundred and six initial questionnaires were collected. The patients were mostly women (56.6 %), aged 60 to 79 years (81 %), retired (77.4 %), with no high school diploma (33.0 %), had never used a chatbot before (95.3 %) and were accustomed to using a smartphone (66.0 %). Patients evaluated their knowledge about cataracts as insufficient (51.8 %) and felt the need to receive additional information (81.1 %). The comprehensibility score of the first questionnaire was 91 (middle school level). The baseline data of the chatbot was composed of 316 questions with a median comprehensibility score of 101 (middle school level). The first test of the chatbot included 18 patients. The median connection time was 4min and 40seconds (standard deviation 6.6). The median of number of questions asked for each connection was 6.5 (standard deviation 6.7). Acceptability was good, with a mean Sus Score of 78.6/100 (standard deviation 11.9). CONCLUSION This study shows the importance of information for cataract surgery patients. The creation of a chatbot for patients undergoing cataract surgery appears to be relevant in achieving this goal.
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Affiliation(s)
- E Razlog
- Université Reims Champagne-Ardenne, CHU Robert Debré, Reims, France
| | - J Chammas
- Université Reims Champagne-Ardenne, CHU Robert Debré, Reims, France
| | - C Arndt
- Université Reims Champagne-Ardenne, CHU Robert Debré, Reims, France
| | - A Denoyer
- Université Reims Champagne-Ardenne, CHU Robert Debré, Reims, France; EA6485 CARDIOVIR, faculté de médecine, université Reims Champagne-Ardenne, Reims, France.
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Maffre C, Fournié P, Durbant E, Arndt C, Djerada Z, Denoyer A. Identifying predictive factors for long-term visual recovery after corneal endothelial keratoplasty in Fuchs' dystrophy: Potential interaction between the corneal dysfunction and retinal status. Front Med (Lausanne) 2023; 10:1120283. [PMID: 36968840 PMCID: PMC10034073 DOI: 10.3389/fmed.2023.1120283] [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: 12/09/2022] [Accepted: 02/20/2023] [Indexed: 03/11/2023] Open
Abstract
IntroductionDescemet membrane endothelial keratoplasty (DMEK) is the main treatment for Fuchs' dystrophy (FECD). The outcomes are excellent, but the final visual recovery may vary from patient to patient with sometimes no obvious reason of such a spread.MethodsWe conducted a clinical prospective multicentric study to identify the predictive factors for the visual result 1 year after surgery. Eighty three patients (83 eyes) were included.ResultsPostoperative BCVA after 1 year was 0.20 ± 0.18 logMAR. Logistic regression revealed that good visual recovery correlated negatively with preoperative central macular thickness (p < 0.001) and the need for rebubbling (p = 0.05), and positively with preoperative visual acuity (p = 0.009). Multivariate formula to predict the 1-year BCVA has been suggested.DiscussionPreoperative retinal status seems to be the main predictive factor for long-term visual result after DMEK. Our predictive multivariate model could assist in better informing the patient about the prognosis of the surgery, and in adjusting the therapeutic strategy also, further highlighting the essential collaboration between both cornea and retina subspecialists.
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Affiliation(s)
- Charlotte Maffre
- University of Reims Champagne-Ardenne, Reims, France
- University Hospital Robert Debré, Reims, France
| | - Pierre Fournié
- University of Toulouse III Paul Sabatier, Toulouse, France
| | - Eve Durbant
- University Hospital Robert Debré, Reims, France
| | - Carl Arndt
- University of Reims Champagne-Ardenne, Reims, France
- University Hospital Robert Debré, Reims, France
| | - Zoubir Djerada
- University of Reims Champagne-Ardenne, Reims, France
- University Hospital Robert Debré, Reims, France
| | - Alexandre Denoyer
- University of Reims Champagne-Ardenne, Reims, France
- University Hospital Robert Debré, Reims, France
- CARDIOVIR Research Team, EA-4684, University of Reims Champagne-Ardenne, Reims, France
- *Correspondence: Alexandre Denoyer
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Razlog E, Baillif S, Arndt C, Denoyer A, Martel A. Amniotic membrane graft for the treatment of a wound healing delay in an exenterated orbital socket after radiation therapy. J Fr Ophtalmol 2023; 46:e97-e98. [PMID: 36609070 DOI: 10.1016/j.jfo.2022.07.021] [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: 07/01/2022] [Accepted: 07/07/2022] [Indexed: 01/05/2023]
Affiliation(s)
- E Razlog
- Service d'ophtalmologie, CHU de Robert-Debré de Reims, université Reims - Champagne-Ardenne, rue du Général-Koenig, 51100 Reims, France
| | - S Baillif
- Service d'ophtalmologie, CHU de Nice, université Côte d'Azur, hôpital Pasteur, 30, Voie Romaine, 06000 Nice, France
| | - C Arndt
- Service d'ophtalmologie, CHU de Robert-Debré de Reims, université Reims - Champagne-Ardenne, rue du Général-Koenig, 51100 Reims, France
| | - A Denoyer
- Service d'ophtalmologie, CHU de Robert-Debré de Reims, université Reims - Champagne-Ardenne, rue du Général-Koenig, 51100 Reims, France
| | - A Martel
- Service d'ophtalmologie, CHU de Nice, université Côte d'Azur, hôpital Pasteur, 30, Voie Romaine, 06000 Nice, France.
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Costedoat I, Wallaert M, Gaultier A, Vasseur R, Vanhaecke C, Viguier M, Cordelette C, Denoyer A, Ferrier le Bouëdec MC, Coutu A, Lamiaux M, Tran THC, Lacour JP, Elmaleh V, Tetart F, Gueudry J, Tauber M, Giordano-Labadie F, Cassagne M, Nosbaum A, Ouilhon C, Jachiet M, Tadayoni R, Dezoteux F, Staumont-Salle D, Bouleau J, Labalette P, Doan S, Soria A, Mortemousque B, Seneschal J, Barbarot S. Multicenter prospective observational study of dupilumab-induced ocular events in atopic dermatitis patients. J Eur Acad Dermatol Venereol 2023; 37:1056-1063. [PMID: 36732052 DOI: 10.1111/jdv.18932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 01/05/2023] [Indexed: 02/04/2023]
Abstract
BACKGROUND Although ocular adverse events are frequent in AD patients treated with dupilumab, their characterization remains limited due to a lack of prospective studies with a systematic ophthalmological examination. OBJECTIVE To examine the incidence, characteristics and risk factors of dupilumab-induced ocular adverse events. METHODS A prospective, multicenter, and real-life study in adult AD patients treated with dupilumab. RESULTS At baseline, 27 out of 181 patients (14.9%) had conjunctivitis. At week 16 (W16), 25 out of 27 had improved their conjunctivitis and 2 remained stable and 34 out of 181 patients (18.7%) had dupilumab-induced blepharoconjunctivitis: either de novo (n = 32) or worsening of underlying blepharoconjunctivitis (n = 2). Most events (27/34; 79.4%) were moderate. A multivariate analysis showed that head and neck AD (OR = 7.254; 95%CI [1.938-30.07]; p = 0.004), erythroderma (OR = 5.635; 95%CI [1.635-21.50]; p = 0.007) and the presence of dry eye syndrome at baseline (OR = 3.51; 95%CI [3.158-13.90]; p = 0.031) were independent factors associated with dupilumab-induced blepharoconjunctivitis. LIMITATIONS Our follow-up period was 16 weeks and some late-onset time effects may still occur. CONCLUSION This study showed that most dupilumab-induced blepharoconjunctivitis cases are de novo. AD severity and conjunctivitis at baseline were not found to be associated risk factors in this study.
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Affiliation(s)
- Ingrid Costedoat
- CHU de Bordeaux, National Reference Center for Rare Skin Diseases, CNRS UMR5164, ImmunoConCept, Univ. Bordeaux, Bordeaux, France
| | - Martin Wallaert
- Department of Dermatology and Ophthalmology, CHU Nantes, UMR 1280 PhAN, INRA, Nantes Université, Nantes, France
| | - Aurelie Gaultier
- CHU Nantes, Direction de la recherche, Plateforme de Méthodologie et Biostatistique, Nantes Université, Nantes, France
| | - Robin Vasseur
- Department of Dermatology and Ophthalmology, CHU Nantes, UMR 1280 PhAN, INRA, Nantes Université, Nantes, France
| | - Clelia Vanhaecke
- Department of Dermatology-Venerology, CHU Robert-Debré, Reims, France
| | - Manuelle Viguier
- Department of Dermatology-Venerology, CHU Robert-Debré, Reims, France
| | | | | | | | - Adrien Coutu
- Department of Dermatology-Venerology and Ophthalmology, Centre Hospitalier Universitaire Clermont-Ferrand, Clermont-Ferrand, France
| | - Marie Lamiaux
- Department of Dermatology-Venerology and Ophthalmology, Lille Catholic Hospital, Lille Catholic University
| | - Thi Ha Châu Tran
- Department of Dermatology-Venerology and Ophthalmology, Lille Catholic Hospital, Lille Catholic University
| | - Jean Philippe Lacour
- Department of Dermatology-Venerology and Ophthalmology, University Hospital of Nice-Côte d'Azur, Nice, France
| | - Valerie Elmaleh
- Department of Dermatology-Venerology and Ophthalmology, University Hospital of Nice-Côte d'Azur, Nice, France
| | - Florence Tetart
- Department of Dermatology-Venerology and Ophthalmology, Rouen University Hospital, Rouen, France
| | - Julie Gueudry
- Department of Dermatology-Venerology and Ophthalmology, Rouen University Hospital, Rouen, France
| | - Marie Tauber
- Department of Dermatology-Venerology and Ophthalmology, Toulouse, France
| | | | - Myriam Cassagne
- Department of Ophthalmology, Toulouse University Hospital, Toulouse, France
| | - Audrey Nosbaum
- Centre Hospitalier Lyon Sud, Service d'Allergologie et Immunologie Clinique, Service d'Ophtalmologie, Civils de Lyon, Pierre Bénite, France.,CIRI - Centre International de Recherche en Infectiologie (International Center for Infectiology Research), INSERM U1111, CNRS UMR, Univ Lyon, Lyon, France
| | - Coralie Ouilhon
- Centre Hospitalier Lyon Sud, Service d'Allergologie et Immunologie Clinique, Service d'Ophtalmologie, Civils de Lyon, Pierre Bénite, France.,CIRI - Centre International de Recherche en Infectiologie (International Center for Infectiology Research), INSERM U1111, CNRS UMR, Univ Lyon, Lyon, France
| | - Marie Jachiet
- Faculty of Medicine, Assistance Publique-Hôpitaux de Paris (APHP), Department of Dermatology, Saint-Louis Hospital, University of Paris, Paris, France
| | - Ramin Tadayoni
- Faculty of Medicine, Assistance Publique-Hôpitaux de Paris (APHP), Department of Ophthalmology, Lariboisiere Hospital, University of Paris, Paris, France
| | - Frederic Dezoteux
- Centre de Référence des Syndromes Hyperéosinophiliques, Department of Dermatology-Venerology, CHU Lille, U1286 Inserm INFINITE, Université de Lille, Lille, France
| | - Delphine Staumont-Salle
- Centre de Référence des Syndromes Hyperéosinophiliques, Department of Dermatology-Venerology, CHU Lille, U1286 Inserm INFINITE, Université de Lille, Lille, France
| | - Julien Bouleau
- Department of Ophthalmology, CHU Lille, Univ. Lille, Lille, France
| | - Pierre Labalette
- Department of Ophthalmology, CHU Lille, Univ. Lille, Lille, France
| | - Serge Doan
- Departement of Dermatology-Venerology and Allergology, Hôpital Tenon, Paris HUEP, APHP, Paris, France.,Sorbonne Université, Paris, France.,Centre d'Immunologie et des Maladies Infectieuses - Paris (Cimi-Paris), INSERM U1135, Paris, France
| | - Angele Soria
- Departement of Dermatology-Venerology and Allergology, Hôpital Tenon, Paris HUEP, APHP, Paris, France.,Sorbonne Université, Paris, France.,Centre d'Immunologie et des Maladies Infectieuses - Paris (Cimi-Paris), INSERM U1135, Paris, France
| | - Bruno Mortemousque
- CHU de Bordeaux, National Reference Center for Rare Skin Diseases, CNRS UMR5164, ImmunoConCept, Univ. Bordeaux, Bordeaux, France
| | - Julien Seneschal
- CHU de Bordeaux, National Reference Center for Rare Skin Diseases, CNRS UMR5164, ImmunoConCept, Univ. Bordeaux, Bordeaux, France
| | - Sebastien Barbarot
- Department of Dermatology and Ophthalmology, CHU Nantes, UMR 1280 PhAN, INRA, Nantes Université, Nantes, France
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Henry A, Dormegnie LP, Ferreira de Moura T, Olory-Garnotel L, Ramoul CE, Maffre C, Celerier I, Arndt C, Denoyer A. Mise en place des examens cliniques objectifs structurés (ECOS) facultaires en ophtalmologie. J Fr Ophtalmol 2022; 45:803-811. [DOI: 10.1016/j.jfo.2022.02.018] [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: 12/27/2021] [Revised: 02/18/2022] [Accepted: 02/21/2022] [Indexed: 11/17/2022]
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Ferreira de Moura T, Henry A, Arndt C, Denoyer A, Collot L. Schlaegel lines in a pediatric case of idiopathic multifocal choroiditis. J Fr Ophtalmol 2022; 45:e415-e416. [DOI: 10.1016/j.jfo.2022.05.004] [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: 03/17/2022] [Revised: 04/27/2022] [Accepted: 05/05/2022] [Indexed: 10/17/2022]
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Ferreira de Moura T, Limelette A, Arndt C, Guillard T, Andreoletti L, Denoyer A. First use of a new rapid multiplex PCR system for the microbiological diagnosis and the clinical management of severe infectious keratitis: A case report. Am J Ophthalmol Case Rep 2022; 27:101601. [PMID: 35668738 PMCID: PMC9162950 DOI: 10.1016/j.ajoc.2022.101601] [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: 02/21/2022] [Revised: 05/04/2022] [Accepted: 05/26/2022] [Indexed: 11/18/2022] Open
Abstract
Purpose Observations Conclusions and importance
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Affiliation(s)
- Thomas Ferreira de Moura
- University of Reims Champagne-Ardenne, University Hospital, Ophthalmology, Reims, France
- University of Reims Champagne-Ardenne, Research Team EA4684, CARDIOVIR, Reims, France
| | - Anne Limelette
- University Hospital, Department of Biology, Reims, France
| | - Carl Arndt
- University of Reims Champagne-Ardenne, University Hospital, Ophthalmology, Reims, France
| | - Thomas Guillard
- University Hospital, Department of Biology, Reims, France
- University of Reims Champagne-Ardenne, Inserm UMRS1250, P3Cell, Reims, France
| | - Laurent Andreoletti
- University of Reims Champagne-Ardenne, Research Team EA4684, CARDIOVIR, Reims, France
- University Hospital, Department of Biology, Reims, France
| | - Alexandre Denoyer
- University of Reims Champagne-Ardenne, University Hospital, Ophthalmology, Reims, France
- University of Reims Champagne-Ardenne, Research Team EA4684, CARDIOVIR, Reims, France
- Corresponding author. Department of ophthalmology, Robert Debré University Hospital, rue du general Koenig, 51100, Reims, France.
