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Uvéite bilatérale associée à un traitement par nivolumab. J Fr Ophtalmol 2018; 41:536-539. [DOI: 10.1016/j.jfo.2017.10.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 10/01/2017] [Accepted: 10/16/2017] [Indexed: 10/28/2022]
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Comparison of the Efficacy and Safety of two Formulations of Diclofenac Sodium 0.1 % Eyedrops in Controlling Postoperative Inflammation after Cataract Surgery. Eur J Ophthalmol 2018; 15:702-11. [PMID: 16329054 DOI: 10.1177/112067210501500608] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To compare the efficacy and safety of diclofenac sodium 0.1% eyedrops packaged in an Abak multidose container without preservative (Dicloabak) with the reference product, sodium merthiolate-preserved diclofenac sodium 0.1% eyedrops, in controlling postoperative inflammation after cataract surgery. METHODS The multicenter, controlled, randomized, single-masked study included 194 patients (Dicloabak 96, preserved diclofenac 98) scheduled to have cataract surgery by phacoemulsification with foldable intraocular lens. All were evaluated preoperatively and postoperatively after 1, 7, and 28 days. Postoperative inflammation was measured by the total score of anterior chamber cells and flare. Ocular plin, conjunctival hyperemia and ciliary flush were also assessed. Postoperative patient assessments also included visual acuity, objective tolerance by slit-lamp, fluorescein test, and subjective evaluation of local tolerance. RESULTS There was no statistically significant difference between the groups in the total score of flare and cells or the degree of conjunctival hyperemia and ciliary flush at any study visit. Dicloabak was demonstrated to be not inferior to preserved diclofenac at all assessment times. The overall assessment of local tolerance was similar for both study medications. CONCLUSIONS Preservative suppression did not alter diclofenac efficacy. Results support the good safety profile of both formulations when dosed three times daily for 4 weeks in absence of concomitant use of drugs potentially toxic for cornea. Preservative-free formulations like Dicloabak should be preferred to generic diclofenac formulations including other ingredients and may improve the safety profile of this topical nonsteroid anti-inflammatory drug.
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INFLIXIMAB and ADALIMUMAB in uveitic macular edema. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.02334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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High-dose chemotherapy with autologus hematopoeitic stem cell transplantation in relapsing Vitreoretinal Lymphoma, a LOC network study. Acta Ophthalmol 2017. [DOI: 10.1111/j.1755-3768.2017.0s081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Ocular candidiasis in intravenous drug misusers. Acta Ophthalmol 2016. [DOI: 10.1111/j.1755-3768.2016.0343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Macular OCT features in eyes with VKH disease. Acta Ophthalmol 2016. [DOI: 10.1111/j.1755-3768.2016.0360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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[Congenital iris cyst]. J Fr Ophtalmol 2016; 39:652. [PMID: 27546162 DOI: 10.1016/j.jfo.2016.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 05/18/2016] [Accepted: 05/30/2016] [Indexed: 10/21/2022]
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Imagerie multimodale d’une maculopathie liée aux antipaludéens de synthèse. J Fr Ophtalmol 2016; 39:111-3. [DOI: 10.1016/j.jfo.2015.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 05/22/2015] [Accepted: 06/11/2015] [Indexed: 11/17/2022]
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[Comparison of early management of central retinal vein occlusion with ranibizumab versus hemodilution]. J Fr Ophtalmol 2015; 38:815-21. [PMID: 26456487 DOI: 10.1016/j.jfo.2015.03.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2014] [Revised: 02/18/2015] [Accepted: 03/02/2015] [Indexed: 11/29/2022]
Abstract
