The trans-ancestral genomic architecture of glycemic traits

Glycemic traits are used to diagnose and monitor type 2 diabetes and cardiometabolic health. To date, most genetic studies of glycemic traits have focused on individuals of European ancestry. Here we aggregated genome-wide association studies comprising up to 281,416 individuals without diabetes (30% non-European ancestry) for whom fasting glucose, 2-h glucose after an oral glucose challenge, glycated hemoglobin and fasting insulin data were available. Trans-ancestry and single-ancestry meta-analyses identified 242 loci (99 novel; P < 5 x 10(-8)), 80% of which had no significant evidence of between-ancestry heterogeneity. Analyses restricted to individuals of European ancestry with equivalent sample size would have led to 24 fewer new loci. Compared with single-ancestry analyses, equivalent-sized trans-ancestry fine-mapping reduced the number of estimated variants in 99% credible sets by a median of 37.5%. Genomic-feature, gene-expression and gene-set analyses revealed distinct biological signatures for each trait, highlighting different underlying biological pathways. Our results increase our understanding of diabetes pathophysiology by using trans-ancestry studies for improved power and resolution. A trans-ancestry meta-analysis of GWAS of glycemic traits in up to 281,416 individuals identifies 99 novel loci, of which one quarter was found due to the multi-ancestry approach, which also improves fine-mapping of credible variant sets.Peer reviewe

Post-keratoplasty astigmatism management by relaxing incisions: a systematic review

Abstract Postoperative visual acuity can be limited by post-keratoplasty astigmatism, even with a clear corneal graft. Astigmatism management can be performed by selective suture removal, adjustment of sutures, optical correction, photorefractive procedures, wedge resection, intra-ocular lens implantation, intracorneal ring segments, relaxing incisions with or without compression sutures and repeated keratoplasty. Relaxing incisions can be made in the graft, graft-host interface or host cornea. Despite the unpredictability of the method because the flat and steep meridians are usually not orthogonal after penetrating keratoplasty, with asymmetric power distribution, all the studies showed an overall reduction of refractive, keratometric or topographic astigmatism, ranging from 30% to 72% with manual or femtosecond-assisted techniques. Most patients with astigmatism higher than 6 diopters had residual cylinder less than or equal to 3 diopters, which can be treated by laser excimer ablation or secondary intraocular lens implantation

Amebaborne “Attilina massiliensis” Keratitis, France

We report a case of Acanthamoeba castellani keratitis in a person who wore contact lenses. The amebae hosted an ameba-resistant bacterial symbiont, provisionally named “Attilina massiliensis,” a yet undescribed α-Proteobacterium

Exudative Retinal Detachment Treatment in a Patient with Thrombotic Thrombocytopenic Purpura

Purpose: We report a case of unilateral exudative retinal detachment in a patient with thrombotic thrombocytopenic purpura (TTP), without associated hypertension, successfully treated with plasmapheresis. Case Report: A 46-year-old woman with a medical history of TTP presented with unilateral exudative retinal detachment. Biological and radiological assessment eliminated other causes of exudative retinal detachment, including hypertension. Plasma exchange was performed, followed by a rapid improvement in visual acuity and total disappearance of serous detachment. Conclusion: Exudative unilateral retinal detachment is a rare complication of TTP and can be successfully treated by plasma exchange

Using the angular backscattered light to assess transparency of human corneal grafts after treatment byvarious anti-edematous eye drops

International audienc

Using the angular backscattered light to assess transparency of human corneal grafts after treatment byvarious anti-edematous eye drops

International audienc

Detection of fine modifications in bulk corneal grafts based on backscattered light quantification

International audienceA very sensitive technique for quantifying corneal backscattered light which measures the angle-resolved light scattering throughout the reflected space is proposed. Its efficiency to detect different scattering states is compared to that of a technique currently used in hospitals: the Pentacam ®. This technique, based on analyzing the backscattered light close to the specular beam, is less sensitive and it is demonstrate first on agar-agar samples, for which the level of scattering is controlled. In a second time, both techniques are applied on corneal grafts and the first result is confirmed: the Pentacam ® detects an edema after the corneal graft has swollen by hundreds of micrometers; the proposed technique detects the change in scattering before the cornea start to swells. Since the scattering measurements are performed in the reflected space, this highly sensitive method could be applied to in-vivo analysis

Detection of fine modifications in bulk corneal grafts based on backscattered light quantification

International audienc

Practice patterns in the management of bacterial keratitis: a five-continent survey

PurposeTo assess the current diagnostic and therapeutic practice patterns in early management of bacterial keratitis over five continents.MethodsBetween March and August 2019, we distributed an online survey including two clinical scenarios of bacterial keratitis, namely, a mild case and severe case, to 2936 ophthalmologists from 144 countries around the world. The survey consisted of 29 questions. We performed descriptive statistics and a comparative analysis of the answers according to the participants' continent of practice, practice setting, seniority, and subspecialty.ResultsWe received 237 surveys from 54 countries (8% response rate). The proportion of respondents performing microbiological investigations was higher in North America, Asia, Europe, and Oceania than Africa and South America (p &lt; 0.05). This ratio was also higher among ocular surface specialists than for other ophthalmologists (p &lt; 0.001). For mild cases, fluoroquinolone monotherapy and a combination of two or more antibiotics were prescribed by 46% and 41% respondents, respectively. For severe cases, fluoroquinolone monotherapy and a combination of antibiotics were prescribed by 20% and 78% respondents, respectively. Fluoroquinolone monotherapy was the most commonly prescribed treatment in South America, Africa, and Oceania. A combination of two antibiotics was preferentially prescribed in the rest of the world. Topical steroids were prescribed in both circumstances, respectively, in 72% and 75% of cases.ConclusionOur results highlight essential geographical disparities in the current management of bacterial keratitis over five continents