Introduction à l’étude des Salmonella et des salmonelloses en Iran

Néel R., Kaweh M., Jorgensen K., Taslimi H. Introduction à l’étude des Salmonella et des salmonelloses en Iran. In: Bulletin de l'Académie Vétérinaire de France tome 106 n°10, 1953. pp. 547-554

Causes of blindness and vision impairment in 2020 and trends over 30 years, and prevalence of avoidable blindness in relation to VISION 2020: the Right to Sight: an analysis for the Global Burden of Disease Study

Background: Many causes of vision impairment can be prevented or treated. With an ageing global population, the demands for eye health services are increasing. We estimated the prevalence and relative contribution of avoidable causes of blindness and vision impairment globally from 1990 to 2020. We aimed to compare the results with the World Health Assembly Global Action Plan (WHA GAP) target of a 25% global reduction from 2010 to 2019 in avoidable vision impairment, defined as cataract and undercorrected refractive error. Methods: We did a systematic review and meta-analysis of population-based surveys of eye disease from January, 1980, to October, 2018. We fitted hierarchical models to estimate prevalence (with 95% uncertainty intervals [UIs]) of moderate and severe vision impairment (MSVI; presenting visual acuity from <6/18 to 3/60) and blindness (<3/60 or less than 10° visual field around central fixation) by cause, age, region, and year. Because of data sparsity at younger ages, our analysis focused on adults aged 50 years and older. Findings: Global crude prevalence of avoidable vision impairment and blindness in adults aged 50 years and older did not change between 2010 and 2019 (percentage change −0·2% [95% UI −1·5 to 1·0]; 2019 prevalence 9·58 cases per 1000 people [95% IU 8·51 to 10·8], 2010 prevalence 96·0 cases per 1000 people [86·0 to 107·0]). Age-standardised prevalence of avoidable blindness decreased by −15·4% [–16·8 to −14·3], while avoidable MSVI showed no change (0·5% [–0·8 to 1·6]). However, the number of cases increased for both avoidable blindness (10·8% [8·9 to 12·4]) and MSVI (31·5% [30·0 to 33·1]). The leading global causes of blindness in those aged 50 years and older in 2020 were cataract (15·2 million cases [9% IU 12·7–18·0]), followed by glaucoma (3·6 million cases [2·8–4·4]), undercorrected refractive error (2·3 million cases [1·8–2·8]), age-related macular degeneration (1·8 million cases [1·3–2·4]), and diabetic retinopathy (0·86 million cases [0·59–1·23]). Leading causes of MSVI were undercorrected refractive error (86·1 million cases [74·2–101·0]) and cataract (78·8 million cases [67·2–91·4]). Interpretation: Results suggest eye care services contributed to the observed reduction of age-standardised rates of avoidable blindness but not of MSVI, and that the target in an ageing global population was not reached. Funding: Brien Holden Vision Institute, Fondation Théa, The Fred Hollows Foundation, Bill & Melinda Gates Foundation, Lions Clubs International Foundation, Sightsavers International, and University of Heidelberg

A prospective ultrasound biomicroscopy evaluation of changes in anterior segment morphology following laser iridotomy in European eyes

PURPOSE: The aim of this study is to quantify changes in anterior segment morphology by the use of ultrasound biomicroscopy (UBM) after Nd:YAG laser iridotomy in primary angle closure (PAC) and PAC glaucoma (PACG) in European eyes. METHODS: A total of 35 eyes of 28 consecutive patients presenting with PAC or PACG were examined by UBM at presentation, and 1 week after Nd:YAG laser peripheral iridotomy (LPI). Mean age of patients was 63.5+/-14.4 (SD) years. Seventeen patients were females (60%). The trabecular-iris angle (TIA) was measured in the superior, nasal, inferior, and temporal quadrants. Baseline measurements were made under light and dark conditions. MAIN OUTCOME MEASURE: UBM measurements of the trabecular-iris angle (TIA) and the angle opening distance (AOD). DESIGN: Consecutive observational case series. RESULTS: All measurements were made in four quadrants. Before LPI, mean superior TIA was 3.59+/-4.5 degrees (mean+/-SD), nasal TIA was 6.37+/-4.9 degrees , inferior TIA was 9.33+/-7.6 degrees , and temporal TIA was 8.65+/-7.3 degrees in light conditions. After LPI, these values increased, respectively, to 12.58+/-6.9 degrees (P<0.05), 15.40+/-6.8 degrees (P<0.05), 16.37+/-7.4 degrees (P<0.05), and 15.95+/-11.3 degrees (P<0.05), showing a significant widening of the angle in all four quadrants. Superior AOD increased from 0.060+/-0.07 to 0.107+/-0.07 mm (P=0.09). No serious LPI-related complications were encountered. CONCLUSIONS: Dimensions of the anterior chamber angle can be significantly influenced by Nd:YAG laser iridotomy in narrow angle European eyes. UBM examination is a viable tool for the quantitative evaluation of the anterior chamber angle before and after laser iridotomy

Likelihood ratios for glaucoma diagnosis using spectral-domain optical coherence tomography.

