Flat Choroidal Nevus Inaccessible to Ultrasound Sonography Evaluated by Enhanced Depth Imaging Optical Coherence Tomography

Purpose: To demonstrate the usefulness of enhanced depth imaging optical coherence tomography (EDI-OCT) in investigating choroidal lesions inaccessible to ultrasound sonography. Methods: In a 60-year-old woman with an asymptomatic choroidal nevus, normal OCT was used to observe the macula and EDI-OCT to image the choroidal nevus that was inaccessible to ultrasound. The exact location of the lesion in the choroid and the dimensions of the nevus were measured. Results: The lesion was located in the superior macula, and the nevus was homogeneous in its reflectivity. We observed a thickened choroid delineated by the shadow cone behind it, measuring 1,376 × 325 µm in the larger vertical cut and 1,220 × 325 µm in the larger horizontal cut in an image with a 1:1 pixel mapping and automatic zoom. The macular profile and thickness were both normal. Conclusions: EDI-OCT appears to be an excellent technique for measuring choroidal nevi and all choroidal lesions accessible to OCT imaging by depicting their exact location in the choroid, their dimensions, and their demarcation from the surrounding healthy tissue, thus allowing for a more efficient and accurate follow-up

Baseline SD-OCT characteristics of diabetic macular oedema patterns can predict morphological features and timing of recurrence in patients treated with dexamethasone intravitreal implants

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PRIMA subretinal wireless photovoltaic microchip implantation in non-human primate and feline models

Purpose To evaluate the surgical technique for subretinal implantation of two sizes of PRIMA photovoltaic wireless microchip in two animal models, and refine these surgical procedures for human trials. Methods Cats and Macaca fascicularis primates with healthy retina underwent vitrectomy surgery and were implanted with subretinal wireless photovoltaic microchip at the macula/central retina. The 1.5mm PRIMA chip was initially studied in feline eyes. PRIMA implant (2mm,1.5mm sizes) arrays were studied in primates. Feasibility of subretinal chip implantation was evaluated with a newly-developed surgical technique, with surgical complications and adverse events recorded. Results The 1.5mm implant was placed in the central retina of 11 feline eyes, with implantation duration 43-106 days. The 1.5mm implant was correctly positioned into central macula of 11 primate eyes, with follow-up periods of minimum 6 weeks (n = 11), 2 years (n = 2), and one eye for 3 years. One primate eye underwent multi-chip 1.5mm implantation using two 1.5mm chips. The 2mm implant was delivered to 4 primate eyes. Optical coherence tomography confirmed correct surgical placement of photovoltaic arrays in the subretinal space in all 26 eyes. Intraoperative complications in primate eyes included retinal tear, macular hole, retinal detachment, and vitreous hemorrhage that resolved spontaneously. Postoperatively, there was no case of significant ocular inflammation in the 1.5mm implant group. Conclusions We report subretinal implantation of 1.5mm and 2mm photovoltaic arrays in the central retina of feline and central macula of primate eyes with a low rate of device-related complications. The in vivo PRIMA implantation technique has been developed and refined for use for a 2mm PRIMA implant in ongoing human trials

Assessment of Spontaneous Retinal Arterial Pulsations in Acute Central Retinal Vein Occlusions

Central retinal vein occlusion (CRVO) is a common retinal disease. Recent works mentioned spontaneous retinal arterial pulsations (SRAPs) as a feature of some CRVOs. This is a retrospective study on patients presenting with CRVO who were followed up for at least 6 months. The objective was to identify SRAP in the acute phase of the disease and determine their relationship with patients’ characteristics and visual prognosis. A 10-second infrared film centered on the optic disc was recorded within a month of the onset of symptoms, and SRAPs were detected in two-thirds of the cases. Patients with SRAP were significantly younger than those without SRAP. Mean central macular thickness was significantly higher in the absence of SRAP, which was translated into a more severe macular edema; however, this difference faded with time. BCVA tended to be higher in the presence of SRAP at the 6-month follow-up when adjusted to baseline. This study demonstrates that SRAPs are a frequent finding, easily detected by infrared fundus video recording, and associated with a younger age and lesser macular edema

Améliorer les performances et le bien être des truies gravides par la mobilisation de nouvelles technologies pour une alimentation de précision et la détection de signaux comportementaux.