PURPOSE This study was designed to evaluate and compare the efficacy of early treatment of CRVO with either hemodilution by erythrocytopheresis or intravitreal (IVT) ranibizumab, or both. MATERIAL AND METHODS A multicentric prospective randomized study including patients with CRVO for less than 1 month was designed. Patients were randomized into 3 treatment groups: hemodilution (HD group), 3 monthly intravitreal injections of ranibizumab followed by PRN treatment (IVT group), or combined treatment (IVT+HD group). A monthly evaluation during a 6-month follow-up included best-corrected visual acuity (BCVA) and macular thickness measurements with OCT. Fluorescein angiography was performed at baseline, month 2 and month 6. Local and systemic tolerability of the different treatments were also compared. RESULTS Forty-four CRVO patients were included between February 2010 and June 2013: 20 in the IVT group, 13 in the HD group and 11 in the HD+IVT group. The mean duration of CRVO at baseline was 10 days and 16 days at the time of treatment without any significant difference between groups. Retinal ischemia was present at baseline in 40% of eyes in each group. After a 6-month follow-up, no difference between the 3 groups was observed in BCVA (10.5 ETDRS letters, 14.6 and 14.1 in the IVT group, HD group and IVT+HD group respectively, P=0.726) or in macular thickness (398 μ, 440 μ and 379 μ respectively, P=0.465). The time until treatment from CRVO onset, ranging from 1 to 35 days, was not correlated to final outcomes. No significant difference in the mean number of IVT (3.2 in the IVT+HD group vs 3.7 in the IVT group) was observed at 6 months. CONCLUSION No difference in BCVA nor in macular thickness was seen at M6 between the study groups. The duration of CRVO at the time of the initiation of the treatment was not correlated to better visual outcomes. Therefore, etiologic treatment with HD can still be proposed as a first-line treatment in young patients, which allows delaying or avoiding the IVT treatment and its potential side effects. Anti-VEGF IVT still remains an effective option in every case and can be started one month after the beginning of the CRVO.
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Optic disc swelling: Prospective study of sixty-seven patients. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.1623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Cataract surgery in adult patients with uveitis. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.0414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Optic disc swelling: Prospective study of sixty-seven patients. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.0623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Efficacy of anti-TNF alpha in severe and/or refractory Behçet's disease: Multicenter study of 124 patients. J Autoimmun 2015; 62:67-74. [PMID: 26162757 DOI: 10.1016/j.jaut.2015.06.005] [Citation(s) in RCA: 143] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2015] [Revised: 06/06/2015] [Accepted: 06/07/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To report the efficacy and safety of anti-TNF agents in patients with severe and/or refractory manifestations of Behçet's disease (BD). METHODS We performed a multicenter study of main characteristics and outcomes of anti-TNF alpha treatments [mainly infliximab (62%), and adalimumab (30%)] in 124 BD patients [48% of men; median age of 33.5 (28-40) years]. RESULTS Overall response (i.e. complete and partial) rate was 90.4%. Clinical responses were observed in 96.3%, 88%, 70%, 77.8%, 92.3% and 66.7% of patients with severe and/or refractory ocular, mucocutaneous, joint, gastro-intestinal manifestations, central nervous system manifestations and cardiovascular manifestations, respectively. No significant difference was found with respect to the efficacy of anti-TNF used as monotherapy or in association with an immunosuppressive agent. The incidence of BD flares/patient/year was significantly lower during anti-TNF treatment (0.2 ± 0.5 vs 1.7 ± 2.4 before the use of anti-TNF, p < 0.0001). The prednisone dose was significantly reduced at 6 and 12 months (p < 0.0001). In multivariate analysis, retinal vasculitis was negatively associated with complete response to anti-TNF (OR = 0.33 [0.12-0.89]; p = 0.03). The efficacy and relapse free survival were similar regardless of the type of anti-TNF agent used. After a median follow-up of 21 [7-36] months, side effects were reported in 28% of patients, including infections (16.3%) and hypersensitivity reactions (4.1%). Serious adverse events were reported in 13% of cases. CONCLUSION Anti-TNF alpha therapy is efficient in all severe and refractory BD manifestations. Efficacy appears to be similar regardless of the anti-TNF agent used (infliximab or adalimumab).