PurposeTo present a methodology for calculating likelihood ratios for glaucoma diagnosis for continuous retinal nerve fiber layer (RNFL) thickness measurements from spectral-domain optical coherence tomography (spectral-domain OCT).DesignObservational cohort study.MethodsA total of 262 eyes of 187 patients with glaucoma and 190 eyes of 100 control subjects were included in the study. Subjects were recruited from the Diagnostic Innovations Glaucoma Study. Eyes with preperimetric and perimetric glaucomatous damage were included in the glaucoma group. The control group was composed of healthy eyes with normal visual fields from subjects recruited from the general population. All eyes underwent RNFL imaging with Spectralis spectral-domain OCT. Likelihood ratios for glaucoma diagnosis were estimated for specific global RNFL thickness measurements using a methodology based on estimating the tangents to the receiver operating characteristic (ROC) curve.ResultsLikelihood ratios could be determined for continuous values of average RNFL thickness. Average RNFL thickness values lower than 86 μm were associated with positive likelihood ratios (ie, likelihood ratios greater than 1), whereas RNFL thickness values higher than 86 μm were associated with negative likelihood ratios (ie, likelihood ratios smaller than 1). A modified Fagan nomogram was provided to assist calculation of posttest probability of disease from the calculated likelihood ratios and pretest probability of disease.ConclusionThe methodology allowed calculation of likelihood ratios for specific RNFL thickness values. By avoiding arbitrary categorization of test results, it potentially allows for an improved integration of test results into diagnostic clinical decision making

Intraocular Pressure Telemetry for Managing Glaucoma during the COVID-19 Pandemic.

PurposeTo evaluate in glaucoma patients the feasibility and use of remote monitoring of intraocular pressure (IOP) with an implanted telemetry sensor during the coronavirus disease 2019 (COVID-19) lockdown.DesignCross-sectional study.ParticipantsPatients previously implanted with a telemetric IOP sensor (Eyemate; Implandata GmbH) were included.MethodsIntraocular pressure measurements acquired by the patients during the lockdown were collected by physicians who were located remotely. A questionnaire was sent to 10 participating study centers to evaluate the clinical impact of remote monitoring of IOP via the IOP sensor system.Main outcome measuresNumber of patients who obtained home IOP measurements.ResultsData were available from all centers and from 37 eyes of 37 patients (16 patients with a sulcus-based sensor and 21 patients with a suprachoroidal sensor). Thirty-four patients obtained IOP measurements during the lockdown. Mean age of the patients was 69.3 ± 9.6 years, and 48.6% were women. A total of 8415 IOP measurements from 370 measurement days were obtained. Based on remote IOP measurements, treatment was changed in 5 patients. In another 5 patients, treatment change was considered when physicians received the IOP measurements after the lockdown. Nine of the 10 study centers judged remote IOP measurements to have a clinical impact.ConclusionsThese results show the feasibility of patient-acquired measurement of IOP in conjunction with remote IOP monitoring by physicians with an implantable sensor. The data obtained impacted clinical decision making, including adjustment of ocular hypotensive therapy and avoiding unnecessary office visits during the COVID-19 pandemic

Dark Adaptation in Patients with Primary Open-Angle Glaucoma, Pseudoexfoliation Glaucoma and Childhood Glaucoma

Purpose To investigate the state of dark adaptation and macular blood flow in different forms of glaucoma. Methods Eighteen eyes of 18 patients with primary open-angle glaucoma, 14 eyes of 14 patients with pseudoexfoliation glaucoma, and 10 eyes of 10 patients with childhood glaucoma (CG) were examined by means of dark adaptometry, scanning-laser retinal flowmetry, and retinal tomography. Results All glaucomatous eyes had comparable optic disc excavation (one-way ANOVA, p = 0.138). Eyes with CG had significantly lower best-corrected visual acuity than the other groups (Tukey, all p < 0.0001). Macular perfusion was comparable in all three groups (one - way ANOVA, p = 0.08). The delay in rod-cone break time in the CG group was significantly higher than in the other groups (Tukey, all p < 0.0001). The scotopic sensitivity threshold in the CG group was significantly greater than in the other groups (Tukey, all p < 0.01). Conclusion This underlying dysfunction of dark adaptation may contribute, at least to some extent, to the decreased visual perception observed in patients with CG

The Effect of Therapeutic IOP-lowering Interventions on the 24-hour Ocular Dimensional Profile Recorded with a Sensing Contact Lens