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Santorini M, Ferreira De Moura T, Barraud S, Litré CF, Brugniart C, Denoyer A, Djerada Z, Arndt C. Comparative Evaluation of Two SD-OCT Macular Parameters (GCC, GCL) and RNFL in Chiasmal Compression. Eye Brain 2022; 14:35-48. [PMID: 35282333 PMCID: PMC8906826 DOI: 10.2147/eb.s337333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Accepted: 12/24/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To evaluate the relationship between different macular thickness parameters analyzed by SD-OCT and the central visual field (VF) evaluated with automated kinetic perimetry in a cohort of patients with pituitary tumors. Methods Data from patients with pituitary adenoma treated at Reims University Hospital between October 1st, 2017, and May 31st, 2018 were collected. All patients underwent an automated kinetic perimetry and a SD-OCT to map the ganglion cell complex (GCC), the ganglion cell layer (GCL) thickness and the retinal nerve fiber layer (RNFL) using devices from two different manufacturers. Univariate and multivariate analysis were used to evaluate the correlation between the area of central VF in square degrees (deg2) and the SD-OCT parameters (μm). Results Eighty-eight eyes were included in the analysis. All the thickness parameters measured in SD-OCT decreased with the visual field alteration. The best correlation was observed between superior thickness parameters (GCC, GCL) and the inferior central visual field. The most pertinent predictive factors for visual field loss were the inferior central GCL and the nasal RNFL (both AUC=0.775) with a sensitivity respectively of 86% and 70%. Conclusion This study suggests that both GCC, GCL thickness parameters could be reliable predictors of central visual field impairment in patients with pituitary tumors. There was no significative difference between both devices.
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Affiliation(s)
- Mélissa Santorini
- Department of Ophthalmology, Robert Debré Hospital, Reims, France
- Correspondence: Mélissa Santorini, Department of Ophthalmology, Robert Debré Hospital, Reims, France, Tel +33616521403, Email
| | | | - Sara Barraud
- Department of Endocrinology, Robert Debré Hospital, Reims, France
| | | | | | | | - Zoubir Djerada
- Department of Pharmacology, Robert Debré Hospital, Reims, France
| | - Carl Arndt
- Department of Ophthalmology, Robert Debré Hospital, Reims, France
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Marquant K, Quinquenel A, Arndt C, Denoyer A. Corneal in vivo confocal microscopy to detect belantamab mafodotin-induced ocular toxicity early and adjust the dose accordingly: a case report. J Hematol Oncol 2021; 14:159. [PMID: 34602074 PMCID: PMC8489063 DOI: 10.1186/s13045-021-01172-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [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: 07/24/2021] [Accepted: 09/22/2021] [Indexed: 02/15/2023] Open
Abstract
Background New targeted antibody–drug conjugates (ADCs) against multiple myeloma are known to induce adverse effects that may lead to treatment discontinuation. Preclinical studies reported early severe ocular damage related to the use of belantamab mafodotin (belamaf), including ocular surface inflammation, severe dry eye, and a specific toxicity to the cornea, namely microcystic keratopathy. While belamaf-induced ocular changes have not been prospectively studied, a better understanding of mechanisms involved as well as kinetics may aid in anticipating dose adjustment rather than stopping the treatment once clinical ocular damage is too severe. Case presentation A 61-year-old woman scheduled for belamaf as a fifth-line treatment against multiple myeloma was prospectively included. Clinical examinations were performed before and every 3 weeks afterward, together with in vivo confocal microscopy (IVCM) of the cornea. Visual acuity, symptoms, slit-lamp examination, and ultrastructural changes of the cornea were recorded according to the received dose of belamaf. More precisely, kinetics, shape, density, and location of the toxic corneal lesions have been followed and analyzed using IVCM. Also, specific lesions at the sub-basal nerve plexus layer were detected and characterized for the first time. This advanced approach allowed a better understanding of the belamaf-induced toxicity, further balancing the dose to maintain good vision and eye health while continuing the treatment. Conclusions Systematic ultrastructural analysis and follow-up of the corneal state during ADCs treatment for multiple myeloma may open new avenues in the therapeutic approach. Early preclinical detection of ocular damage may accurately contribute to finding the correct dose for each patient and not stopping the treatment due to severe ocular adverse effects. Supplementary Information The online version contains supplementary material available at 10.1186/s13045-021-01172-5.
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Affiliation(s)
- Kevin Marquant
- University Hospital of Reims, Reims, France.,University of Reims Champagne-Ardenne, Reims, France
| | - Anne Quinquenel
- University Hospital of Reims, Reims, France.,University of Reims Champagne-Ardenne, Reims, France
| | - Carl Arndt
- University Hospital of Reims, Reims, France.,University of Reims Champagne-Ardenne, Reims, France
| | - Alexandre Denoyer
- University Hospital of Reims, Reims, France. .,University of Reims Champagne-Ardenne, Reims, France. .,Institut de la Vision, U968, Sorbonne University, Paris, France. .,Research Team CARDIOVIR, EA4684, University of Reims Champagne-Ardenne, Reims, France. .,Robert Debré University Hospital, Rue du General Koenig, 51100, Reims, France.
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Santorini M, Durbant E, Boulagnon C, Ducasse A, Arndt C, Denoyer A, Larré I. Utility of genetic sequencing in the diagnosis of a very large orbital tumor. J Fr Ophtalmol 2021; 45:e89-e93. [PMID: 34509305 DOI: 10.1016/j.jfo.2021.03.022] [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: 01/30/2021] [Revised: 03/26/2021] [Accepted: 03/29/2021] [Indexed: 11/17/2022]
Affiliation(s)
- M Santorini
- Service d'ophtalmologie, CHU Robert-Debré, rue du Général Koenig, 51100 Reims, France; Université de Reims Champagne-Ardenne.
| | - E Durbant
- Service d'ophtalmologie, CHU Robert-Debré, rue du Général Koenig, 51100 Reims, France; Université de Reims Champagne-Ardenne
| | - C Boulagnon
- Service d'ophtalmologie, CHU Robert-Debré, rue du Général Koenig, 51100 Reims, France; Université de Reims Champagne-Ardenne
| | - A Ducasse
- Université de Reims Champagne-Ardenne
| | - C Arndt
- Service d'ophtalmologie, CHU Robert-Debré, rue du Général Koenig, 51100 Reims, France; Université de Reims Champagne-Ardenne
| | - A Denoyer
- Service d'ophtalmologie, CHU Robert-Debré, rue du Général Koenig, 51100 Reims, France; Université de Reims Champagne-Ardenne
| | - I Larré
- Service d'ophtalmologie, CHU Robert-Debré, rue du Général Koenig, 51100 Reims, France
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15
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Ferreira de Moura T, Bartolomeu D, Arndt C, Denoyer A. [Euphorbia myrsinites keratouveitis: Case report]. J Fr Ophtalmol 2021; 45:e25-e28. [PMID: 34353663 DOI: 10.1016/j.jfo.2021.01.039] [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: 12/14/2020] [Revised: 12/22/2020] [Accepted: 01/04/2021] [Indexed: 11/19/2022]
Affiliation(s)
- T Ferreira de Moura
- Service d'ophtalmologie, CHU de Robert-Debré, université de Reims Champagne-Ardenne, rue du Général-Koenig, 51100 Reims, France; EA4684, CARDIOVIR, Université Reims Champagne-Ardenne, 51100 Reims, France.
| | - D Bartolomeu
- Service d'ophtalmologie, CHU de Robert-Debré, université de Reims Champagne-Ardenne, rue du Général-Koenig, 51100 Reims, France
| | - C Arndt
- Service d'ophtalmologie, CHU de Robert-Debré, université de Reims Champagne-Ardenne, rue du Général-Koenig, 51100 Reims, France
| | - A Denoyer
- Service d'ophtalmologie, CHU de Robert-Debré, université de Reims Champagne-Ardenne, rue du Général-Koenig, 51100 Reims, France; EA4684, CARDIOVIR, Université Reims Champagne-Ardenne, 51100 Reims, France
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16
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Durbant E, Radoi C, Garcia T, Denoyer A, Arndt C. Intravitreal triamcinolone injections in non-arteritic anterior ischemic optic neuropathy - A retrospective report. J Fr Ophtalmol 2021; 44:777-785. [PMID: 34053770 DOI: 10.1016/j.jfo.2020.07.027] [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: 04/10/2020] [Revised: 06/25/2020] [Accepted: 07/30/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Non-arteritic anterior ischemic optic neuropathy (NAION) is a common cause of vision loss but no treatment has demonstrated its efficiency. A preliminary study showed an improvement on the visual acuity (VA) in a group of patients who received intravitreal administration of triamcinolone acetonide (IVTA) versus a non-treated group. In the present series, the visual outcome of IVTA in NAION was evaluated on a larger group of patients. METHODS This retrospective, unmasked and non-randomized study took place at Reims University Hospital between 2009 and 2017. The data of consecutive patients presenting with isolated optic disc edema characteristic of recent NAION (<1month of visual acuity loss) were included. After informed consent, a single intravitreal injection of filtrated 4mg/0.1mL triamcinolone acetonide were administered. Twenty-seven control patients chose not to be injected and therefore served as controls. LogMar visual acuity (VA), VA rating (VAR) (1 line=0.1LogMAR=5 VAR letters), retinal nerve fiber layer thickness assessed by OCT and static visual field were evaluated at presentation, after 7days, after 3months and after 6months. RESULTS Sixty-eight patients with NAION were evaluated. Forty-one received IVTA, 29 were injected within 15days after the onset of symptoms and 12 after 15days. There was a higher proportion of patients improving VA of 2 lines or more (10 or more VAR letters) in the injected group (49%) compared with the non-injected group (11%, P=0.019). Among the patients injected before 15days, the proportion improving for 2 lines or more (55% vs. 11%, respectively, P=0.013) and for 3 lines or more (45% vs. 11%, respectively, P=0.035) were significantly higher than in the non-injected group. Also, comparing the VA at presentation with the VA after 6months in the injected eyes, it improved significantly (P=0.003) and also in the subgroup injected within 15days (P=0.0007) but not in the injected group after 15days (P=0.801). Visual field improvement was only observed in the subgroup of patients injected within 15days with a significant improvement of the mean deviation (dB) within 6months (P=0.015). CONCLUSIONS This follow-up study confirms the results of the previous series displaying an apparent benefit of intravitreal steroids injected in the acute phase of NAION. Only patients receiving IVTA within 15days from onset of NAION have a significant improvement of VA and visual field during the follow-up period of 6months.
