Vermot-Desroches V, Rezkallah A, Kodjikian L
… +9 more, Barbarroux A, Fricker J, Barkat I, Chumbi-Flores J, Saux R, Bonjour M, Sejournet L, Mathis T, Denis P
PURPOSE: The goal of the present study was to compare the effect of nasal versus temporal placement of the iStent Inject W® during phacoemulsification on intraocular pressure (IOP). DESIGN AND PARTICIPANTS: Over 5 consec...PURPOSE: The goal of the present study was to compare the effect of nasal versus temporal placement of the iStent Inject W® during phacoemulsification on intraocular pressure (IOP). DESIGN AND PARTICIPANTS: Over 5 consecutive years, 389 eyes of 244 patients undergoing phacoemulsification with 2 iStent Inject W® injections in a tertiary referral center were included retrospectively. In 50.6% of eyes, 2 iStent Inject W® were injected in the inferior nasal region of right eyes, while 49.4% received injections in the inferior temporal region of left eyes. MAIN OUTCOME MEASURES: The main parameters were IOP and the number glaucoma medications. RESULTS: One month after surgery, there was no significant difference in the mean (SD) change in IOP between right eyes injected nasally [-1.2 (6.7) mmHg] and left eyes injected temporally [-1.2 (6.7) mmHg; P=0.71] and no significant difference in the mean (SD) change in the number of glaucoma medications for the right eyes injected nasally [-0.4 (1.3)] and left eyes injected temporally [-0.5 (1.3); P=0.67]. There was also no significant difference at 6 months or 12 months. Subgroup analysis in patients who underwent surgery in both eyes found no significant difference in IOP or change in glaucoma medications at 1, 6, or 12 months. The complication rate was low. CONCLUSION: The efficacy of the iStent Inject W® is not dependent on its area of implantation. From these results, we propose that iStent Inject W® can be injected either temporally or nasally based on the surgeon's preferences. This has significant implications for simplifying and speeding up the procedure and might result in improved surgical outcomes for the patient.
PURPOSE: To evaluate the performance of an innovative, noninvasive, rapid chromatic multifocal dynamic pupillometry protocol (mPFTCo) in detecting functional retinal changes in three chronic diseases: age-related maculop...PURPOSE: To evaluate the performance of an innovative, noninvasive, rapid chromatic multifocal dynamic pupillometry protocol (mPFTCo) in detecting functional retinal changes in three chronic diseases: age-related maculopathy (ARM), age-related macular degeneration (AMD), and diabetic retinopathy (DR). METHODS: A cohort of 222 participants (68 controls, 18 ARM, 79 AMD, 57 DR) was tested with mPFTCo. This one-minute test per eye used a multifocal stimulus covering 40° of the visual field, divided into nine regions, each periodically modulated in luminance, with chromatic alternation (blue, red, green, gray) every 15s. Regional and spectral pupillary responses were analyzed to characterize functional deficits. Group comparisons were performed using Student's t-tests and ROC curve analyses. RESULTS: Compared with controls, significant regional alterations were observed in all three diseases. In AMD, pupillary responses were reduced in central and paracentral regions, particularly under red stimulation (P<0.001). In ARM, a moderate paracentral deficit was observed with blue and green stimulation (P<0.005). In DR, a diffuse deficit affected the entire visual field across all colors (P<0.001). This brief, objective, well-tolerated test showed excellent diagnostic performance (AUC=1). CONCLUSION: mPFTCo enables rapid, noninvasive topographic assessment of retinal function. It effectively discriminates between pathological profiles and identifies subclinical alterations not detected by conventional visual tests, representing a promising tool for screening, monitoring, and functional evaluation of treatments in routine clinical practice.
PURPOSE: To assess the prevalence of light-induced toxic effects on the ocular and palpebral regions in maritime professionals chronically exposed to light radiation in the Provence-Alpes-Côte d'Azur region and to compar...PURPOSE: To assess the prevalence of light-induced toxic effects on the ocular and palpebral regions in maritime professionals chronically exposed to light radiation in the Provence-Alpes-Côte d'Azur region and to compare the results to a non-overexposed population. The study also investigates risk factors for and protective factors against ocular phototoxicity in exposed individuals. DESIGN: Single-center, cross-sectional comparative analysis. PARTICIPANTS: The study included 77 maritime professionals (overexposed group) and 70 non-overexposed individuals (control group). Participants were examined between July 2023 and June 2024 at the ophthalmology department of Sainte-Anne Military Hospital. METHODS: Cross-sectional comparative analysis was performed between the two groups. Participants underwent a clinical examination, including ocular imaging, focused on ocular conditions such as conjunctival lesions, cataracts, and macular changes linked to light overexposure, and completed questionnaires on sun exposure. RESULTS: The study found no connection between age-related macular degeneration (AMD) and solar overexposure but highlighted the significant role of light reflection from water in other ocular conditions. Four basal cell carcinomas were found in the exposed group, consistent with the pathogenesis of these skin cancers. A higher risk of conjunctival lesions (pinguecula and/or pterygium) and cortical cataracts was noted. Macular epithelial damage was linked to increased light exposure. Protective solar equipment reduced the risk of ocular damage in certain conditions. CONCLUSIONS: The PHOTOPPA study is the first to compare ocular pathologies related to light overexposure in maritime professionals. It confirms the increased risk of ocular conditions, emphasizing the importance of comprehensive sun protection to reduce light-induced ocular damage and possibly prevent AMD development.
