Positioning In Macular hole Surgery (PIMS): statistical analysis plan for a randomised controlled trial

UK National Institute for Health Research (NIHR) through its Research for Patient Benefit scheme (grant number PB-PG-0213-30085)

How to improve screening for diabetic retinopathy: the Burgundy experience.

International audienceOBJECTIVES: The aim of this study was to evaluate the impact of a mobile diabetic retinopathy (DR) screening programme on the overall ophthalmological follow-up of diabetics in Burgundy. METHODS: The primary objective was to compare the rate of eye examinations, according to the information personnalisée aux professionnels de santé (IPPS; personalized information sent to health professionals) database, in diabetics before and after the screening campaign in selected zones. The secondary objectives were to compare the rate of eye examinations in diabetics before and after the screening programme in two different situations: with a mobile site; and with general practitioners (GPs) who teach in medical school. The impact of the different kinds of information on improving DR screening participation was also assessed. RESULTS: The overall rate of ophthalmological visits did not change significantly before vs after the screening campaign (42.2% vs 41.8%; P=0.73), nor did the rate of ophthalmological visits in screened areas (44% vs 43%; P=0.58), compared with non-screened areas (41% vs 41%; P=0.99) and the sectors with GPs as teachers (47% vs 49%). Patients referred to the screening programme were mainly informed of the screening by flyers provided by the National Health System. CONCLUSION: The DR screening campaign represents a major improvement in diabetic management, as around 80% of the screened patients with DR consulted an ophthalmologist after the screening campaign. However, the overall rate of diabetics having the recommended annual ophthalmological visit in the region of Burgundy remained unchanged

Chirurgie rétino-vitréenne en ambulatoire : une expérience enrichissante, mais coûteuse…

National audienc

042 Effets de colorants intravitréens sur l’électrorétinogramme chez le rat

Communication orale lors du 113e congrès de la Société Française d'Ophtalmologie.International audienc

Effect of intravitreal injection of Indocyanine Green, Triamcinolone Acetonide and Trypan Blue on the electroretinographic response of rats

International audiencePurpose:: Indocyanine Green (ICG) and Tripan Blue (TB) are commonly used in macular surgery by making easier the internal limiting membrane (ILM) removing. However, the innocuousness of these dyes is not actually established notably for ICG. Then, several authors proposed the use of triamcinolone acetonide (TA) as an alternative to the use of intraoperative dyes for visualizing the ILM. The purpose of this study was to evaluate the effects of intravitreal injection of ICG, TB and TA on the rat electroretinogram (ERG). Methods:: Three groups of 12-week-old Sprague Dawley rats (n=6) received intravitreal injection in one eye of 0.1mL of either ICG 0.5mg/mL, TB 3mg/mL or TA 40mg/mL followed by a rinse using a 1mL of saline solution. The controlateral eye was used as a control and was injected similarly with a saline solution only. The scotopic ERG was recorded at different intensities (10mcds/m², 2500mcds/m² and 25000mcds/m²) before injection and 28 days after treatment. Results:: No effect of the treatment was observed on the ERG amplitudes and wave latencies in control eyes and in eyes treated with TB and TA. The ERG b-wave amplitudes and latencies were significantly reduced in eyes treated with ICG at 10mcds/m² and 2500mcds/m² but not at 25000mcds/m² (amplitude means: t0=174.8µV versus t28=55.0µV at 10mcds/m² p<0.05; t0=176.5µV versus t28=70.0µV at 2500mcds/m² p<0.05; t0=140.3µV versus t28=40.0µV at 25000mcds/m² p=0.057). The ERG a-wave amplitudes and latencies were also significantly lower at 2500mcds/m² in eyes treated with ICG (amplitude means: t0=45.0µV versus t28=23µV p<0.05; latency means: t0=7.6msec versus t28=9.5msec p<0.01). Conclusions:: This study shows a negative effect of ICG on retinal function one month after a transient retinal exposure. TA and TB could be considered as an interesting alternative to ICG for macular surgery

Early Reactional Hyperplasia and Neuronal Differentiation of the Ciliary Epithelium (CE) in Experimental Retinal Detachment (RD) with Proliferative VitreoRetinopathy (PVR) in the Porcine Eye

Background: Rare quiescent retinal progenitor cells have been isolated in the adult amphibian ciliary marginal zone (Hollyfield, 1968), then in the mammalian (Tropepe et al, 2000) (Ahmad et al, 2000) (Fischer and Rey, 2000) and human CE (Coles et al, 2004) (Ballios et al, 2011). This contingent might be inhibited in the adult eye by the signaling pathway ephrin (Chen, personal communication, ARVO 2012, submitted, Stem Cells). Retinal injury might be a triggering factor to quit the dormant state in the adult mammalian CE (Ooto, 2004) (Nickerson, 2007) (Nishiguchi 2008) (Kiyama et Wang, 2010), as it has been demonstrated also in the human brain (Moe et al, 2005) (Logan et al, 2006) . We have reported a CE proliferation with retinal neuronal and photoreceptor differentiation in three human eyes eviscerated for longstanding RD and PVR (Ducournau et al 2012). The CE strongly expressed EGFR. The concept of niche (Fischer and Rey, 2003) is now well established in stem cells recruitment processes. We have hypothezised that the disease RD and PVR might stimulate a dormant population of Retinal Progenitor Cells (RPCs) in the CE in the human eye in vivo in presence of a niche constituted by EGF. Proliferation in the ciliary body, together with nestin expression in ciliary MCM2+ (macrophage/microglia marker F4/80) cells were found in mice eyes with experimental RD, suggesting that RD might activate putative RPCs (Suburo et al, 2010). The aim of the present work was to study the CE in the porcine eye with experimental DR and PVR