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Affiliation(s)
- E Durbant
- Department of Ophthalmology, Reims University Hospital, Reims, France.
| | - C Radoi
- Department of Ophthalmology, Reims University Hospital, Reims, France
| | - T Garcia
- Department of Ophthalmology, Reims University Hospital, Reims, France
| | - A Denoyer
- Department of Ophthalmology, Reims University Hospital, Reims, France; Université Reims Champagne Ardennes, URCA, Reims, France; EA4684, CARDIOVIR, URCA, Reims, France
| | - C Arndt
- Department of Ophthalmology, Reims University Hospital, Reims, France; Université Reims Champagne Ardennes, URCA, Reims, France
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17
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Boutillier G, Bernheim D, Denoyer A, Gabison E, Sitbon C, Hacquard M, Muraine M. Refractive accuracy and visual outcomes after combined descemet membrane endothelial keratoplasty and cataract surgery: A French multicentric study. J Fr Ophtalmol 2021; 44:792-798. [PMID: 34049717 DOI: 10.1016/j.jfo.2020.06.052] [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: 05/09/2020] [Revised: 06/16/2020] [Accepted: 06/18/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE Descemet membrane endothelial keratoplasty (DMEK) combined with cataract extraction and intraocular lens insertion (new triple procedure) limits postoperative refractive errors. The objective of this study was to assess refractive accuracy after DMEK combined with cataract extraction and intraocular lens implantation. SETTING Four university hospitals (Rouen, Paris, Reims, Grenoble). DESIGN This retrospective multicenter study included patients with symptomatic corneal endothelial decompensation and cataract. METHODS The primary outcome was the difference between the target spherical equivalent and postoperative refraction at months 2 and 6. Secondary outcomes were visual acuity, keratometry, pachymetry and endothelial cell density. RESULTS A total of 130 eyes of 111 patients (mean age 66.2 years) were included (94% with Fuchs' endothelial dystrophy). For a mean refractive target set at -0.50 (±0.57) D, the mean (95% CI) refractive error was hyperopia of +0.49 (0.314; 0.664) D at 2 months and +0.46 (0.299; 0.619) D at 6 months. Best corrected distance visual acuity was improved in all patients: from 0.49 (±0.3) logMAR to 0.14 (±0.14) logMAR at 2 months and 0.05 (±0.1) logMAR at 6 months. Mean corneal thickness decreased from 621.6 (±37.6) μm to 515.2 (±42.6) μm at 2 months and 539.0 (±39.0) μm at 6 months. CONCLUSIONS Good refractive accuracy was obtained after the new triple procedure with DMEK. Hyperopic shift is common after triple procedures, and its persistence should be evaluated in future studies in order to anticipate a change in its value to optimize intraocular lens power calculation.
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Affiliation(s)
- G Boutillier
- Department of Ophthalmology, Rouen University Hospital, 1, Rue de Germont, 76031 Rouen cedex, France.
| | - D Bernheim
- Department of Ophthalmology, Grenoble University Hospital, Avenue Maquis du Grésivaudan, 38700 La Tronche, France
| | - A Denoyer
- Department of Ophthalmology, Reims University Hospital, Rue du Général Koenig, 51100, Reims, France
| | - E Gabison
- Department of Ophthalmology, Fondation Rothschild, Paris University Hospital, 44, Avenue Mathurin Moreau, 75019 Paris, France
| | - C Sitbon
- Department of Ophthalmology, Fondation Rothschild, Paris University Hospital, 44, Avenue Mathurin Moreau, 75019 Paris, France
| | - M Hacquard
- Department of Ophthalmology, Grenoble University Hospital, Avenue Maquis du Grésivaudan, 38700 La Tronche, France
| | - M Muraine
- Department of Ophthalmology, Rouen University Hospital, 1, Rue de Germont, 76031 Rouen cedex, France
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18
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El Maftouhi A, Quaranta-El Maftouhi M, Baudouin C, Denoyer A. Cystic maculopathy of the inner nuclear layer in glaucoma patients. J Fr Ophtalmol 2021; 44:786-791. [PMID: 34045105 DOI: 10.1016/j.jfo.2020.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/10/2020] [Accepted: 11/10/2020] [Indexed: 11/15/2022]
Abstract
PURPOSE The study aimed to detect and describe glaucoma-related pseudocystic abnormalities at the internal nuclear layer (INL) of the macula using OCT, in relation with visual field defects and other clinical data. PATIENTS AND METHODS Primary open-angle glaucoma patients presenting for a follow-up visit were consecutively included over 5 months and underwent clinical examination, OCT imaging, and central 10-2 visual field testing. OCT measures included the thickness of the peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell complex (GCC), together with an analysis of B-Scans and en-face images. All data provided by OCT were analyzed and compared with the visual field testing. RESULTS Fourteen patients out of 216 showed pseudocysts in the INL of the macula. These cysts were hyporeflective, fusiform, and of variable size (15 to 25μm) and were always associated with a thinning of both the RNFL and GCC. En-face OCT showed evidence of a distribution of cysts in the macular region, based on the appearance of numerous, dense hyporeflective pits whose localization matched precisely with the vision loss as assessed by central 10-2 visual field testing. No other correlations were found. DISCUSSION Pseudocysts of the internal nuclear layer of the macular region are found in some cases of chronic glaucoma. Their presence is always associated with a scotoma in the visual field and appear to constitute a marker for glaucoma progression. Glaucoma-related central pseudocysts could result from Müller cell changes, excitotoxicity, and/or trans-synaptic retrograde degeneration. The presence of pseudocysts could be a marker of a particular subpopulation whose features remain to be determined.
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Affiliation(s)
- A El Maftouhi
- Rabelais center, Lyon, France; Quinze-Vingts national hospital center of ophthalmology, IHU ForeSight, Paris, France
| | | | - C Baudouin
- Quinze-Vingts national hospital center of ophthalmology, IHU ForeSight, Paris, France; Vision institute, INSERM (National institute of health & medical research) UMR968, Paris, France; Versailles Saint-Quentin en Yvelines University, Versailles, France
| | - A Denoyer
- Robert-Debré university hospital, avenue General-Koenig, 51100 Reims, France; University of Reims Champagne-Ardenne, Reims, France.
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19
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Edorh NA, El Maftouhi A, Djerada Z, Arndt C, Denoyer A. New model to better diagnose dry eye disease integrating OCT corneal epithelial mapping. Br J Ophthalmol 2021; 106:1488-1495. [PMID: 34031042 DOI: 10.1136/bjophthalmol-2021-318826] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 01/13/2021] [Revised: 03/29/2021] [Accepted: 05/03/2021] [Indexed: 11/04/2022]
Abstract
PURPOSE To optimise the objective diagnosis of dry eye disease (DED), the capabilities of wide corneal epithelial mapping using optical coherence tomography (OCT) were studied and subsequently integrated into a new scoring method. METHODS Fifty-nine patients (118 eyes) with DED and 55 control subjects (110 eyes) were included. All patients underwent a complete ocular surface evaluation. Corneal epithelial thickness was collected using OCT for seven zones. DED and the control group were compared using a t-test, and univariate receiver operating characteristic (ROC) curves were calculated to define the diagnostic ability of OCT epithelial mapping. Multivariate analyses were performed using artificial intelligence (random forest) and logistic regression approaches to define the best way to integrate OCT mapping in the diagnosis of DED. Then, a final multivariable model for diagnosing DED was validated through a bootstrapping method. RESULTS The DED group had significant epithelial thinning compared with the controls, regardless of location. Superior intermediate epithelial thickness was the best marker for diagnosing DED using OCT (binormal estimated area under ROC: 0.87; best cut-off value: 50 µm thickness). The difference between the inferior and superior peripheral zones was the best marker for grading the severity of DED (analysis of variance, p=0.009). A multivariate approach identified other significant covariables which were integrated into a multivariate model to improve the sensitivity (86.4%) and specificity (91.7%) of this innovative diagnostic method. CONCLUSION Including OCT corneal epithelial mapping in a new diagnostic tool for DED could allow optimisation of the screening and staging of the disease in current practice as well as for clinical research purposes.
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Affiliation(s)
- Norah A Edorh
- Department of Ophthalmology, CHU Reims, Reims, France
| | - Adil El Maftouhi
- Department 3, National Hospital Centre for Ophthalmology Quinze-Vingts, Paris, France
| | | | - Carl Arndt
- Department of Ophthalmology, CHU Reims, Reims, France.,Reims Champagne-Ardenne University, Reims, France
| | - Alexandre Denoyer
- Department of Ophthalmology, CHU Reims, Reims, France .,Reims Champagne-Ardenne University, Reims, France
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20
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Santorini M, Durbant E, Bartolomeu D, Arndt C, Denoyer A. [Retrospective evaluation of residencies in private ophthalmology practice from 2015 to 2018 in Champagne-Ardenne]. J Fr Ophtalmol 2021; 44:163-168. [PMID: 33422343 DOI: 10.1016/j.jfo.2020.04.062] [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: 03/24/2020] [Revised: 04/28/2020] [Accepted: 04/29/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION Between 2010 and 2018, the quota for admission to ophthalmology residencies increased by 50 % (106 in 2010 vs 150 in 2018). In order to accommodate this increasing number of residents, the University Hospital of Reims formulated an agreement with the Regional Health Agency in May 2015 enabling certain ophthalmologists in the private sector to train a resident within their private practice for a semester. We will present the results of three and one half years of this experience. METHODS Two retrospective questionnaires were created and completed. One was addressed to the host supervisor, the other to the resident. Their objective was to evaluate and standardize the experience from both points of view. The following aspects were explored: the extent to which the environment was welcoming, the resident's clinical ability and progress, the resident's surgical ability and progress, time-management, resident-patient relations and respective assessments. We also requested information on the number of residents hosted by each private practice as well as the positive and negative aspects of the internship for both the supervisor and the intern. RESULTS Between May 2015 and October 2018 (seven semesters), 12 residents from the University Hospital of Reims did an internship with one of the six proposed private sector ophthalmologists in the Champagne-Ardennes region. The residents were between their second and eighth semesters of professional training. Seven residents did their first or second semester of ophthalmology training in a private practice. The survey results led to the conclusion of a positive experience for both trainer and trainee regarding the progress made by the resident, both clinically and surgically. CONCLUSION Given the growing number of ophthalmology residents and the limits of the training capacity of hospital-based residencies, private sector internships with practitioners actively involved in teaching increase the training capacity for residents and complement the conventional hospital training.
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Affiliation(s)
- M Santorini
- CHU Robert Debré, Université Reims Champagne-Ardenne, rue Général Koenig, 51100 Reims, France
| | - E Durbant
- CHU Robert Debré, Université Reims Champagne-Ardenne, rue Général Koenig, 51100 Reims, France
| | - D Bartolomeu
- CHU Robert Debré, Université Reims Champagne-Ardenne, rue Général Koenig, 51100 Reims, France
| | - C Arndt
- CHU Robert Debré, Université Reims Champagne-Ardenne, rue Général Koenig, 51100 Reims, France
| | - A Denoyer
- CHU Robert Debré, Université Reims Champagne-Ardenne, rue Général Koenig, 51100 Reims, France.
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21
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Marek V, Reboussin E, Dégardin-Chicaud J, Charbonnier A, Domínguez-López A, Villette T, Denoyer A, Baudouin C, Réaux-Le Goazigo A, Mélik Parsadaniantz S. Implication of Melanopsin and Trigeminal Neural Pathways in Blue Light Photosensitivity in vivo. Front Neurosci 2019; 13:497. [PMID: 31178682 PMCID: PMC6543920 DOI: 10.3389/fnins.2019.00497] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 04/30/2019] [Indexed: 01/30/2023] Open
Abstract
Photophobia may arise from various causes and frequently accompanies numerous ocular diseases. In modern highly illuminated world, complaints about greater photosensitivity to blue light increasingly appear. However, the pathophysiology of photophobia is still debated. In the present work, we investigated in vivo the role of various neural pathways potentially implicated in blue-light aversion. Moreover, we studied the light-induced neuroinflammatory processes on the ocular surface and in the trigeminal pathways. Adult male C57BL/6J mice were exposed either to blue (400-500 nm) or to yellow (530-710 nm) LED light (3 h, 6 mW/cm2). Photosensitivity was measured as the time spent in dark or illuminated parts of the cage. Pharmacological treatments were applied: topical instillation of atropine, pilocarpine or oxybuprocaine, intravitreal injection of lidocaine, norepinephrine or "blocker" of the visual photoreceptor transmission, and intraperitoneal injection of a melanopsin antagonist. Clinical evaluations (ocular surface state, corneal mechanical sensitivity and tear quantity) were performed directly after exposure to light and after 3 days of recovery in standard light conditions. Trigeminal ganglia (TGs), brainstems and retinas were dissected out and conditioned for analyses. Mice demonstrated strong aversion to blue but not to yellow light. The only drug that significantly decreased the blue-light aversion was the intraperitoneally injected melanopsin antagonist. After blue-light exposure, dry-eye-related inflammatory signs were observed, notably after 3 days of recovery. In the retina, we observed the increased immunoreactivity for GFAP, ATF3, and Iba1; these data were corroborated by RT-qPCR. Moreover, retinal visual and non-visual photopigments distribution was altered. In the trigeminal pathway, we detected the increased mRNA expression of cFOS and ATF3 as well as alterations in cytokines' levels. Thus, the wavelength-dependent light aversion was mainly mediated by melanopsin-containing cells, most likely in the retina. Other potential pathways of light reception were also discussed. The phototoxic message was transmitted to the trigeminal system, inducing both inflammation at the ocular surface and stress in the retina. Further investigations of retina-TG connections are needed.