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[Bitemporal hemianopia as presenting sign of severe ethambutol toxicity]. J Fr Ophtalmol 2013; 36:e163-7. [PMID: 24094504 DOI: 10.1016/j.jfo.2012.12.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2012] [Revised: 12/05/2012] [Accepted: 12/12/2012] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Optic neuropathy is a severe and well-known complication of ethambutol treatment. If not detected early, it may lead to profound and irreversible vision loss. CASE REPORT We report the case of a 83-year-old female patient, referred for rapidly progressive, painless, bilateral visual loss, unimproved after bilateral cataract surgery. Automated Humphrey 24-2 visual field demonstrated bitemporal hemianopia associated with bilateral central scotoma. Brain MRI did not demonstrate any compressive lesion in the chiasmal region. However, on T2-weighted sequences, an area of elevated signal intensity appeared within the optic chiasm, enhancing after gadolinium injection. On detailed history, it was noted that the patient had been on ethambutol for the last 18months, for the treatment of a Mycobacterium avium-related pneumonitis. DISCUSSION The incidence of ethambutol-related toxic optic neuropathy has dramatically decreased since the recommendations for regular follow-up of patients treated with ethambutol. This treatment is classically responsible for bilateral central or ceco-central scotoma due to optic neuropathy, although a few cases of bitemporal hemianopia have been reported in the literature, mimicking a compressive chiasmal lesion. However, none of these cases demonstrated a hypersignal in the optic chiasm on brain magnetic resonance imaging (MRI). CONCLUSION Bitemporal hemianopia on visual field testing is very suggestive of a chiasmal lesion, which is generally due to a compressive, or more rarely inflammatory, lesion in the sellar region. Toxic chiasmal lesions are rare, but in the absence of any tumoral lesion in the sellar area, a detailed history must be obtained in order to rule out drug toxicity, so as to prevent irreversible visual loss.
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Azathioprine in severe uveitis of Behçet's disease. Arthritis Care Res (Hoboken) 2010; 62:1733-8. [PMID: 20665749 DOI: 10.1002/acr.20308] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2010] [Accepted: 07/20/2010] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To investigate the efficacy and tolerance of azathioprine in severe uveitis related to Behçet's disease (BD). METHODS We reported 157 consecutive patients with severe uveitis (active posterior uveitis or panuveitis) fulfilling the international criteria for BD and treated with corticosteroids (0.5-1 mg/kg/day) and azathioprine (2.5 mg/kg/day). Long-term outcome and factors associated with complete remission were assessed. RESULTS Mean±SD age at diagnosis was 29.9±10.1 years, with 71.3% men. At baseline, 59 patients (37.6%) had loss of useful vision, 54 (34.4%) had retinal vasculitis, 66 (42.0%) had panuveitis, and 132 (84.1%) had bilateral uveitis. Following azathioprine therapy, 81 patients (51.6%) were complete responders, 65 (41.4%) were partial responders, and 11 (7%) were nonresponders. The visual acuity significantly improved (P<0.001), and a significant decrease in the mean oral prednisone dosage (55.3 to 10.5 mg/day; P<0.001) was observed after therapy. Patients with retinal vasculitis (odds ratio [OR] 0.45 [95% confidence interval (95% CI) 0.2-0.9], P=0.02) and severe visual loss (OR 0.28 [95% CI 0.2-0.7], P<0.0001) at diagnosis were less likely to be complete responders. Azathioprine was well tolerated, with only 3 withdrawals due to hepatotoxic effects (n=2) and bacterial septicemia (n=1). CONCLUSION Azathioprine represents an effective and safe therapy in patients with severe uveitis of BD.
