Pharmaceutics

The purpose of this study is to evaluate the visual acuity (VA) gain profiles between patients with drug-naive diabetic macular edema (DME) treated by dexamethasone implant (DEX-implant) and assess the baseline anatomical and functional factors that could influence the response to the treatment in real-life conditions. A retrospective, multi-center observational study included 129 eyes with drug-naive DME treated by DEX-implant. The Median follow-up was 13 months. Two groups of VA gain trajectories were identified-Group A, with 71% (n = 96) of patients whose average VA gain was less than five letters and Group B, with 29% (n = 33) of patients with an average gain of 20 letters. The probability of belonging to Group B was significantly higher in patients with baseline VA \textbackslashtextless 37 letters (p = 0.001). Ellipsoid zone alterations (EZAs) or disorganization of retinal inner layers (DRILs) were associated with a lower final VA (53.0 letters versus 66.4, p = 0.002) but without a significant difference in VA gain (4.9 letters versus 6.8, p = 0.582). Despite a low baseline VA, this subgroup of patients tends to have greater visual gain, encouraging treatment with DEX-implant in such advanced-stage disease. However, some baseline anatomic parameters, such as the presence of EZAs or DRILs, negatively influenced final vision

Réactions cellulaires et moléculaires dans un modèle de néovascularisation choroïdienne expérimentalement induite par photocoagulation rétinienne au laser argon chez la souris

La néovascularisation choroïdienne (NVC) est une complication de la maculopathie liée à l'âge responsable de baisse de l'acuité visuelle profonde. Nous avons étudié un modèle murin de NVC induite par photocoagulation (PC) laser argon chez la souris C57BI/6J. La réalisation d'un impact rétinien de 50 m, 400mW, 0,05s entraîne dès J3 une réaction néovasculaire choroïdienne. Les macrophages infiltrent tôt cette réaction multicellulaire. Elle est significativement réduite après injection intravitréenne de triamcinolone. L'âge est un facteur indépendant de NVC, elle est significativement plus élevée chez les souris âgées et persiste plus longtemps. Le profil d'expression des ARNm pour GFAP, VEGF et MCP1 sont également âge-dépendants et expliquent pour part la réponse néovasculaire plus intense avec l'âge. Quelquesoit l'âge, les mêmes types cellulaires sont mis en jeu dans le processus de réparation tissulaire, mais les réactions cellulaires et moléculaires diffèrent par leur intensité.Choroidal neovascularization (CN) is a complication of aged related maculopathy that leads to deep vision loss. Using C57BI/6J mice, we investigated the CN experimental model induced by argon laser photocoagulation (PC). We observed CN from 3 days after PC (laser impact of 50 m, 400mW, 0,05s). Macrophages infiltrated early this multicellular reaction. CN area was significantly reduced by triamcinolone intravitreal injection. Age appeared as an independent factor for CN, that was larger in aged mice and more persistent. mRNA expression for GFAP, VEGF and MCP1 were age dependant too and can explain in part this higher response to laser trauma with aging. Whatever the age, the same cells were involved in the wound healing processes, but cellular and molecular reactions differed in intensity.PARIS5-BU Méd.Cochin (751142101) / SudocSudocFranceF

Real-Life Value of the Odysight® Application in At-Home Screening for Exudative Recurrence of Macular Edema

Background: The aim of this study was to describe the value of the Odysight® application in addition to a classical follow-up regimen in the detection of exudative recurrences in patients with macular edema. Methods: We conducted an observational, multicenter, retrospective study. The Odysight® application includes a visual acuity (VA) test that can lead to alerts in case of a drop of >5 VA letters on two successive tests. The efficacy of the alerts in detecting exudative recurrence was studied. Results: A total of 149 eyes of 123 patients were included. The sensitivity of alerts for the detection of recurrence was 30.8% (95% CI [17.6; 44.0]) and its specificity was 83.7% (95% CI [73.2; 94.3]. A better baseline VA was found to be significantly associated with a better retention of the application (OR = 0.05, 95% CI [0.002; 0.62]; p = 0.045). Of the 12/39 alerts that detected a recurrence, eight (20.5% of all alerts) resulted in the scheduling or advancement of an intravitreal injection. Conclusions: In the present study, the sensitivity and positive predictive value of the Odysight® application seems low but its use in addition to the usual follow-up of the patient can detect, in certain cases, an early recurrence and thus allow an anticipated readjustment of the treatment