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Affiliation(s)
- Veronika Marek
- R&D, Essilor International, Paris, France
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Centre National de la Recherche Scientifique, Institut de la Vision, Paris, France
| | - Elodie Reboussin
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Centre National de la Recherche Scientifique, Institut de la Vision, Paris, France
| | - Julie Dégardin-Chicaud
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Centre National de la Recherche Scientifique, Institut de la Vision, Paris, France
| | - Angéline Charbonnier
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Centre National de la Recherche Scientifique, Institut de la Vision, Paris, France
| | - Alfredo Domínguez-López
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Centre National de la Recherche Scientifique, Institut de la Vision, Paris, France
| | | | - Alexandre Denoyer
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Centre National de la Recherche Scientifique, Institut de la Vision, Paris, France
- Centre Hospitalier Nationale d’Ophtalmologie des Quinze-Vingts, Paris, France
- CHU Robert Debré, Université Reims Champagne-Ardenne, Reims, France
| | - Christophe Baudouin
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Centre National de la Recherche Scientifique, Institut de la Vision, Paris, France
- Centre Hospitalier Nationale d’Ophtalmologie des Quinze-Vingts, Paris, France
- Versailles Saint-Quentin-en-Yvelines Université, Versailles, France
| | - Annabelle Réaux-Le Goazigo
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Centre National de la Recherche Scientifique, Institut de la Vision, Paris, France
| | - Stéphane Mélik Parsadaniantz
- Sorbonne Université, Institut National de la Santé et de la Recherche Médicale, Centre National de la Recherche Scientifique, Institut de la Vision, Paris, France
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Herbaut A, Liang H, Denoyer A, Baudouin C, Labbé A. [Tear film analysis and evaluation of optical quality: A review of the literature (French translation of the article)]. J Fr Ophtalmol 2019; 42:226-243. [PMID: 30879832 DOI: 10.1016/j.jfo.2018.10.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 10/15/2018] [Accepted: 10/22/2018] [Indexed: 01/20/2023]
Abstract
Dry eye is a complex multifactorial disease of the ocular surface and tears. It is associated with ocular surface symptoms and is one of the most common causes for ophthalmologic consultation. Despite their frequent use in clinical practice, the usual tests to evaluate dry eye and ocular surface disease-history of symptoms, tear break-up time (TBUT), Meibomian gland evaluation, corneal fluorescein staining, Schirmer test-have shown low reproducibility and reliability. In addition, subjective symptoms are often weakly or poorly correlated with objective signs. Since the tear film is the first system through which light must pass, the optical quality of the eye is highly dependent on the homogeneity of the tear film. Various investigative methods have been developed to evaluate both the structural and functional quality of the tear film, such as corneal topography, interferometry, tear meniscus measurement, evaporation rate, tear osmolarity and even aberrometry. Some are easily accessible to clinicians, while others remain in the field of clinical research. All of these tests provide a better understanding of the pathophysiology of the tear film. This review hopes to provide an overview of the existing tests and their role in evaluating the significance of the tear film in visual function.
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Affiliation(s)
- A Herbaut
- Service d'ophtalmologie III, CHNO des Quinze-Vingts, IHU Sight Restore, Paris, France
| | - H Liang
- Service d'ophtalmologie III, CHNO des Quinze-Vingts, IHU Sight Restore, Paris, France; CHNO des Quinze-Vingts, IHU ForeRestore, INSERM-DHOS CIC 1423, Paris, France; Inserm, U968; UPMC Université Paris 06, UMR_S968, institut de la Vision; CNRS, UMR 7210; CHNO des Quinze-Vingts, INSERMDHOS CIC 503, Paris, France
| | - A Denoyer
- Inserm, U968; UPMC Université Paris 06, UMR_S968, institut de la Vision; CNRS, UMR 7210; CHNO des Quinze-Vingts, INSERMDHOS CIC 503, Paris, France; Service d'ophtalmologie, CHU Robert Debré, Université Reims, Champagne-Ardenne, Reims, France
| | - C Baudouin
- Service d'ophtalmologie III, CHNO des Quinze-Vingts, IHU Sight Restore, Paris, France; CHNO des Quinze-Vingts, IHU ForeRestore, INSERM-DHOS CIC 1423, Paris, France; Inserm, U968; UPMC Université Paris 06, UMR_S968, institut de la Vision; CNRS, UMR 7210; CHNO des Quinze-Vingts, INSERMDHOS CIC 503, Paris, France; Service d'ophtalmologie, hôpital Ambroise-Paré, AP-HP, université de Versailles Saint-Quentin-en-Yvelines, Versailles, France
| | - A Labbé
- Service d'ophtalmologie III, CHNO des Quinze-Vingts, IHU Sight Restore, Paris, France; CHNO des Quinze-Vingts, IHU ForeRestore, INSERM-DHOS CIC 1423, Paris, France; Inserm, U968; UPMC Université Paris 06, UMR_S968, institut de la Vision; CNRS, UMR 7210; CHNO des Quinze-Vingts, INSERMDHOS CIC 503, Paris, France; Service d'ophtalmologie, hôpital Ambroise-Paré, AP-HP, université de Versailles Saint-Quentin-en-Yvelines, Versailles, France.
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Marek V, Potey A, Réaux-Le-Goazigo A, Reboussin E, Charbonnier A, Villette T, Baudouin C, Rostène W, Denoyer A, Mélik Parsadaniantz S. Blue light exposure in vitro causes toxicity to trigeminal neurons and glia through increased superoxide and hydrogen peroxide generation. Free Radic Biol Med 2019; 131:27-39. [PMID: 30496813 DOI: 10.1016/j.freeradbiomed.2018.11.029] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [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: 10/17/2018] [Revised: 11/22/2018] [Accepted: 11/22/2018] [Indexed: 01/08/2023]
Abstract
Today the noxiousness of blue light from natural and particularly artificial (fluorescent tubes, LED panels, visual displays) sources is actively discussed in the context of various ocular diseases. Many of them have an important neurologic component and are associated with ocular pain. This neuropathic signal is provided by nociceptive neurons from trigeminal ganglia. However, the phototoxicity of blue light on trigeminal neurons has not been explored so far. The aim of the present in vitro study was to investigate the cytotoxic impact of various wavebands of visible light (410-630 nm) on primary cell culture of mouse trigeminal neural and glial cells. Three-hour exposure to narrow wavebands of blue light centered at 410, 440 and 480 nm of average 1.1 mW/cm2 irradiance provoked cell death, altered cell morphology and induced oxidative stress and inflammation. These effects were not observed for other tested visible wavebands. We observed that neurons and glial cells processed the light signal in different manner, in terms of resulting superoxide and hydrogen peroxide generation, inflammatory biomarkers expression and phototoxic mitochondrial damage. We analyzed the pathways of photic signal reception, and we proposed that, in trigeminal cells, in addition to widely known mitochondria-mediated light absorption, light could be received by means of non-visual opsins, melanopsin (opn4) and neuropsin (opn5). We also investigated the mechanisms underlying the observed phototoxicity, further suggesting an important role of the endoplasmic reticulum in neuronal transmission of blue-light-toxic message. Taken together, our results give some insight into circuit of tangled pain and photosensitivity frequently observed in patients consulting for these ocular symptoms.
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Affiliation(s)
- V Marek
- R&D, Essilor International, Paris, France; Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France.
| | - A Potey
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | | | - E Reboussin
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | - A Charbonnier
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | - T Villette
- R&D, Essilor International, Paris, France
| | - C Baudouin
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France; Centre Hospitalier Nationale d'Ophtalmologie des Quinze-Vingts, Paris, France; Versailles-Saint-Quentin-en-Yvelines Université, Versailles, France
| | - W Rostène
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France
| | - A Denoyer
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France; Centre Hospitalier Nationale d'Ophtalmologie des Quinze-Vingts, Paris, France; CHU Robert Debré, Université Reims Champagne-Ardenne, Reims, France
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Herbaut A, Liang H, Denoyer A, Baudouin C, Labbé A. Tear film analysis and evaluation of optical quality: A review of the literature. J Fr Ophtalmol 2019; 42:e21-e35. [PMID: 30679123 DOI: 10.1016/j.jfo.2018.12.001] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 12/11/2018] [Accepted: 12/12/2018] [Indexed: 12/19/2022]
Abstract
Dry eye is a complex multifactorial disease of the ocular surface and tears. It is associated with ocular surface symptoms and is one of the most common causes for ophthalmologic consultation. Despite their frequent use in clinical practice, the usual tests to evaluate dry eye and ocular surface disease-history of symptoms, tear break-up time (TBUT), Meibomian gland evaluation, corneal fluorescein staining, Schirmer test-have shown low reproducibility and reliability. In addition, subjective symptoms are often weakly or poorly correlated with objective signs. Since the tear film is the first system through which light must pass, the optical quality of the eye is highly dependent on the homogeneity of the tear film. Various investigative methods have been developed to evaluate both the structural and functional quality of the tear film, such as corneal topography, interferometry, tear meniscus measurement, evaporation rate, tear osmolarity and even aberrometry. Some are easily accessible to clinicians, while others remain in the field of clinical research. All of these tests provide a better understanding of the pathophysiology of the tear film. This review hopes to provide an overview of the existing tests and their role in evaluating the significance of the tear film in visual function.
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Affiliation(s)
- A Herbaut
- Service d'ophtalmologie III, CHNO des Quinze-Vingts, IHU ForeSight, 75012 Paris, France
| | - H Liang
- Service d'ophtalmologie III, CHNO des Quinze-Vingts, IHU ForeSight, 75012 Paris, France; Inserm-DHOS CIC 1423CHNO des Quinze-Vingts, IHU ForeSight, 75012 Paris, France; Inserm, U968; UPMC, université Paris 06, UMR_S968, institut de la vision; CNRS, UMR 7210; CHNO des Quinze-Vingts, Inserm-DHOS CIC 503, 75012 Paris, France
| | - A Denoyer
- Inserm, U968; UPMC, université Paris 06, UMR_S968, institut de la vision; CNRS, UMR 7210; CHNO des Quinze-Vingts, Inserm-DHOS CIC 503, 75012 Paris, France; Service d'ophtalmologie, CHU Robert-Debré, université Reims, Champagne-Ardenne, 51100 Reims, France
| | - C Baudouin
- Service d'ophtalmologie III, CHNO des Quinze-Vingts, IHU ForeSight, 75012 Paris, France; Inserm-DHOS CIC 1423CHNO des Quinze-Vingts, IHU ForeSight, 75012 Paris, France; Inserm, U968; UPMC, université Paris 06, UMR_S968, institut de la vision; CNRS, UMR 7210; CHNO des Quinze-Vingts, Inserm-DHOS CIC 503, 75012 Paris, France; Service d'ophtalmologie, hôpital Ambroise-Paré, université de Versailles Saint-Quentin-en-Yvelines, AP-HP, 78000 Versailles, France
| | - A Labbé
- Service d'ophtalmologie III, CHNO des Quinze-Vingts, IHU ForeSight, 75012 Paris, France; Inserm-DHOS CIC 1423CHNO des Quinze-Vingts, IHU ForeSight, 75012 Paris, France; Inserm, U968; UPMC, université Paris 06, UMR_S968, institut de la vision; CNRS, UMR 7210; CHNO des Quinze-Vingts, Inserm-DHOS CIC 503, 75012 Paris, France; Service d'ophtalmologie, hôpital Ambroise-Paré, université de Versailles Saint-Quentin-en-Yvelines, AP-HP, 78000 Versailles, France.
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Marek V, Mélik-Parsadaniantz S, Villette T, Montoya F, Baudouin C, Brignole-Baudouin F, Denoyer A. Blue light phototoxicity toward human corneal and conjunctival epithelial cells in basal and hyperosmolar conditions. Free Radic Biol Med 2018; 126:27-40. [PMID: 30040995 DOI: 10.1016/j.freeradbiomed.2018.07.012] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [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: 04/13/2018] [Revised: 06/12/2018] [Accepted: 07/19/2018] [Indexed: 12/28/2022]
Abstract
AIMS The ocular surface is the very first barrier between the visual system and external environment. It protects the eye from the exposure to various light sources that significantly emit in blue spectrum. However, the impact of blue light on the ocular surface has been poorly explored so far. In this study, we investigated in vitro the phototoxicity of blue light illumination in human epithelial cells of the ocular surface. We worked either in basal conditions or under hyperosmolar stress, in order to mimic dry eye disease (DED) that is the most common disease involving the ocular surface. RESULTS Corneal and conjunctival epithelial cells suffered the most from violet-blue light but also from longer-wave blue light. Exposure to blue wavebands significantly decreased cellular viability, impacted on cellular morphology and provoked reactive oxygen species (ROS) over-production. Conjunctival epithelial cell line had a greater photosensitivity than the corneal epithelial one. Hyperosmolar stress potentiated the blue light phototoxicity, increasing inflammation, altering mitochondrial membrane potential, and triggering the glutathione-based antioxidant system. INNOVATION In human epithelial corneal and conjunctival cells of the ocular surface, we demonstrated the harmful impact of blue light on viability, redox state and inflammation processes, which was modified by hyperosmolarity. CONCLUSION Blue light induced cell death and significant ROS production, and altered the expression of inflammatory genes and operation of the cellular defensive system. We established for the first time that hyperosmolar stress impacted phototoxicity, further suggesting that DED patients might be more sensitive to blue light ocular toxicity.