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113 Traitement par laser externe ou associé à une vitrectomie des masses télangiectasiques périphériques. J Fr Ophtalmol 2009. [DOI: 10.1016/s0181-5512(09)73241-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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153 Intérêt de la biopsie des glandes salivaires accessoires dans le diagnostic des uvéites sarcoïdosiques. J Fr Ophtalmol 2009. [DOI: 10.1016/s0181-5512(09)73281-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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178 Implantation intraoculaire lors de la chirurgie de la cataracte des enfants atteints d’uvéite chronique : devenir à long terme et pronostic visuel. J Fr Ophtalmol 2009. [DOI: 10.1016/s0181-5512(09)73306-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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115 Étiologies des déficiences visuelles des 350 athlètes de « haut niveau » examinés lors des Jeux Paralympiques de Pékin 2008. J Fr Ophtalmol 2009. [DOI: 10.1016/s0181-5512(09)73243-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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751 Uvéite associée à l’arthrite juvénile idiopathique : analyse de 2 familles. J Fr Ophtalmol 2009. [DOI: 10.1016/s0181-5512(09)73876-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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085 Bénéfice ophtalmologique à long terme de l’antagoniste du récepteur de l’IL1, anakinra, chez 5 patients atteints d’un syndrome de CINCA. J Fr Ophtalmol 2009. [DOI: 10.1016/s0181-5512(09)73222-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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144 QuantiFERON-TB Gold dans la prise en charge diagnostique des uvéites : résultats quantitatifs. J Fr Ophtalmol 2009. [DOI: 10.1016/s0181-5512(09)73272-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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038-1 Diagnostic et prise en charge des sarcoïdoses oculaires histologiquement prouvées. J Fr Ophtalmol 2008. [DOI: 10.1016/s0181-5512(08)70632-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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645 Le Quantiféron en ophtalmologie : étude préliminaire sur 96 cas. J Fr Ophtalmol 2008. [DOI: 10.1016/s0181-5512(08)71244-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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499 Rhéophérèse dans la DMLA non exsudative : protocole d’une étude prospective randomisée et multicentique. J Fr Ophtalmol 2008. [DOI: 10.1016/s0181-5512(08)71097-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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568 Utilité de l’ERG multifocal dans le diagnostic différentiel des neuropathies optiques. J Fr Ophtalmol 2005. [DOI: 10.1016/s0181-5512(05)73687-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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028 Rôle des lymphocytes T pathogènes dans un modèle d’uvéorétinite expérimentale induite par un néoantigène rétinien. J Fr Ophtalmol 2005. [DOI: 10.1016/s0181-5512(05)74424-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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111 Rétinochoroïdopathie de type birdshot : analyse des formes familiales. J Fr Ophtalmol 2005. [DOI: 10.1016/s0181-5512(05)74507-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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293 Utilisation thérapeutiqure de l’infliximab au cours des uvéites réfractaires: analyse rétrospective de l’efficacité, des effets indésirables et des limites. J Fr Ophtalmol 2005. [DOI: 10.1016/s0181-5512(05)74690-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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662 Prise en charge thérapeutique par interféron alpha de décollements séreux rétiniens sévères, entrant dans le cadre d’une maladie de Vogt-Koyanagi- Harada. J Fr Ophtalmol 2005. [DOI: 10.1016/s0181-5512(05)73780-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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289 Bartonellose oculaire : aspects évolutifs en angiographie rétinienne à la fluorescéine et à l’indocyanine et en OCT. J Fr Ophtalmol 2005. [DOI: 10.1016/s0181-5512(05)74686-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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032 Diagnostic et traitement du syndrome de Susac : résultats d’une étude rétrospective multicentrique. J Fr