Pr\ue9cis: The 24-hour ocular dimensional profile recorded by a contact lens sensor was affected by intraocular pressure lowering interventions. Among different treatments, incisional surgery had the most significant effect. Purpose: We investigated the effect of different intraocular pressure (IOP)-lowering interventions on contact lens sensor (CLS) parameters and their relationship with Goldmann applanation tonometry (GAT)-measured IOP reduction. Methods: Data from reliable CLS recordings performed before and after IOP-lowering interventions were analyzed. Three interventions were evaluated: Topical medications, laser trabeculoplasty, and incisional surgery. A set of 115 different CLS parameters were derived from 24-hour curves. We compared before versus after values for each parameter. In addition, linear regression was performed using the percentage change of each CLS parameter as the outcome variable and the type of IOP-lowering procedure as the predictor after adjusting age and race. Finally, we investigated the relationship between changes in CLS parameters and GAT IOP with the Spearman rank correlation coefficient. Results: A total of 182 eyes of 182 patients were included in the analyses: 60 (33%) topical medications, 69 (38%) laser, and 53 (29%) surgery. The mean GAT IOP change was 3.6\ub16.5 mm Hg (Plaser=drug). Linear regression showed that, for 20 CLS parameters, surgery was the most predictive of greatest percentage change in CLS signals. In all, 11 (9.5%) of the CLS parameters were significantly correlated with GAT changes. Conclusions: Incisional glaucoma surgery had a more pronounced effect on GAT and CLS parameters than laser and drugs. The CLS can detect changes in patterns resulting from IOP-lowering interventions beyond daytime GAT IOP. This device could potentially be used to assess treatment efficacy in glaucoma

Safety and performance of a suprachoroidal sensor for telemetric measurement of intraocular pressure in the EYEMATE-SC trial

AIM: To investigate the safety and performance of a telemetric suprachoroidal intraocular pressure (IOP) sensor (EYEMATE-SC) and the accuracy of its IOP measurements in open angle glaucoma (OAG) patients undergoing simultaneous non-penetrating glaucoma surgery (NPGS). METHODS: Prospective, multicentre, open-label, single-arm, interventional clinical trial. Twenty-four eyes of 24 patients with OAG regularly scheduled for NPGS (canaloplasty or deep sclerectomy) were simultaneously implanted with an EYEMATE-SC sensor. Six-month follow-up on the sensor's safety and performance as well as on the level of agreement between the EYEMATE-SC measurements and IOP measurements with Goldmann applanation tonometry (GAT). RESULTS: The eyes underwent canaloplasty (n=15) or deep sclerectomy (n=9) and achieved successful implantation of the sensor. No device migration, dislocation or serious device-related complications occurred. A total of 367 comparisons were included in the IOP agreement analysis. The overall mean difference between GAT and EYEMATE-SC measurements was 1.31 mm Hg (lower limit of agreement (LoA) 7.55 mm Hg; upper LoA -4.92 mm Hg). The maximum difference of 2.5 mm Hg ±3.96 (LoA 0.30-2.29) was reached on day 10 and continuously improved to an agreement of -0.15 mm Hg ±2.28 (LoA -1.24 to 0.89) after 6 months. Accordingly, the percentage of eyes within an IOP difference of ±5 mm Hg improved from 78% (day 3) to 100% (6 months). CONCLUSIONS: After 6 months, the EYEMATE-SC sensor was safe and well tolerated, and allowed continual IOP monitoring. TRIAL REGISTRATION NUMBER: NCT03756662

EYEMATE-SC Trial: 12-Month Safety, Performance and Accuracy of a Suprachoroidal Sensor for Telemetric Measurement of Intraocular Pressure

BACKGROUND: Measuring and controlling intraocular pressure (IOP) provide the foundation for glaucoma treatment. Self-tonometry has been proposed as an alternative to better measure IOP throughout the entire day. The novel EYEMATE-SC sensor is implanted in the suprachoroidal space to enable contactless continual IOP monitoring. The aim of the present study was to investigate the 1-year safety, performance and accuracy of the EYEMATE-SC in primary open-angle glaucoma (POAG) patients undergoing simultaneous non-penetrating glaucoma surgery (NPGS). METHODS: In this prospective, multicenter, open-label, single-arm, interventional clinical trial, 24 eyes of 24 POAG patients who were due to undergo NPGS (canaloplasty or deep sclerectomy) were enrolled. An EYEMATE-SC sensor was implanted during NPGS. Goldmann applanation tonometry (GAT) measures were compared with the sensors' IOP measures at all post-operative visits through 12 months. Device position and adverse events were recorded throughout the follow-up. RESULTS: 15 eyes underwent canaloplasty and 9 underwent deep sclerectomy. Successful implantation of the sensor was achieved in all eyes with no reported intraoperative difficulties. Through the 12-month follow-up, no device migration, dislocation or serious device-related complications were recorded. A total of 536 EYEMATE-SC measures were pairwise included in the IOP agreement analysis. The overall mean difference between GAT and EYEMATE-SC measurements was 0.8 mmHg (limits of agreement (CI 95%, LoA): -5.1 and 6.7 mmHg). The agreement gradually improved and from 3-month post-operatively until the end of the follow-up, the mean difference was -0.2 mmHg (LoA: -4.6 and 4.2 mmHg) over a total of 264 EYEMATE-SC measures, and 100% of measures were within ± 5 mmHg of GAT. CONCLUSIONS: The EYEMATE-SC sensor was safe and well-tolerated through 12 months. Moreover, it allowed accurate continuous IOP monitoring