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Affiliation(s)
- Veronika Marek
- Essilor International, R&D Department, Paris, France; Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France.
| | | | | | - Fanny Montoya
- Essilor International, R&D Department, Paris, France
| | - Christophe Baudouin
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France; Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France; Versailles-Saint-Quentin-en-Yvelines Université, Versailles, France
| | - Françoise Brignole-Baudouin
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France; Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France; Sorbonne Paris Cité - Paris Descartes Université, Faculté de Pharmacie de Paris, Département de Toxicologie, Paris, France
| | - Alexandre Denoyer
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, Paris, France; Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France; CHU Robert Debré, Université Reims Champagne-Ardenne, Reims, France
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Chiche A, Trinh L, Baudouin C, Denoyer A. [SMILE (Small Incision Lenticule Extraction) among the corneal refractive surgeries in 2018 (French translation of the article)]. J Fr Ophtalmol 2018; 41:650-658. [PMID: 30170707 DOI: 10.1016/j.jfo.2018.03.006] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 03/05/2018] [Accepted: 03/13/2018] [Indexed: 11/24/2022]
Abstract
Refractive surgery is a field in constant evolution. In recent years, a new procedure has appeared under the name SMILE (Small Incision Lenticule Extraction). This technique, carried out solely with a femtosecond laser, should make it possible to better preserve corneal innervation and biomechanics. After a detailed review of the technique itself, we then focus on the scientific evidence for the safety and efficacy of SMILE and its current indications. Advantages of SMILE will be discussed in comparison to disadvantages of the conventional techniques, particularly concerning dry eye and the risk of corneal ectasia with LASIK. Lastly, the current limitations of SMILE (indications, retreatment) are discussed, and future applications are considered regarding improvements in the technique.
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Affiliation(s)
- A Chiche
- Service d'ophtalmologie 3, centre hospitalier national d'ophtalmologie des Quinze-Vingts, université de Versailles-Saint-Quentin-en-Yvelines, 28, rue de Charenton, 75012 Paris, France
| | - L Trinh
- Service d'ophtalmologie 3, centre hospitalier national d'ophtalmologie des Quinze-Vingts, université de Versailles-Saint-Quentin-en-Yvelines, 28, rue de Charenton, 75012 Paris, France; Espace Nouvelle Vision, 6, rue de la Grande Chaumière, 75006 Paris, France
| | - C Baudouin
- Service d'ophtalmologie 3, centre hospitalier national d'ophtalmologie des Quinze-Vingts, université de Versailles-Saint-Quentin-en-Yvelines, 28, rue de Charenton, 75012 Paris, France; Inserm U968, université UPMC Paris VI, UMR S 968, CNRS, UMR 7210, 75012 Paris, France
| | - A Denoyer
- Inserm U968, université UPMC Paris VI, UMR S 968, CNRS, UMR 7210, 75012 Paris, France; Hôpital Robert-Debré, CHU de Reims, rue du Général Koenig, 51100 Reims, France; URCA, université de Reims-Champagne-Ardenne, Reims, France.
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Chiche A, Trinh L, Baudouin C, Denoyer A. SMILE (Small Incision Lenticule Extraction) among the corneal refractive surgeries in 2018. J Fr Ophtalmol 2018; 41:e245-e252. [PMID: 29914764 DOI: 10.1016/j.jfo.2018.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 04/27/2018] [Accepted: 05/15/2018] [Indexed: 11/27/2022]
Abstract
Refractive surgery is a field in constant evolution. In recent years, a new procedure has appeared under the name SMILE (SMall Incision Lenticule Extraction). This technique, carried out solely with a femtosecond laser, should make it possible to better preserve corneal innervation and biomechanics. After a detailed review of the technique itself, we then focus on the scientific evidence for the safety and efficacy of SMILE and its current indications. Advantages of SMILE will be discussed in comparison to the conventional techniques, particularly concerning dry eye and the risk of corneal ectasia related to LASIK. Lastly, the current limitations of SMILE (indications, retreatment) are discussed, and future applications are considered regarding new improvements in the technique.
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Affiliation(s)
- A Chiche
- Ophthalmology Service 3, Quinze-Vingts National Ophthalmology Hospital, University of Versailles Saint-Quentin-en-Yvelines, 78000 Versailles, France
| | - L Trinh
- Ophthalmology Service 3, Quinze-Vingts National Ophthalmology Hospital, University of Versailles Saint-Quentin-en-Yvelines, 78000 Versailles, France; Espace Nouvelle Vision, 75012 Paris, France
| | - C Baudouin
- Ophthalmology Service 3, Quinze-Vingts National Ophthalmology Hospital, University of Versailles Saint-Quentin-en-Yvelines, 78000 Versailles, France; INSERM, U968, 75012 Paris, France; UMR S 968, Institut de la Vision, University UPMC Paris VI, 75012 Paris, France; CNRS, UMR 7210, 75012 Paris, France
| | - A Denoyer
- INSERM, U968, 75012 Paris, France; UMR S 968, Institut de la Vision, University UPMC Paris VI, 75012 Paris, France; CNRS, UMR 7210, 75012 Paris, France; University Hospital Robert-Debré, rue du Général-Koenig, 51100 Reims, France; URCA, University of Reims Champagne-Ardenne, 51100 Reims, France.
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Datta S, Baudouin C, Brignole-Baudouin F, Denoyer A, Cortopassi GA. The Eye Drop Preservative Benzalkonium Chloride Potently Induces Mitochondrial Dysfunction and Preferentially Affects LHON Mutant Cells. Invest Ophthalmol Vis Sci 2017; 58:2406-2412. [PMID: 28444329 PMCID: PMC5407244 DOI: 10.1167/iovs.16-20903] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Purpose Benzalkonium chloride (BAK) is the most commonly used eye drop preservative. Benzalkonium chloride has been associated with toxic effects such as "dry eye" and trabecular meshwork degeneration, but the underlying biochemical mechanism of ocular toxicity by BAK is unclear. In this study, we propose a mechanistic basis for BAK's adverse effects. Method Mitochondrial O2 consumption rates of human corneal epithelial primary cells (HCEP), osteosarcoma cybrid cells carrying healthy (control) or Leber hereditary optic neuropathy (LHON) mutant mtDNA [11778(G>A)], were measured before and after acute treatment with BAK. Mitochondrial adenosine triphosphate (ATP) synthesis and cell viability were also measured in the BAK-treated control: LHON mutant and human-derived trabecular meshwork cells (HTM3). Results Benzalkonium chloride inhibited mitochondrial ATP (IC50, 5.3 μM) and O2 consumption (IC50, 10.9 μM) in a concentration-dependent manner, by directly targeting mitochondrial complex I. At its pharmaceutical concentrations (107-667 μM), BAK inhibited mitochondrial function >90%. In addition, BAK elicited concentration-dependent cytotoxicity to cybrid cells (IC50, 22.8 μM) and induced apoptosis in HTM3 cells at similar concentrations. Furthermore, we show that BAK directly inhibits mitochondrial O2 consumption in HCEP cells (IC50, 3.8 μM) at 50-fold lower concentrations than used in eye drops, and that cells bearing mitochondrial blindness (LHON) mutations are further sensitized to BAK's mitotoxic effect. Conclusions Benzalkonium chloride inhibits mitochondria of human corneal epithelial cells and cells bearing LHON mutations at pharmacologically relevant concentrations, and we suggest this is the basis of BAK's ocular toxicity. Prescribing BAK-containing eye drops should be avoided in patients with mitochondrial deficiency, including LHON patients, LHON carriers, and possibly primary open-angle glaucoma patients.
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Affiliation(s)
- Sandipan Datta
- Department of Molecular Bioscience, School of Veterinary Medicine, University of California, Davis, Davis, California, United States
| | - Christophe Baudouin
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, CNRS, Institut de la Vision, Paris, France 3CHNO des Quinze-Vingts, DHU Sight Restore, INSERM-DHOS CIC, Paris, France 4Université Versailles-Saint-Quentin-en-Yvelines UVSQ, Hôpital Ambroise Paré, APHP, Boulogne-Billancourt, France
| | - Francoise Brignole-Baudouin
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, CNRS, Institut de la Vision, Paris, France 3CHNO des Quinze-Vingts, DHU Sight Restore, INSERM-DHOS CIC, Paris, France 5Université Sorbonne Paris Cité USPC, Université Paris Descartes, Faculté de Pharmacie de Paris, Paris, France
| | - Alexandre Denoyer
- Sorbonne Universités, UPMC Univ Paris 06, INSERM, CNRS, Institut de la Vision, Paris, France 3CHNO des Quinze-Vingts, DHU Sight Restore, INSERM-DHOS CIC, Paris, France
| | - Gino A Cortopassi
- Department of Molecular Bioscience, School of Veterinary Medicine, University of California, Davis, Davis, California, United States
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Randon M, Liang H, Abbas R, Michée S, Denoyer A, Baudouin C, Labbé A. [A new classification for meibomian gland diseases with in vivo confocal microscopy]. J Fr Ophtalmol 2016; 39:239-47. [PMID: 26896195 DOI: 10.1016/j.jfo.2015.07.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 07/10/2015] [Accepted: 07/20/2015] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Meibomian gland dysfunction (MGD) is a frequent disorder often associated with dry eye disease. Slit-lamp examination with digital expression of the tarsal Meibomian glands allows examination of the contents of the distal Meibomian gland and the meatus. However, the Meibomian epithelium, interglandular space and proximal secretions cannot be clinically assessed. In vivo confocal microscopy (IVCM) is a rapid and non-invasive imaging technique that provides high-resolution images of the ocular surface and eyelids. The primary objective of the present study was to establish a classification of MGD with IVCM. Secondary objectives were to evaluate this scoring system by analyzing the correlation with OSDI, infrared (IR) meibography and Demodex infestation. MATERIAL AND METHODS Forty-six dry eye patients (Ocular Surface Disease Index [OSDI] >13) associated with MGD were enrolled. Ten healthy subjects without dry eye disease or blepharitis were also included as controls. An OSDI questionnaire, clinical examination, IVCM and infrared meibography of the lower lid were performed in all subjects by the same examiner. RESULTS A new MGD score was established based on IVCM findings: the first stage was Meibomian obstruction with a clear epithelium, the second stage was an inflammatory state with Meibomian gland obstruction, epithelial and interglandular inflammation, and the last stage was glandular fibrosis. This score was significantly correlated with the meiboscore obtained with infrared meibography (correlation coefficient 0.47, CI95% [0.22-0.66]). CONCLUSION IVCM of the Meibomian gland complex complements the clinical examination by determining the stage of dysfunction and may help clinicians evaluate and treat MGD.
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Affiliation(s)
- M Randon
- Service d'ophtalmologie III, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Centre d'investigations cliniques Inserm-DHOS CIC 1423, centre hospitalier national d'ophtalmologie des Quinze-Vingts, DHU vision et handicaps, 28, rue de Charenton, 75012 Paris, France.