Since the new welfare regulation, farmers have to breed pregnant sows penned in the group. Thus, breeders observed more heterogeneity in the backfat thickness of sows when they are entering the farrowing units, implying more losses of piglets. It is also more difficult to observe lameness issues in large groups of sows. The objectives of this project are (i) to develop an activity sensor to feed each sow according to the energy it spends and (ii) to create an early detection system for lameness problems. The first step of this project was to develop a sensor able to record the individual activity level of sows penned in a group. As a result, Acti’Sow has been created. It is an ear tag accelerometer offering to know the daily time spent lying, standing and walking by a sow with a global accuracy close to 85 %. This project offers a better knowledge about sow behavior thanks to automatic feeders, connected drinkers, weighing scale and activity sensors. On average, the daily water consumption is 8.2 l/day/sow, but this result hides a huge variability close to 50 % when comparing a sow to another and 38 % for the same sow from a day to the next one. About their activity, an average sow spends 67 % of its time lying down, a bit more than 28 % standing up without moving and less than 5% walking. According to that, between the laziest one and the more active one, energy expenditure represent more than 500 g offeed. It means, with the same fixed objective of backfat thickness with these two sows, a farmer will need to give 500 g more feed/day for the very active sow. Early warning system for lameness issues was the other main result of this study. Through the use of watering and feeding behavior (number of visits per day, time of each visit, quantity of water/feed consumed, access rank to the feeder), individual weight and activity level, we built a first model able to individually predict lameness issue 24 hours before the farmer can observe it. The accuracy is close to 77 %. It means, that a cell phone app can alert farmers when a sow needs to be checked.Depuis la mise en groupe des truies gestantes, les éleveurs observent plus d’hétérogénéité de l’état corporel des truies lors de leur entrée en maternité impliquant plus de pertes de porcelets. Il est également plus difficile d’observer les problèmes d’aplombs dans des grands groupes de truies. La première étape de ce projet avait pour objectif le développement d’un capteur capable d’enregistrer le niveau d’activité individuel des truies logées en groupe conformément à la réglementation bien-être. Cette étude a donc permis la mise au point de l’Acti’Sow. Il s’agit d’un accéléromètre autonome, positionné à l’oreille des truies, qui permet de connaître le temps quotidien passé par les truies à rester couchée, debout ou encore à marcher. Par ailleurs, cette étude offre également une meilleure connaissance du comportement des truies grâce aux nourrisseurs et aux abreuvoirs connectés, à la station de pesée identifiée et aux capteurs d’activité. En moyenne, la consommation d'eau quotidienne d’une truie est de 8,2 l / jour mais ce résultat cache une variabilité conséquente de près de 50% lorsque l'on compare une truie par rapport à une autre et de 38% pour la même truie d'un jour à l'autre. À propos de leur activité, une truie « normale » passe 67% de son temps en position couchée, un peu plus de 28% en position debout sans bouger et moins de 5% en marche. Sachant cela, entre la plus fainéante et la plus active, la dépense énergétique liée à cette activité représente plus de 500 g d’aliment. Le système d'alerte précoce des problèmes de boiterie est l'autre principal objectif de cette étude. En utilisant les comportements alimentaire et hydrique (nombre de visites par jour, heure de chaque visite, quantité d’eau / d’aliments consommée, rang d’accès au nourrisseur / abreuvoirs), le poids individuel et le niveau d’activité, nous avons construit un premier modèle capable de prédire individuellement les boiteries 24 heures avant que l’agriculteur puisse l’observer. La précision est proche de 77

Perioperative risk of bleeding with antithrombotic agents in macular surgery: a national, prospective, multicentre study

International audiencePurpose To compare the risk of haemorrhagic complications in elective macular surgery between patients with no antithrombotic (AT) treatment (defined as patients with no history of AT therapy or who discontinued AT therapy) and patients who continued AT treatment during the surgery. Methods E-case report forms were prospectively recorded in a database before vitreoretinal surgery and 1 month after. Data on patient characteristics, surgical techniques, haemorrhagic complications and antithrombotic status were collected. Patients with retinal detachment, proliferative diabetic retinopathy and previous retinal haemorrhage were excluded. Results A total of 748 procedures (single procedure in one eye per patient) were performed between January and May 2019. Among them, 202 patients (27.0%) were treated with antithrombotic therapy at the time of surgery: 19.5% with antiplatelet agents (n = 146), 6.3% with anticoagulants (n = 47) including 3.2% (n = 24) patients treated with novel oral anticoagulants, 0.8% (n = 6) with anticoagulants and antiplatelet agents, and 0.4% (n = 3) with heparin. Overall, 92 patients (12.3%) developed one or more haemorrhagic complications, of which 63 (11.5%) and 29 (14.4%) were in the non-AT and AT group, respectively. The multivariate logistic regression model showed no difference between AT treatment groups regarding ocular bleeding complications (odds ratio [OR] 1.2, 95% confidence interval (CI) [0.7-2.2], p = 0.54). Conclusion No cases of uncontrolled or severe perioperative haemorrhage in patients continuing antithrombotic agents were reported in this selected population. For the majority of the patients taking antiplatelets or anticoagulants, these agents could be safely continued during macular surgery