Ophtalmol 2005. [DOI: 10.1016/s0181-5512(05)74428-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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297 Efficacité et tolérance de l’interféron alpha dans le traitement des uvéites réfractaires cécitantes : étude rétrospective monocentrique de 45 patients. J Fr Ophtalmol 2005. [DOI: 10.1016/s0181-5512(05)74694-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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296 Interféron alpha 2a au cours des panuvéites chroniques avec larges précipités rétrocornéens. J Fr Ophtalmol 2005. [DOI: 10.1016/s0181-5512(05)74693-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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295 Interféron alpha2 et choriorétinopathie de Birdshot compliquée d’œdème maculaire. J Fr Ophtalmol 2005. [DOI: 10.1016/s0181-5512(05)74692-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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451 Ptosis isolé et cytopathie mitochondriale. J Fr Ophtalmol 2005. [DOI: 10.1016/s0181-5512(05)73571-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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030 Évaluation de l’épaississement maculaire par tomographie en cohérence optique (OCT) dans l’uvéite. J Fr Ophtalmol 2005. [DOI: 10.1016/s0181-5512(05)74426-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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286 Pronostic visuel à moyen terme chez les patients atteints de rétinopathies nécrosantes virales. J Fr Ophtalmol 2005. [DOI: 10.1016/s0181-5512(05)74683-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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287 Suivi à long terme des patients atteints de choroïdite serpigineuse. J Fr Ophtalmol 2005. [DOI: 10.1016/s0181-5512(05)74684-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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086 Prise en charge chirurgicale et suivi à long terme des cataractes chez les enfants atteints d’uvéites. J Fr Ophtalmol 2005. [DOI: 10.1016/s0181-5512(05)74482-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Abstract
Recent developments in molecular biology allow novel diagnostic approaches in intraocular inflammation. Genetic markers as well as species-specific sequences are used for the diagnostics of infection or masquerade syndromes. This article provides state-of-the art information about diagnostic vitrectomy.
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Alveolar lymphocytosis in patients with chronic uveitis: relationship to sarcoidosis. Lung 2002; 179:305-17. [PMID: 11976898 DOI: 10.1007/s004080000070] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2002] [Indexed: 11/24/2022]
Abstract
Bronchoalveolar lavage (BAL) is frequently performed in patients with suspected ocular sarcoidosis. This study describes the immunogenetical, immunological, radiological, and functional features of a subclinical alveolar lymphocytosis unrelated to sarcoidosis in patients with chronic uveitis. Two hundred and ten patients with chronic uveitis of unknown origin, who underwent fiber-optic bronchoscopy with BAL as part of a prospective protocol over a three-year period, were evaluable for retrospective analysis. Sixty-five patients had alveolar lymphocytosis: Sarcoidosis was diagnosed in 13 (6%) patients, whereas alveolar lymphocytosis was considered unrelated to sarcoidosis in 52 (25%). Alveolar lymphocytosis unrelated to sarcoidosis was not associated with radiologically detectable interstitial lung disease or pulmonary function impairment. CD4/CD8 lymphocyte ratio was 3.7 +/- 3.0. Total cell count, total lymphocyte, and CD4 lymphocyte percentage were significantly lower when compared with sarcoidosis-related alveolitis (129,000 +/- 80,000 vs. 218,000 +/- 117,000, p <0.05; 33.1% +/- 13.2 vs. 39.7% +/- 13.2, p <0.05; and 54.3% +/- 18.2 vs. 65.4% +/- 10.1, p <0.05, respectively). Patients with alveolar lymphocytosis unrelated to sarcoidosis were older (47.8 +/- 17.7 years vs. 42.7 +/- 14.2 years, p <0.05) and more likely to carry the HLA-B51 allele (19.7% vs. 7.1%, p <0.01) than patients with chronic uveitis without alveolar lymphocytosis. They did not appear to be at risk of developing clinically apparent interstitial lung disease on followup. We conclude that alveolar lymphocytosis is frequently observed in patients with chronic uveitis. It is generally unrelated to sarcoidosis and may then be associated with a distinctive immunogenetic phenotype.