| | - H Liang
- Service d'ophtalmologie III, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Centre d'investigations cliniques Inserm-DHOS CIC 1423, centre hospitalier national d'ophtalmologie des Quinze-Vingts, DHU vision et handicaps, 28, rue de Charenton, 75012 Paris, France
| | - R Abbas
- Département d'épidémiologie et recherche clinique, CIC-EC 1425, hôpital Bichat, groupe hospitalier Paris Nord Val-de-Seine, AP-HP, 75018 Paris, France; UMR 1123 ECEVE, hôpital Robert-Debré, université Paris Diderot, Sorbonne Paris Cité, 48, boulevard Serurier, 75019 Paris, France
| | - S Michée
- Service d'ophtalmologie III, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Service d'ophtalmologie, hôpital Ambroise-Paré, AP-HP, université de Versailles Saint-Quentin-en-Yvelines, 75012 Versailles, France
| | - A Denoyer
- Service d'ophtalmologie III, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Centre d'investigations cliniques Inserm-DHOS CIC 1423, centre hospitalier national d'ophtalmologie des Quinze-Vingts, DHU vision et handicaps, 28, rue de Charenton, 75012 Paris, France
| | - C Baudouin
- Service d'ophtalmologie III, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Centre d'investigations cliniques Inserm-DHOS CIC 1423, centre hospitalier national d'ophtalmologie des Quinze-Vingts, DHU vision et handicaps, 28, rue de Charenton, 75012 Paris, France; Service d'ophtalmologie, hôpital Ambroise-Paré, AP-HP, université de Versailles Saint-Quentin-en-Yvelines, 75012 Versailles, France
| | - A Labbé
- Service d'ophtalmologie III, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris, France; Centre d'investigations cliniques Inserm-DHOS CIC 1423, centre hospitalier national d'ophtalmologie des Quinze-Vingts, DHU vision et handicaps, 28, rue de Charenton, 75012 Paris, France; Service d'ophtalmologie, hôpital Ambroise-Paré, AP-HP, université de Versailles Saint-Quentin-en-Yvelines, 75012 Versailles, France
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Roubeix C, Godefroy D, Mias C, Sapienza A, Riancho L, Degardin J, Fradot V, Ivkovic I, Picaud S, Sennlaub F, Denoyer A, Rostene W, Sahel JA, Parsadaniantz SM, Brignole-Baudouin F, Baudouin C. Intraocular pressure reduction and neuroprotection conferred by bone marrow-derived mesenchymal stem cells in an animal model of glaucoma. Stem Cell Res Ther 2015; 6:177. [PMID: 26377305 PMCID: PMC4574127 DOI: 10.1186/s13287-015-0168-0] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [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: 01/14/2015] [Revised: 01/28/2015] [Accepted: 08/21/2015] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Glaucoma is a sight-threatening retinal neuropathy associated with elevated intraocular pressure (IOP) due to degeneration and fibrosis of the trabecular meshwork (TM). Glaucoma medications aim to reduce IOP without targeting the specific TM pathology, Bone-marrow mesenchymal stem cells (MSCs) are used today in various clinical studies. Here, we investigated the potential of MSCs therapy in an glaucoma-like ocular hypertension (OHT) model and decipher in vitro the effects of MSCs on primary human trabecular meshwork cells. METHODS Ocular hypertension model was performed by cauterization of 3 episcleral veins (EVC) of Long-Evans male rat eyes. MSCs were isolated from rat bone marrow, amplified in vitro and tagged with quantum dot nanocrystals. Animals were distributed as 1) MSCs group receiving 5.10(5)cells/6μl Minimum Essential Medium and 2) MEM group receiving 6μl MEM (n = 10 each). Injections were performed into the anterior chamber of 20 days-hypertensive eyes and IOP was monitored twice a week for 4 weeks. At the end of experiment, cell distribution in the anterior segment was examined in confocal microscopy on flat mounted corneas. Moreover, we tested in vitro effects of MSCs conditioned medium (MSC-CM) on primary human trabecular meshwork cells (hTM cells) using Akt activation, myosin phosphorylation and TGF-β2-dependent profibrotic phenotype in hTM cells. RESULTS We demonstrated a rapid and long-lasting in vivo effect of MSCs transplantation that significantly reduced IOP in hypertensive eyes induced by EVC. MSCs were located to the ciliary processes and the TM. Enumeration of RGCs on whole flat-mounted retina highlighted a protective effect of MSCs on RGCs death. In vitro, MSC-CM promotes: (i) hTM cells survival by activating the antiapoptotic pathway, Akt, (ii) hTM cells relaxation as analyzed by the decrease in myosin phosphorylation and (iii) inhibition of TGF-β2-dependent profibrotic phenotype acquisition in hTM cells. CONCLUSIONS MSCs injection in the ocular anterior chamber in a rat model of OHT provides neuroprotective effect in the glaucoma pathophysiology via TM protection. These results demonstrate that MSCs constitute promising tool for treating ocular hypertension and retinal cell degeneration.
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Affiliation(s)
- Christophe Roubeix
- INSERM, U968, Paris, F-75012, France.
- UPMC Université Paris 06, UMR_S 968, Institut de la Vision, Paris, F-75012, France.
- CNRS, UMR_7210, Paris, F-75012, France.
| | - David Godefroy
- INSERM, U968, Paris, F-75012, France.
- UPMC Université Paris 06, UMR_S 968, Institut de la Vision, Paris, F-75012, France.
- CNRS, UMR_7210, Paris, F-75012, France.
| | - Céline Mias
- Institut des Maladies Métaboliques et Cardiovasculaires, INSERM UMR 1048, 31432 Toulouse cedex 4, France, Toulouse, France.
| | - Anaïs Sapienza
- INSERM, U968, Paris, F-75012, France.
- UPMC Université Paris 06, UMR_S 968, Institut de la Vision, Paris, F-75012, France.
- CNRS, UMR_7210, Paris, F-75012, France.
| | - Luisa Riancho
- INSERM, U968, Paris, F-75012, France.
- UPMC Université Paris 06, UMR_S 968, Institut de la Vision, Paris, F-75012, France.
- CNRS, UMR_7210, Paris, F-75012, France.
| | - Julie Degardin
- INSERM, U968, Paris, F-75012, France.
- UPMC Université Paris 06, UMR_S 968, Institut de la Vision, Paris, F-75012, France.
- CNRS, UMR_7210, Paris, F-75012, France.
| | - Valérie Fradot
- INSERM, U968, Paris, F-75012, France.
- UPMC Université Paris 06, UMR_S 968, Institut de la Vision, Paris, F-75012, France.
- CNRS, UMR_7210, Paris, F-75012, France.
| | - Ivana Ivkovic
- INSERM, U968, Paris, F-75012, France.
- UPMC Université Paris 06, UMR_S 968, Institut de la Vision, Paris, F-75012, France.
- CNRS, UMR_7210, Paris, F-75012, France.
| | - Serge Picaud
- INSERM, U968, Paris, F-75012, France.
- UPMC Université Paris 06, UMR_S 968, Institut de la Vision, Paris, F-75012, France.
- CNRS, UMR_7210, Paris, F-75012, France.
| | - Florian Sennlaub
- INSERM, U968, Paris, F-75012, France.
- UPMC Université Paris 06, UMR_S 968, Institut de la Vision, Paris, F-75012, France.
- CNRS, UMR_7210, Paris, F-75012, France.
| | - Alexandre Denoyer
- INSERM, U968, Paris, F-75012, France.
- UPMC Université Paris 06, UMR_S 968, Institut de la Vision, Paris, F-75012, France.
- CNRS, UMR_7210, Paris, F-75012, France.
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, INSERM-DHOS CIC 503, Paris, F-75012, France.
| | - William Rostene
- INSERM, U968, Paris, F-75012, France.
- UPMC Université Paris 06, UMR_S 968, Institut de la Vision, Paris, F-75012, France.
- CNRS, UMR_7210, Paris, F-75012, France.
| | - José Alain Sahel
- INSERM, U968, Paris, F-75012, France.
- UPMC Université Paris 06, UMR_S 968, Institut de la Vision, Paris, F-75012, France.
- CNRS, UMR_7210, Paris, F-75012, France.
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, INSERM-DHOS CIC 503, Paris, F-75012, France.
| | - Stéphane Melik Parsadaniantz
- INSERM, U968, Paris, F-75012, France.
- UPMC Université Paris 06, UMR_S 968, Institut de la Vision, Paris, F-75012, France.
- CNRS, UMR_7210, Paris, F-75012, France.
| | - Françoise Brignole-Baudouin
- INSERM, U968, Paris, F-75012, France.
- UPMC Université Paris 06, UMR_S 968, Institut de la Vision, Paris, F-75012, France.
- CNRS, UMR_7210, Paris, F-75012, France.
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, INSERM-DHOS CIC 503, Paris, F-75012, France.
- University Paris Descartes, Sorbonne Paris Cité, Paris, F-75006, France.
- Faculté de Pharmacie de Paris, University Paris Descartes, Sorbonne Paris Cité, Paris, F-75006, France.
| | - Christophe Baudouin
- INSERM, U968, Paris, F-75012, France.
- UPMC Université Paris 06, UMR_S 968, Institut de la Vision, Paris, F-75012, France.
- CNRS, UMR_7210, Paris, F-75012, France.
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, INSERM-DHOS CIC 503, Paris, F-75012, France.
- Department of Ophthalmology, Hôpital Ambroise Pare, AP HP, Boulogne, F-92100, France.
- University Versailles St Quentin en Yvelines, Montigny-Le-Bretonneux, F-78180, France.
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Abstract
Mesenchymal stem cells (MSC) are adult stem cells, first identified in skeletal tissues and then found in the entire body. MSC are able to not only differentiate into specialized cells within skeletal tissue - chondrocytes, osteocytes, adipocytes and fibroblasts - but also secrete a large range of soluble mediators defining their secretome and allowing their interaction with a number of cell protagonists. Thus, in a general sense, MSC are involved in tissue homeostasis through their secretome and are specifically responsible for cell turn-over in skeletal tissues. For a decade and a half, safety and efficiency of MSC has led to the development of many clinical trials in various fields. However, results were often disappointing, probably because of difficulties in methods and evaluation. At a time when the first clinical trials using MSC are emerging in ophthalmology, the goal of this literature review is to gather and put into perspective preclinical and clinical results in order to better predict the future of this innovative therapeutic pathway.
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Affiliation(s)
- C Roubeix
- Inserm, U968, 75012 Paris, France; UMR_S 968, institut de la vision, UPMC université Paris 06, 17, rue Moreau, 75012 Paris, France; CNRS, UMR_7210, 75012 Paris, France.
| | - A Denoyer
- Inserm, U968, 75012 Paris, France; UMR_S 968, institut de la vision, UPMC université Paris 06, 17, rue Moreau, 75012 Paris, France; CNRS, UMR_7210, 75012 Paris, France; Inserm-DHOS CIC 503, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 75012 Paris, France
| | - F Brignole-Baudouin
- Inserm, U968, 75012 Paris, France; UMR_S 968, institut de la vision, UPMC université Paris 06, 17, rue Moreau, 75012 Paris, France; CNRS, UMR_7210, 75012 Paris, France; Inserm-DHOS CIC 503, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 75012 Paris, France; Faculté de pharmacie de Paris, université Paris Descartes, Sorbonne Paris-Cité, 75006 Paris, France
| | - C Baudouin
- Inserm, U968, 75012 Paris, France; UMR_S 968, institut de la vision, UPMC université Paris 06, 17, rue Moreau, 75012 Paris, France; CNRS, UMR_7210, 75012 Paris, France; Inserm-DHOS CIC 503, centre hospitalier national d'ophtalmologie des Quinze-Vingts, 75012 Paris, France; Service d'ophtalmologie, hôpital Ambroise-Paré, AP-HP, 92100 Boulogne, France; Université Versailles-Saint-Quentin-en-Yvelines, 78180 Montigny-le-Bretonneux, France
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Denoyer A, Roubeix C, Sapienza A, Réaux-Le Goazigo A, Mélik-Parsadaniantz S, Baudouin C. [Retinal and trabecular degeneration in glaucoma: new insights into pathogenesis and treatment]. J Fr Ophtalmol 2015; 38:347-56. [PMID: 25659482 DOI: 10.1016/j.jfo.2014.11.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 11/28/2014] [Indexed: 12/31/2022]
Abstract
Academic and industrial research has brought new insights into the pathogenesis of glaucoma, aiming at identifying and targeting specific mechanisms to improve our current therapeutic strategy. Retinal neurodegeneration is still the main focus, whether in terms of extrinsic factors such as neurotrophin deprivation, glutamate toxicity, vascular deficiency and neuro-inflammation from glial cells, or in terms of retinal ganglion cell intrinsic sensibility to proapoptotic signals. However, glaucoma is not solely a retinal disease but also involves retinal and trabecular meshwork degeneration, extending into and/or even originating from the brain. The present review summarizes our current knowledge of key mechanisms involved in glaucoma degeneration, focusing on the direction of current research towards the future of glaucoma therapy.
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Affiliation(s)
- A Denoyer
- Centre hospitalier national d'ophtalmologie des Quinze-Vingt, 28, rue de Charenton, 75012 Paris, France; Inserm CIC 503, centre d'investigation clinique, 28, rue de Charenton, 75012 Paris, France; Inserm U968, UPMC UMRS 968, CNRS UMR 7210, institut de la Vision, 17, rue Moreau, 75012 Paris, France.