PURPOSE: To evaluate mid-term safety and efficacy of a new surgical technique using amniotic membrane plugs for the treatment of posterior or retracted retinal breaks or those associated with chorioretinal atrophy in tra...PURPOSE: To evaluate mid-term safety and efficacy of a new surgical technique using amniotic membrane plugs for the treatment of posterior or retracted retinal breaks or those associated with chorioretinal atrophy in tractional and chronic rhegmatogenous retinal detachment. METHODS: Patients with rhegmatogenous retinal detachment with at least grade C proliferative vitreoretinopathy or tractional retinal detachment whose retinal breaks were sealed with amniotic membrane plugs were included. With a minimum follow-up of 12 months, parameters measured included visual acuity evaluation, optical coherence tomography, retinal photography, intraocular pressure and re-detachment rate at 1, 3, 6 and 12 months. RESULTS: Nine eyes of 9 patients were included. The mean 12-month postoperative best-corrected visual acuity was 1.12 logMAR. Fundus photography and optical coherence tomography showed that the plugs stayed in place at 1, 3, 6 and 12 months without dislocation. Glial tissue regeneration was seen without restoration of the original retinal layers. Only one retinal re-detachment occurred after silicone oil removal. Neither elevation of intraocular pressure nor signs of inflammation were observed. CONCLUSION: Amniotic membrane plugs represent a safe and effective surgical technique to manage posterior or retracted retinal breaks, or those associated with chorioretinal atrophy, without the limitations of laser retinopexy.
Congenital horizontal tarsal kink syndrome is a rare but well-defined form of congenital upper eyelid entropion, characterized by a horizontal tarsal fold causing inversion of the lid margin and lashes, with absence of a...Congenital horizontal tarsal kink syndrome is a rare but well-defined form of congenital upper eyelid entropion, characterized by a horizontal tarsal fold causing inversion of the lid margin and lashes, with absence of a visible upper eyelid crease. Induced trichiasis may lead to corneal complications and a major risk of amblyopia if diagnosis and management are delayed. We report the case of a 4-week-old infant with right unilateral tarsal kink complicated by a central corneal ulcer and associated microphthalmia. This case was managed by an anterior approach with release of orbicularis adhesions, everting sutures, amniotic membrane graft and temporary tarsorrhaphy, achieving rapid corneal healing and sustained normal eyelid position. A systematic review of 38 prior published cases from 1894 to 2025 revealed a male predominance, mostly unilateral, and high frequency of corneal lesions. Surgery was required in 94.9% without reported recurrence, regardless of technique (open or closed, anterior or posterior). In this condition, early recognition and prompt surgical management can prevent corneal damage and amblyopia.
PURPOSE: Endophthalmitis is a rare but serious ophthalmologic emergency that can lead to permanent vision loss. Due to limited literature on the subject, many aspects of its management remain controversial. This study ai...PURPOSE: Endophthalmitis is a rare but serious ophthalmologic emergency that can lead to permanent vision loss. Due to limited literature on the subject, many aspects of its management remain controversial. This study aims to provide an overview of current management practices in French university hospitals (CHU). METHODS: A descriptive, observational, cross-sectional survey was conducted among hospital-based ophthalmologists working in CHUs using an online questionnaire. It covered diagnostic and therapeutic modalities (medical and surgical), as well as the presence of institutional protocols. RESULTS: Twenty-eight centers participated. Systemic antibiotic therapy was used in 64.3% of cases; intravenous induction followed by oral continuation was employed in 72.2% of reported cases. Levofloxacin is the most frequently prescribed antibiotic (94.4% of centers reporting use of systemic antibiotic therapy). Intravitreal injections (mainly vancomycin/ceftazidime) were systematically performed, although the number of injections varied between centers. Surgery during the "acute" phase was performed in 75% of CHUs, although the indication criteria were heterogeneous. CONCLUSION: This study highlights significant variability in the management of endophthalmitis in French university hospitals. It underscores the absence of recent national guidelines and the need for multicenter studies to evaluate therapeutic strategies, particularly the role of systemic antibiotic therapy and surgical indications for vitrectomy.
PURPOSE: This study aimed to evaluate retinal structural and microvascular changes in children with atopic dermatitis (AD) using optical coherence tomography (OCT) and OCT angiography (OCTA) and to analyze their associat...PURPOSE: This study aimed to evaluate retinal structural and microvascular changes in children with atopic dermatitis (AD) using optical coherence tomography (OCT) and OCT angiography (OCTA) and to analyze their associations with disease severity, comorbidities, corticosteroid use, and IgE levels. METHODS: A prospective, cross-sectional case-control study included 43 children with AD and 32 age- and sex-matched healthy controls. Peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell layer (GCL) thicknesses were measured by spectral-domain OCT. Retinal microvasculature was assessed by OCTA with 6×6mm macular scans. Vascular densities in superficial and deep capillary plexuses and choriocapillaris were calculated using the ETDRS grid. Clinical data included SCORAD scores, serum IgE, skin hydration, eosinophil counts, and duration of corticosteroid use. RESULTS: Children with AD showed significantly reduced superior and temporal RNFL thickness compared with controls (P<0.05). Central and superior GCL thicknesses were lower but not significantly so. Foveal vascular density of the superficial plexus was significantly reduced in AD (18.7±3.3% vs. 20.4±3.4%, P=0.039). Correlation analyses showed superior RNFL thickness positively associated with skin hydration, whereas inferior GCL thickness correlated negatively. Longer corticosteroid use correlated with increased foveal superficial and superior deep vascular density, while serum IgE correlated positively with superior deep density and negatively with nasal density. CONCLUSION: Pediatric AD may be linked to selective RNFL thinning and subtle macular vascular alterations, reflecting systemic inflammation. OCT and OCTA may serve as biomarkers for monitoring severity and early ocular involvement, underscoring the importance of interdisciplinary care.