Real-Life Value of the Odysight (R) Application in At-Home Screening for Exudative Recurrence of Macular Edema

International audienceBackground: The aim of this study was to describe the value of the Odysight (R) application in addition to a classical follow-up regimen in the detection of exudative recurrences in patients with macular edema. Methods: We conducted an observational, multicenter, retrospective study. The Odysight (R) application includes a visual acuity (VA) test that can lead to alerts in case of a drop of >5 VA letters on two successive tests. The efficacy of the alerts in detecting exudative recurrence was studied. Results: A total of 149 eyes of 123 patients were included. The sensitivity of alerts for the detection of recurrence was 30.8% (95% CI [17.6; 44.0]) and its specificity was 83.7% (95% CI [73.2; 94.3]). A better baseline VA was found to be significantly associated with a better retention of the application (OR = 0.05, 95% CI [0.002; 0.62]; p = 0.045). Of the 12/39 alerts that detected a recurrence, eight (20.5% of all alerts) resulted in the scheduling or advancement of an intravitreal injection. Conclusions: In the present study, the sensitivity and positive predictive value of the Odysight (R) application seems low but its use in addition to the usual follow-up of the patient can detect, in certain cases, an early recurrence and thus allow an anticipated readjustment of the treatment

Triplets de photons : de l'optique non linéaire à l'optique quantique

National audienc

Safety and long-term efficacy of repeated dexamethasone intravitreal implants for the treatment of cystoid macular edema secondary to retinal vein occlusion with or without a switch to anti-VEGF agents: a 3-year experience

Article de 8 p.International audiencePURPOSE: To evaluate the safety and efficacy of repeated dexamethasone intravitreal implants (DEX implants) over 3 years in eyes with macular edema (ME) secondary to branch retinal vein occlusion (BRVO) or central retinal vein occlusion (CRVO). METHODS: We conducted a 3-year, retrospective, multicenter study that included adult patients with ME secondary to BRVO or CRVO treated with first-line DEX implants. Patients were divided into two different subgroups: patients who received DEX implant injections only (group 1) and those who received DEX implants first and then were switched to anti-VEGF agents (group 2). Primary endpoints were changes in best-corrected visual acuity (BCVA) and central retinal thickness (CRT) from baseline to month 6 and month 36. Secondary endpoints included changes in both BCVA and CRT after each DEX implant and adverse events, particularly cataract extraction and elevated intraocular pressure (IOP). RESULTS: Sixty-six patients with a median [IQR (interquartile ratio)] age of 72 [65.0; 81.1] years were included (40.9% BRVO, 59.1% CRVO), who received a median of 5.0 [min, 1.0; max, 10.0] DEX implants over 3 years. Median [IQR] time to retreatment was 4.8 [4.2; 6.0] months. The median [IQR] improvements in BCVA from baseline until months 6 and 36 were respectively + 10.0 [0; + 20.0] letters (P = 0.040) and + 10.0 [- 8.7; + 20.0] letters (P = 0.364) in the whole population. In group 1, the results were similar, whereas in group 2, BCVA significantly increased at M36 compared with baseline (P = 0.003). The median [IQR] CRT reductions from baseline to months 6 and 36 were respectively - 227.5 [- 337.0; - 52.7] mum and - 224.0 [- 405.0; - 83.8] mum (P < 0.001) in the whole population. Results were similar in both groups. The most common adverse events were cataract extraction (70.4%) and elevated IOP (54.5%). No other serious local complications were observed. Treatment was switched to anti-VEGF agents in 16 (24.2%) patients. CONCLUSIONS: DEX implants are an effective treatment for BRVO and CRVO-associated ME over 3 years. It is a valid treatment even though complications remain frequent. However, functional efficacy seems to decrease with time and repeated injections

Triple photons : a new state of light

International audienc

Triple photons generation : toward a new state of light

International audienc