| | - C Roubeix
- Inserm U968, UPMC UMRS 968, CNRS UMR 7210, institut de la Vision, 17, rue Moreau, 75012 Paris, France
| | - A Sapienza
- Inserm U968, UPMC UMRS 968, CNRS UMR 7210, institut de la Vision, 17, rue Moreau, 75012 Paris, France
| | - A Réaux-Le Goazigo
- Inserm U968, UPMC UMRS 968, CNRS UMR 7210, institut de la Vision, 17, rue Moreau, 75012 Paris, France
| | - S Mélik-Parsadaniantz
- Inserm U968, UPMC UMRS 968, CNRS UMR 7210, institut de la Vision, 17, rue Moreau, 75012 Paris, France
| | - C Baudouin
- Centre hospitalier national d'ophtalmologie des Quinze-Vingt, 28, rue de Charenton, 75012 Paris, France; Inserm CIC 503, centre d'investigation clinique, 28, rue de Charenton, 75012 Paris, France; Inserm U968, UPMC UMRS 968, CNRS UMR 7210, institut de la Vision, 17, rue Moreau, 75012 Paris, France; Hôpital Ambroise-Paré, AP-HP, université de Versailles-Saint-Quentin-en-Yvelines, 9, avenue Charles-de-Gaulle, 92104 Boulogne-Billancourt, France
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Denoyer A, Landman E, Trinh L, Faure JF, Auclin F, Baudouin C. Dry eye disease after refractive surgery: comparative outcomes of small incision lenticule extraction versus LASIK. Ophthalmology 2014; 122:669-76. [PMID: 25458707 DOI: 10.1016/j.ophtha.2014.10.004] [Citation(s) in RCA: 170] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Revised: 10/06/2014] [Accepted: 10/07/2014] [Indexed: 10/24/2022] Open
Abstract
PURPOSE To compare small incision lenticule extraction (SMILE) versus LASIK for post-refractive dry eye disease. DESIGN Prospective, comparative, nonrandomized clinical study. PARTICIPANTS Thirty patients scheduled for bilateral myopic SMILE and 30 age-, sex-, and refraction-matched patients scheduled for bilateral myopic LASIK were enrolled and followed for 6 months after the surgery. METHODS Complete evaluation of dry eye disease was performed at 1 and 6 months postoperatively, which included vision-related quality of life (Ocular Surface Disease Index [OSDI]), clinical examinations (tear film breakup time [TBUT], Schirmer I test, corneal staining), and tear osmolarity measurements, together with an overall severity score. Function and morphology of the corneal innervation were evaluated by corneal esthesiometry and subbasal nerve imaging using in vivo confocal microscopy (IVCM). MAIN OUTCOME MEASURES Overall analysis of dry eye disease and corneal innervation. RESULTS High incidence of mild to moderate dry eye disease was observed in both groups 1 month postoperatively, which remained significantly higher in the LASIK group than in the SMILE group 6 months after surgery (overall severity score [0-4]: 1.2±1.1 vs. 0.2±0.4, respectively, P < 0.01), leading to more frequent use of tear substitutes over the long term. Corneal sensitivity was better in SMILE than in LASIK eyes 1 month postoperatively (3.5±1.79 vs. 2.45±2.48, respectively, P < 0.01) and then recovered to statistically similar values at 6 months. Corneal nerve density, number of long fibers, and branchings as assessed by IVCM were significantly higher in the SMILE group compared with the LASIK group 1 and 6 months after surgery. Corneal sensitivity was negatively correlated with dry eye-related corneal damage (R² = 0.48, P < 0.01), and the long fiber nerve density was independently correlated with the OSDI score (R² = 0.50, P < 0.01) and the Schirmer test (R² = 0.21, P < 0.01) 6 months postoperatively. CONCLUSIONS The SMILE procedure has a less pronounced impact on the ocular surface and corneal innervation compared with LASIK, further reducing the incidence of dry eye disease and subsequent degradation in quality of life after refractive surgery.
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Affiliation(s)
- Alexandre Denoyer
- Quinze-Vingts National Ophthalmology Hospital, Paris, France; French National Institute of Health and Medical Research, UPMC University Paris, Institut de la Vision, CNRS, Paris, France; Clinical Center for Investigations, Paris, France.
| | - Elise Landman
- Quinze-Vingts National Ophthalmology Hospital, Paris, France
| | - Liem Trinh
- Quinze-Vingts National Ophthalmology Hospital, Paris, France; Espace Nouvelle Vision, Paris, France
| | - Jean-François Faure
- Quinze-Vingts National Ophthalmology Hospital, Paris, France; Espace Nouvelle Vision, Paris, France
| | - François Auclin
- Quinze-Vingts National Ophthalmology Hospital, Paris, France
| | - Christophe Baudouin
- Quinze-Vingts National Ophthalmology Hospital, Paris, France; French National Institute of Health and Medical Research, UPMC University Paris, Institut de la Vision, CNRS, Paris, France; Clinical Center for Investigations, Paris, France; Ambroise Paré Hospital, APHP, University of Versailles St-Quentin en Yvelines, Versailles, France
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Randon M, Liang H, El Hamdaoui M, Tahiri R, Batellier L, Denoyer A, Labbé A, Baudouin C. In vivo confocal microscopy as a novel and reliable tool for the diagnosis of Demodex eyelid infestation. Br J Ophthalmol 2014; 99:336-41. [PMID: 25253768 DOI: 10.1136/bjophthalmol-2014-305671] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIMS Demodex mites are implicated in several ocular surface diseases such as blepharitis, ocular rosacea and dry eye syndrome. Demodex eyelid infestation is classically diagnosed by analysing depilated eyelashes under the light microscope. The use of in vivo confocal microscopy (IVCM) could be an easy way to improve its diagnosis. The ability of IVCM to identify Demodex was evaluated and compared with the classic depilation method. METHODS Eight healthy subjects, 22 patients with dry eye syndrome without anterior blepharitis and 18 patients with anterior blepharitis were examined using lower eyelid IVCM (lash follicles and meibomian glands (MGs)). Twenty-five of the 48 subjects underwent both an IVCM examination and classic depilation to compare the two methods. Ex vivo Demodex obtained from lash depilation were also analysed using the confocal microscope. RESULTS IVCM found 100% of the mite infestations among patients with anterior blepharitis, 60% among dry eye patients without blepharitis and 12% in healthy subjects, whereas the depilation technique found 100%, 50% and 0%, respectively. Demodex brevis and Demodex larvae inside the lash follicles were better detected by IVCM. In symptomatic patients, the Demodex infestation was often associated with MG dysfunction, which was better characterised using IVCM in symptomatic patients (60% and 40% of meibomianitis and gland fibrosis, respectively). CONCLUSIONS IVCM is an efficient and reliable tool for the diagnosis of eyelid mite infestation and may also provide an evaluation of MGs.
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Affiliation(s)
- Matthieu Randon
- Department of Ophthalmology III, Quinze-Vingts National Ophthalmology Hospital, Paris, France Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, DHU ViewMaintain, INSERM-DHOS CIC, Paris, France INSERM, U968, Paris, France Sorbonne Universités, UPMC Univ Paris 06, UMR_S 968, Institut de la Vision, Paris, France CNRS, UMR_7210, Paris, France
| | - Hong Liang
- Department of Ophthalmology III, Quinze-Vingts National Ophthalmology Hospital, Paris, France Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, DHU ViewMaintain, INSERM-DHOS CIC, Paris, France INSERM, U968, Paris, France Sorbonne Universités, UPMC Univ Paris 06, UMR_S 968, Institut de la Vision, Paris, France CNRS, UMR_7210, Paris, France
| | - Mohamed El Hamdaoui
- Department of Ophthalmology III, Quinze-Vingts National Ophthalmology Hospital, Paris, France Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, DHU ViewMaintain, INSERM-DHOS CIC, Paris, France
| | - Rachid Tahiri
- Department of Ophthalmology III, Quinze-Vingts National Ophthalmology Hospital, Paris, France Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, DHU ViewMaintain, INSERM-DHOS CIC, Paris, France
| | - Laurence Batellier
- Department of Medical Biology, Quinze-Vingts National Ophthalmology Hospital, Paris, France
| | - Alexandre Denoyer
- Department of Ophthalmology III, Quinze-Vingts National Ophthalmology Hospital, Paris, France Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, DHU ViewMaintain, INSERM-DHOS CIC, Paris, France INSERM, U968, Paris, France Sorbonne Universités, UPMC Univ Paris 06, UMR_S 968, Institut de la Vision, Paris, France CNRS, UMR_7210, Paris, France
| | - Antoine Labbé
- Department of Ophthalmology III, Quinze-Vingts National Ophthalmology Hospital, Paris, France Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, DHU ViewMaintain, INSERM-DHOS CIC, Paris, France INSERM, U968, Paris, France Sorbonne Universités, UPMC Univ Paris 06, UMR_S 968, Institut de la Vision, Paris, France CNRS, UMR_7210, Paris, France Department of Ophthalmology, Ambroise Paré Hospital, APHP, University of Versailles Saint-Quentin en Yvelines, Versailles, France
| | - Christophe Baudouin
- Department of Ophthalmology III, Quinze-Vingts National Ophthalmology Hospital, Paris, France Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, DHU ViewMaintain, INSERM-DHOS CIC, Paris, France INSERM, U968, Paris, France Sorbonne Universités, UPMC Univ Paris 06, UMR_S 968, Institut de la Vision, Paris, France CNRS, UMR_7210, Paris, France Department of Ophthalmology, Ambroise Paré Hospital, APHP, University of Versailles Saint-Quentin en Yvelines, Versailles, France
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Trinh L, Saubaméa B, Auclin F, Denoyer A, Lai-Kuen R, El Hamdaoui M, Labbé A, Despiau MC, Brignole-Baudouin F, Baudouin C. Femtosecond and excimer laser-assisted endothelial keratoplasty (FELEK): A new technique of endothelial transplantation. J Fr Ophtalmol 2014; 37:211-9. [DOI: 10.1016/j.jfo.2013.07.009] [Citation(s) in RCA: 6] [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] [Received: 05/08/2013] [Revised: 07/04/2013] [Accepted: 07/05/2013] [Indexed: 11/16/2022]
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Abstract
Second leading cause of blindness worldwide, glaucoma is an optic neuropathy related mainly but not exclusively to an increase of intraocular pressure. Angle closure glaucoma is related to a blockade of aqueous humor to the trabecular meshwork, whereas open-angle glaucoma is a degeneration of the trabecular meshwork, the filter that allows aqueous outflow from the eye. Many improvements have been made in terms of diagnosis, follow-up and treatments, although the treatment of glaucoma is restricted to control intraocular pressure, in order to prevent optic nerve degeneration or to stop the progression of the disease toward blindness. The first line therapy is based on topical medications that are administered for the whole life span. Although globally efficient, these treatments, and most likely the preservative included in the excipient to prevent bottle contamination, induce side effects in the long-term that may impair the quality of life, patient compliance or directly induce ocular surface changes like inflammatory cytokine release, or tear film destruction, with further dry eye disease and chronic inflammation. A large body of evidence has been accumulated, showing that benzalkonium chloride, the preservative mainly used, is toxic over the long run and plays a role in such ocular surface impairment. Therefore efforts have been made in the last decade to eliminate or replace this compound, providing safer therapies to the patients. Furthermore, the identification of chemokines as playing a role in the trabecular degeneration has open new directions for treating glaucoma. The blockade of one receptor of CXCL12 has been experimentally shown not only to decrease intraocular pressure but also to prevent trabecular cell degeneration. This is an innovative concept that could allow development of new treatments, more specifically targeting the disease at its onset, rather than attempting to reduce its progression in its later stages.
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Affiliation(s)
- Christophe Baudouin
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28 rue de Charenton, 75012 Paris, France - Institut de la Vision, Université Pierre et Marie Curie, INSERM UMR S968, CNRS UMR 7210, 17 rue Moreau, 75012 Paris, France
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Rostene W, Denoyer A, Baudouin C. [Chemokines: new insights in the treatment of glaucoma and inflammatory diseases of the ocular surface]. Bull Acad Natl Med 2013; 197:1319-1328. [PMID: 25796721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The celebrations of the 200th anniversary of Claude Bernard's birth (1813) give us the opportunity to recall all the pioneer work carried out by the great physiologist, which still remains relevant in both scientific and medical fields. The description that tissues are "floating in a liquid milieu" bringing survival molecules and allowing homeostasis, is particularly illustrated in the physiopathology of glaucoma. Second leading cause of blindness worldwide, glaucoma is an optic neuropathy mainly related to an increase of intraocular pressure. Degeneration of the trabecular meshwork, the filter that allows aqueous humor outflow from the eye, includes loss of trabecular cells, extracellular matrix remodeling, oxidative stress, and release of inflammatory cytokines, which are together the hallmarks of glaucoma. Although globally efficient, the topical treatments of glaucoma with eye drops containing active compounds produce, in the long-term, side effects mainly due to benzalkonium chloride, a preservative added to prevent bottle contamination. Such compound induces inflammatory processes. Thus, new data involving chemokines such as CXCL12, known to play a key role in inflammation and cellular crosstalk in the trabecular meshwork, offer new targets for the development of innovative treatments in glaucoma.
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Trinh L, Saubaméa B, Auclin F, Denoyer A, Lai-Kuen R, El Hamdaoui M, Labbé A, Despiau MC, Brignole-Baudouin F, Baudouin C. A new technique of endothelial graft: the femtosecond and excimer lasers-assisted endothelial keratoplasty (FELEK). Acta Ophthalmol 2013; 91:e497-9. [PMID: 23607667 DOI: 10.1111/aos.12155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Deschamps N, Ricaud X, Rabut G, Labbé A, Baudouin C, Denoyer A. The impact of dry eye disease on visual performance while driving. Am J Ophthalmol 2013; 156:184-189.e3. [PMID: 23706501 DOI: 10.1016/j.ajo.2013.02.019] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Revised: 02/28/2013] [Accepted: 02/28/2013] [Indexed: 11/29/2022]
Abstract
PURPOSE A specific simulator was used to assess the driving visual performance in patients with dry eye disease (DED) and to determine clinical predictors of visual impairments while driving. DESIGN Prospective case-control study. METHODS The study was conducted in the Center for Clinical Investigation of Quinze-Vingts National Ophthalmology Hospital, Paris, France. Twenty dry eye patients and 20 age- and sex-matched control subjects were included. Vision-related driving ability was assessed using a specific driving simulator displaying randomly located targets with a progressive increase in contrast to be identified. Other examinations included clinical examinations, serial measurements of corneal higher-order aberrations (HOAs), and vision-related quality-of-life questionnaire (Ocular Surface Disease Index [OSDI]). Data collected during driving test (ie, the number of targets seen, their position, and the response time) were compared between groups and analyzed according to clinical data, aberration dynamics, and quality-of-life index. RESULTS The percentage of targets missed as well as average response time were significantly increased in DED patients as compared with controls (P < .01). More specifically, the visual function of DED patients was more impaired in specific situations, such as crossroad or roundabout approaches. In DED patients, the response time was found to positively correlate with the progression index for HOAs (P < .01) and with the OSDI "symptoms" subscale (P < .05). CONCLUSIONS Degradation of ocular optical qualities related to DED is associated with visual impairments during driving. This study objectively has demonstrated the impact of tear film-related aberration changes on activities of daily living in DED.