Management of Patients with Diabetic Macular Edema Switched from Dexamethasone Intravitreal Implant to Fluocinolone Acetonide Intravitreal Implant

International audienceTo assess anatomical and functional outcomes after switching from dexamethasone implant (DEXi) to fluocinolone acetonide implant (FAci) in 113 diabetic macular edema eyes, a multicentric retrospective observational study was conducted. Seventy-five eyes (73.5%) were switched 1–8 weeks after their last DEXi. The mean best-corrected visual acuity improved to 59.8 letters at month 4 and remained stable during the follow-up. The mean central macular thickness (CMT) significantly decreased during the follow-up, with a minimum of 320.9 μm at month 3. The baseline CMT was higher in eyes that received the last DEXi >8 weeks versus 8 weeks before the switch. Switching from DEXi to FAci in DME is effective and safe. A short time between the last DEXi and the first FAci reduced CMT fluctuations and the need for early additional treatments

Acta Ophthalmol

PURPOSE: To report visual and anatomical outcomes and determine predictors of good visual acuity (VA) recovery after macula-off rhegmatogenous retinal detachment (RD). METHODS: Prospective multicentre study including 115 eyes from 115 patients successfully operated on for RD, with assessment of VA and spectral-domain optical coherence tomography (SD-OCT) macular images at 1, 3, 6 and 12 months after surgery. RESULTS: Over the follow-up period, VA significantly improved from median [IQR] 62 [46; 72] ETDRS letters at 1 month to 75 [67; 80] ETDRS letters at 12 months (p \textbackslashtextless 0.001) with a concomitant decreased number of eyes with any SD-OCT lesions (p \textbackslashtextless 0.001). The presence of subretinal fluid (SRF) significantly decreased (p \textbackslashtextless 0.001), as did the number of photoreceptor (PR) layer lesions (p = 0.04). At 12 months, lesions in the PR layer and poor VA recovery were significantly associated with a longer time to surgery (p = 0.007 and p \textbackslashtextless 0.001, respectively). The rate of patients without PR lesions increased from 40.9% at 1 month to 60.0% at 6 months and 73.9% at 12 months (p \textbackslashtextless 0.001). The incidence of epiretinal membrane (ERM) significantly increased (p \textbackslashtextless 0.001), while cystoid macular oedema (CME) remained stable over time. Visual acuity (VA) at 3 months postoperatively was a good reflection of final VA recovery (p \textbackslashtextless 0.001). CONCLUSION: Visual acuity (VA) improved in parallel with the decreasing number of eyes with SD-OCT lesions after macula-off rhegmatogenous RD. A long time to surgery was the only preoperative factor associated with poor VA recovery after retinal detachment surgery

PRIMA subretinal wireless photovoltaic microchip implantation in non-human primate and feline models

International audiencePURPOSE:To evaluate the surgical technique for subretinal implantation of two sizes of PRIMA photovoltaic wireless microchip in two animal models, and refine these surgical procedures for human trials.METHODS:Cats and Macaca fascicularis primates with healthy retina underwent vitrectomy surgery and were implanted with subretinal wireless photovoltaic microchip at the macula/central retina. The 1.5mm PRIMA chip was initially studied in feline eyes. PRIMA implant (2mm,1.5mm sizes) arrays were studied in primates. Feasibility of subretinal chip implantation was evaluated with a newly-developed surgical technique, with surgical complications and adverse events recorded.RESULTS:The 1.5mm implant was placed in the central retina of 11 feline eyes, with implantation duration 43-106 days. The 1.5mm implant was correctly positioned into central macula of 11 primate eyes, with follow-up periods of minimum 6 weeks (n = 11), 2 years (n = 2), and one eye for 3 years. One primate eye underwent multi-chip 1.5mm implantation using two 1.5mm chips. The 2mm implant was delivered to 4 primate eyes. Optical coherence tomography confirmed correct surgical placement of photovoltaic arrays in the subretinal space in all 26 eyes. Intraoperative complications in primate eyes included retinal tear, macular hole, retinal detachment, and vitreous hemorrhage that resolved spontaneously. Postoperatively, there was no case of significant ocular inflammation in the 1.5mm implant group.CONCLUSIONS:We report subretinal implantation of 1.5mm and 2mm photovoltaic arrays in the central retina of feline and central macula of primate eyes with a low rate of device-related complications. The in vivo PRIMA implantation technique has been developed and refined for use for a 2mm PRIMA implant in ongoing human trial