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Myopathie oculaire au cours de la myofasciite à macrophages : à propos de trois cas. Rev Med Interne 2001. [DOI: 10.1016/s0248-8663(01)83399-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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Abstract
Two women presented with bilateral internuclear ophthalmoplegia evolving in a few days to complete bilateral horizontal gaze paralysis. Convergence and vertical eye movements were normal. Cerebral MRI showed a few small white matter lesions in the lateral ventricle regions, and, at the brainstem level, a single, small, bilateral lesion affecting the posterior part of the medial pontine tegmentum and responsible for the clinical syndrome. The condition gradually improved in both patients, following a similar progression as at the onset: improvement first involved the adduction movements in both eyes, whereas bilateral abduction paresis still persisted for a few weeks, before complete recovery of eye movements. Bilateral damage to the medial longitudinal fasciculus and subsequent lateral extent of damage to the region of the two abducens emerging fibres may explain the clinical findings. In both cases, the cause was probably multiple sclerosis.
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Intérêt de la prescription d'interféron α dans le traitement des uvéites graves réfractai res aux corticoïdes. Rev Med Interne 1999. [DOI: 10.1016/s0248-8663(99)80149-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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[Abnormalities of the ocular surface in patients with AIDS]. J Fr Ophtalmol 1998; 21:637-42. [PMID: 9894201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/09/2023]
Abstract
PURPOSE AIDS patients more and more complain from conjunctival symptoms related to dry eyes and conjunctivitis, but little is known about ocular surface abnormalities in these patients. We used impression cytology (IC) and tear IgE to assess inflammatory status of the ocular surface in AIDS. METHODS IC were taken in 30 patients infected by HIV (including 28 AIDS patients). After collecting general clinical information, and CD4 rate, we made a complete ophthalmological examination (Schirmer test, BUT, Lissamine green and tear IgE). IC were processed by an immunofluorescence technique with antibodies to HLA DR: an inflammatory marker normally restricted to conjunctival dendritic cells; and to APO 2.7 an apoptotic cell marker. RESULTS Seventy per cent suffered from subjective and/or objective signs, and BUT was abnormal in 70% of patients. Tear IgE was increased in 36% of the eyes, even without known allergy. A decrease in density of dendritic cells and an abnormal expression of HLA DR antigens by epithelial cells were common features in both groups (respectively 90% and 80% of the eyes). An increase of the APO 2.7 marker was significantly found in 70% of eyes. We found no correlation between clinical abnormalities and laboratory findings. However there was a correlation between the blood CD4 decrease and the HLA DR antigen overexpression. Tear IgE were related to HLA DR expression. CONCLUSION This work shows that even when AIDS patients are asymptomatic they may present significant alterations of the ocular surface probably due to their immunological disorders.
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[Endogenous infectious endophthalmitis]. Rev Med Interne 1998; 19:658-60. [PMID: 9793153 DOI: 10.1016/s0248-8663(99)80045-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Endogenous endophthtalmitis is an intraocular infection of hematogenous origin. EXEGESIS It is generally a panuveitis that may be mixed-up with a non-infectious inflammatory disease, promoting delayed treatment and compromising the visual prognosis, as the visual loss rate reaches up to 37.5%. Antibiotherapy should be started immediately after bacteriological examinations and without waiting for vitrectomy. Identification of the causative microorganism is absolutely necessary. It may require aqueous or vitreous culture if cultures from other body fluids are negative and infection progresses. The most common infections are endocarditis and digestive and renal diseases. Virectomy is indicated for first line treatment of ocular abcess and improvement of antibiotic absorption. However, it may lead to retinal detachment. Vitrectomy is also indicated in case of unsuccessful therapy. To decrease the inflammatory reaction and risks of vitreous organization, local or systemic corticotherapy is prescribed after control of the infection. CONCLUSION Although rare, endogenous endophthalmitis should be diagnosed as it may be mixed-up with inflammatory uveitis, leading to inappropriate corticotherapy. Furthermore, antibiotherapy with good intraocular penetration should be started immediately, but it should be kept in mind that the functional prognosis is poor.
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