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Affiliation(s)
- Nathalie Deschamps
- Quinze-Vingts National Ophthalmology Hospital, Clinical Center for Investigations 503, Paris, France
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Denoyer A, Ricaud X, Van Went C, Labbé A, Baudouin C. Influence of corneal biomechanical properties on surgically induced astigmatism in cataract surgery. J Cataract Refract Surg 2013; 39:1204-10. [PMID: 23756347 DOI: 10.1016/j.jcrs.2013.02.052] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Revised: 02/21/2013] [Accepted: 02/22/2013] [Indexed: 10/26/2022]
Abstract
PURPOSE To perform an overall follow-up of the morphologic, optical, and biomechanical properties of the cornea to determine new parameters influencing the refractive outcomes of cataract surgery. DESIGN Clinical study. METHODS Patients scheduled for cataract surgery were assessed for surgically induced corneal astigmatism (SIA) and higher-order aberrations, (HOAs) using a Scheimpflug rotating camera (Pentacam) together with corneal imaging by optical coherence tomography (Spectralis) and biomechanical analysis by the Ocular Response Analyzer preoperatively and 1, 7, and 30 days postoperatively. The central and peripheral corneal thicknesses; incision width, length, and architecture; corneal hysteresis (CH); and corneal resistance factor (CRF) were computed to identify new parameters influencing corneal optical changes that determine the final refractive result. RESULTS The study enrolled 40 patients (40 eyes). The SIA and HOAs were significantly lower after microincision surgery (≤ 2.2 mm) than after small-incision surgery (2.75 mm) (both P<.01). The CRF was significantly reduced with a direct corneal incision compared with a constructed incision (P<.01). Multivariate analysis showed that SIA was correlated not only with incision width (P<.05) but also with preoperative CH (P<.01). Corneal 3rd-order trefoil depended on incision width (P<.01). CONCLUSIONS In addition to the well-known influence of incision size on SIA, CH also modulates optical changes. The biomechanical features of the cornea should be taken into account preoperatively to better predict the refractive outcomes of cataract surgery.
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Duquesne A, Werbrouck A, Fabiani B, Denoyer A, Cervera P, Verpont MC, Bender S, Piedagnel R, Brocheriou I, Ronco P, Boffa JJ, Aucouturier P, Garderet L. Complete remission of monoclonal gammopathy with ocular and periorbital crystal storing histiocytosis and Fanconi syndrome. Hum Pathol 2013; 44:927-33. [PMID: 23313305 DOI: 10.1016/j.humpath.2012.10.012] [Citation(s) in RCA: 21] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2012] [Revised: 10/15/2012] [Accepted: 10/17/2012] [Indexed: 10/27/2022]
Abstract
A 62-year-old woman presented with crystalline keratopathy, crystal-storing histiocytosis, Fanconi syndrome, and a serum monoclonal IgG-κ and urinary κ light chain. Histology and electron microscopy studies revealed the presence of crystals within macrophages in multiple eye sites, in the kidney and in the bone marrow. The variable domain of the pathogenic κ light chain related to the Vk1-39 gene that was also involved in most previously reported cases of Fanconi syndrome. Owing to the severity of the damage to the eye and a potentially poor kidney prognosis, the patient underwent autologous stem cell transplantation. After 18 months follow-up, she is in complete hematological, ophthalmological, and renal remission.
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Affiliation(s)
- Alyette Duquesne
- AP-HP, Hôpital Tenon, Department of Nephrology, Paris, F-75020 France
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Baudouin C, Denoyer A, Desbenoit N, Hamm G, Grise A. In vitro and in vivo experimental studies on trabecular meshwork degeneration induced by benzalkonium chloride (an American Ophthalmological Society thesis). Trans Am Ophthalmol Soc 2012; 110:40-63. [PMID: 23818734 PMCID: PMC3671366] [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] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
PURPOSE Long-term antiglaucomatous drug administration may cause irritation, dry eye, allergy, subconjunctival fibrosis, or increased risk of glaucoma surgery failure, potentially due to the preservative benzalkonium chloride (BAK), whose toxic, proinflammatory, and detergent effects have extensively been shown experimentally. We hypothesize that BAK also influences trabecular meshwork (TM) degeneration. METHODS Trabecular specimens were examined using immunohistology and reverse transcriptase-polymerase chain reaction. A trabecular cell line was stimulated by BAK and examined for apoptosis, oxidative stress, fractalkine and SDF-1 expression, and modulation of their receptors. An experimental model was developed with BAK subconjunctival injections to induce TM degeneration. Mass spectrometry (MS) imaging assessed BAK penetration after repeated instillations in rabbit eyes. RESULTS Trabecular specimens showed extremely low densities of trabecular cells and presence of cells expressing fractalkine and fractalkine receptor and their respective mRNAs. Benzalkonium in vitro induced apoptosis, oxidative stress, and fractalkine expression and inhibited the protective chemokine SDF-1 and Bcl2, also inducing a sustained intraocular pressure (IOP) increase, with dramatic apoptosis of trabecular cells and reduction of aqueous outflow. MS imaging showed that BAK could access the TM at measurable levels after repeated instillations. CONCLUSION BAK enhances all characteristics of TM degeneration typical of glaucoma-trabecular apoptosis, oxidative stress, induction of inflammatory chemokines-and causes degeneration in acute experimental conditions, potentially mimicking long-term accumulation. BAK was also shown to access the TM after repeated instillations. These findings support the hypothesis that antiglaucoma medications, through toxicity of their preservative, may cause further long-term trabecular degeneration and therefore enhance outflow resistance, reducing the impact of IOP-lowering agents.
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Affiliation(s)
- Christophe Baudouin
- Department of Ophthalmology III, Quinze-Vingts National Ophthalmology Hospital, Paris, France
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Denoyer A, Godefroy D, Célérier I, Frugier J, Riancho L, Baudouin F, Rostène W, Baudouin C. CX3CL1 expression in the conjunctiva is involved in immune cell trafficking during toxic ocular surface inflammation. Mucosal Immunol 2012; 5:702-11. [PMID: 22692452 DOI: 10.1038/mi.2012.43] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Inappropriate expression of the chemokine CX3CL1 is reportedly known to act on inflammatory conditions in extraocular immune diseases. We studied the expression and effects of CX3CL1 in human patients, cultured human conjunctival cells, and transgenic mice exposed to benzalkonium chloride (BAC), a commonly used preservative in ophthalmic medications despite its proinflammatory properties, to determine whether CX3CL1 is involved in conjunctival inflammation. We report that CX3CL1 expression is increased in the conjunctiva of patients receiving BAC-containing medication, and correlates with clinical inflammation. BAC enhances the production of CX3CL1 in a conjunctival epithelial cell line, through the tumor-necrosis factor-α pathway, which attracts specific leukocyte subsets. In vivo, BAC-induced macrophage infiltration and subsequent inflammation of the conjunctiva is decreased in CX3CR1-deficient mice as compared with CX3CR1(+/+) controls. This translational study opens new avenue to investigate ocular surface disorders by focusing on chemokine-related inflammation and immune cell trafficking in the ocular conjunctival mucosa.
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Affiliation(s)
- A Denoyer
- UPMC University Paris 6, Institut de la Vision, UMRS968, Paris, France
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Labbé A, Kallel S, Denoyer A, Dupas B, Baudouin C. Imagerie de la cornée. J Fr Ophtalmol 2012; 35:628-34. [DOI: 10.1016/j.jfo.2012.02.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2012] [Accepted: 02/27/2012] [Indexed: 12/17/2022]
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Denoyer A, Godefroy D, Célérier I, Frugier J, Degardin J, Harrison JK, Brignole-Baudouin F, Picaud S, Baleux F, Sahel JA, Rostène W, Baudouin C. CXCR3 antagonism of SDF-1(5-67) restores trabecular function and prevents retinal neurodegeneration in a rat model of ocular hypertension. PLoS One 2012; 7:e37873. [PMID: 22675496 PMCID: PMC3366966 DOI: 10.1371/journal.pone.0037873] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2012] [Accepted: 04/25/2012] [Indexed: 01/10/2023] Open
Abstract
Glaucoma, the most common cause of irreversible blindness, is a neuropathy commonly initiated by pathological ocular hypertension due to unknown mechanisms of trabecular meshwork degeneration. Current antiglaucoma therapy does not target the causal trabecular pathology, which may explain why treatment failure is often observed. Here we show that the chemokine CXCL12, its truncated form SDF-1(5-67), and the receptors CXCR4 and CXCR3 are expressed in human glaucomatous trabecular tissue and a human trabecular cell line. SDF-1(5-67) is produced under the control of matrix metallo-proteinases, TNF-α, and TGF-β2, factors known to be involved in glaucoma. CXCL12 protects in vitro trabecular cells from apoptotic death via CXCR4 whereas SDF-1(5-67) induces apoptosis through CXCR3 and caspase activation. Ocular administration of SDF-1(5-67) in the rat increases intraocular pressure. In contrast, administration of a selective CXCR3 antagonist in a rat model of ocular hypertension decreases intraocular pressure, prevents retinal neurodegeneration, and preserves visual function. The protective effect of CXCR3 antagonism is related to restoration of the trabecular function. These data demonstrate that proteolytic cleavage of CXCL12 is involved in trabecular pathophysiology, and that local administration of a selective CXCR3 antagonist may be a beneficial therapeutic strategy for treating ocular hypertension and subsequent retinal degeneration.
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Affiliation(s)
- Alexandre Denoyer
- UPMC University Paris 6, Institut de la Vision, UMRS968, Paris, France.
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Nochez Y, Denoyer A, Pisella PJ. [0.05% cyclosporine a for treatment of chronic severe ocular surface disease]. Can J Ophthalmol 2009; 44:406-11. [PMID: 19606161 DOI: 10.1139/i09-117] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To evaluate the effects of topical cyclosporin A on severe and corticodependent chronic ocular surface disorders (OSD), in immune inflammatory disease. DESIGN Experimental study, Centre hospitalier universitaire (CHU) Bretonneau, Tours, France. PARTICIPANTS Twenty-one patients diagnosed with dry eye syndrome secondary to vernal keratoconjunctivitis (7 cases), atopic keratoconjunctivitis (8 cases), and ocular rosacea (6 cases) were treated twice a day with a 0.05% cyclosporin ophthalmic emulsion. METHODS Corneal and conjunctival staining, Oxford score, and symptoms severity assessment (OSDI score) were conducted from the beginning of the cyclosporin treatment up to the end of study. Other collected data included visual acuity, intraocular pressure measurements, an adverse effects questionnaire, and evaluation of the use of adjunctive corticosteroids therapy. RESULTS Topical cyclosporin 0.05% gave significant long-term improvement of visual acuity (p = 0.018), symptoms severity (OSDI score, p = 0.001), corneal and conjunctival staining (van Bijesterveld score, p = 0.0003), and Oxford score (p = 0.0002). Topical cyclosporin allowed for less corticosteroid treatment in all cases (p = 0.04), and broke it off with no long-term recurrence in 15 cases (71%). No severe adverse effect occurred, but 3 patients (14%) stopped cyclosporin treatment because of increasing ocular symptoms. CONCLUSION Given our results, topical cyclosporin represents a new well-tolerated treatment for severe and corticodependent chronic ocular surface disorders. In monotherapy or in association with a corticotherapy, topical cyclosporin could be efficient in any OSD involving immune-based inflammation.
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Affiliation(s)
- Yannick Nochez
- Service d'Ophtalmologie, CHRU de Tours, 2 boulevard Tonnellé, Tours, France.
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Nochez Y, Denoyer A, Pisella PJ. La ciclosporine A à 0,05 % dans les troubles chroniques sévères de la surface oculaire. Can J Ophthalmol 2009. [DOI: 10.3129/i09-117] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
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Denoyer A, Denoyer L, Halfon J, Majzoub S, Pisella PJ. Comparative study of aspheric intraocular lenses with negative spherical aberration or no aberration. J Cataract Refract Surg 2009; 35:496-503. [DOI: 10.1016/j.jcrs.2008.11.032] [Citation(s) in RCA: 20] [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: 05/21/2008] [Revised: 11/07/2008] [Accepted: 11/10/2008] [Indexed: 11/25/2022]
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Denoyer A, Denoyer L, Marotte D, Georget M, Pisella PJ. Intraindividual comparative study of corneal and ocular wavefront aberrations after biaxial microincision versus coaxial small-incision cataract surgery. Br J Ophthalmol 2008; 92:1679-84. [DOI: 10.1136/bjo.2007.137067] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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