14 research outputs found
Modifications de la composition en acides gras du meibum et de la surface oculaire de patients souffrant de dysfonctionnement meibomien aprĂšs traitement par minocycline
DIJON-BU MĂ©decine Pharmacie (212312103) / SudocPARIS-BIUM (751062103) / SudocSudocFranceF
Outcome of exudative aged-related macular degeneration (ARMD) after 3 intravitreal injections of bevacizumab
Purpose: To evaluate the efficacy of intravitreal injections of bevacizumab in exudative ARMD. Methods: Retrospective study including naive patients suffering from exudative ARMD whatever the type of neovascularisation. All the participants were treated with three monthly 1.25 mg intravitreal injections of bevacizumab.The primary objective was far and near visual acuity (VA) 1, 3 and 6 months after the third injection. The secondary objective was the residual activity of neovascularisation assessed with fluorescein and ICG angiography and retinal thickness evaluated with OCT3. Results 71 eyes of 66 patients were included. Neovascularisation was occult, visible or combined in 65%, 20% and 15% of the cases, respectively. A statistically significant improvement between pre and postâinjection VA (LogMAR) was observed one month after the third injection, 0.88±0.57 and 0.77±0.60, respectively, p=0.001). An active neovascularisation was still present at that time in 57.7% of the eyes and 34% at 6 months needing further bevacizumab injections (3.85±0.96 per eye). VA was similar at 1, 3 and 6 months (F71,2=1,54 ; p=0,46). A complication occurred in 3 eyes. Conclusion: Three bevacizumab intravitreal injections led to a significant VA improvement. However, more than half of the eyes had an active neovascularisation after these 3 injections
Analyse de la composition en acides gras du film lacrymal chez des patients souffrant de blépharite chronique, de syndrome sec et chez des patients normaux
National audienc
002 Ăvaluation de la toxicitĂ© des acides gras branchĂ©s sur des cellules conjonctivales en culture
Communication orale lors du 113e congrÚs de la Société Française d'Ophtalmologie.International audienc
Enophtalmie rĂ©vĂ©latrice dâun cancer du sein
National audienceIntroduction.â Hormis le classique syndrome de Claude-Bernard-Horner, les Ă©nophtalmies sont gĂ©nĂ©ralement en rapport avec des anomalies anatomiques de la rĂ©gion orbitaire (atĂ©lectasie du sinus maxillaire, varices orbitaires, aplasie de la grande aile du sphĂ©noĂŻde) ou avec des rĂ©ductions du contenu orbitaire (lipodystrophie, atrophie de la graisse orbitaire, postradiothĂ©rapie, atrophie de lâhĂ©miface et sclĂ©rodermie linĂ©aire). Les mĂ©tastases orbitaires font partie des Ă©tiologies plus rares. Patients et mĂ©thodes.â Nous en rapportons ici une observation. Observation.â Une femme nĂ©e en 1947, sans antĂ©cĂ©dent, est vue en consultation pour une Ă©nophtalmie droite apparue progressivement, sans autre signe clinique associĂ©, mais responsable dâune gĂȘne esthĂ©tique. Il nây a pas de baisse de lâacuitĂ© visuelle et le bilan orthoptique rĂ©vĂšle une atteinte rĂ©fractive du muscle supĂ©rieur droit sans retentissement fonctionnel. Elle dĂ©crit depuis plusieurs mois des douleurs des cuisses au repos. LâIRM met en Ă©vidence une atrophie de la graisse orbitaire sans autre anomalie. On note la prĂ©sence dâANA mouchetĂ©s M1 Ă 1280 sans anti-ADN ni anti-ENA et dâanticorps anti-TPO sans dysthyroĂŻdie biologique. Le CH50 et les fractions C3 et C4 sont normaux. Il nâest toutefois notĂ© aucun autre Ă©lĂ©ment en faveur dâune maladie auto-immune ; dans le cadre de lâenquĂȘte Ă©tiologique, le scanner thoraco-abdominopelvien dĂ©couvre des remaniements du cadrant infĂ©ro-externe de la glande mammaire gauche et des ganglions infracentimĂ©triques du creux axillaire. La mammographie et lâĂ©chographie rĂ©vĂšlent un nodule mammaire gauche de 9 mm. La biopsie confirme un adĂ©nocarcinome canalaire infiltrant. La patiente bĂ©nĂ©ficie dâune segmentectomie mammaire gauche avec curage ganglionnaire puis dâune chimiothĂ©rapie adjuvante. Ă deux mois de la chirurgie, lâĂ©nophtalmie persiste. Discussion.â Une localisation orbitaire de diffĂ©rents cancers peut ĂȘtre Ă lâorigine dâune Ă©nophtalmie, en revanche celle-ci est exceptionnellement, comme dans cette observation, la premiĂšre manifestation du cancer. Lâorigine primitive mammaire est la plus frĂ©quente et doit donc ĂȘtre systĂ©matiquement Ă©voquĂ©e devant une Ă©nophtalmie inexpliquĂ©e. Lâinfiltrat rĂ©trobulbaire mĂ©tastatique aurait un potentiel rĂ©tractile expliquant lâenophtalmie. LâĂ©volution est le plus souvent insidieuse, lâĂ©nophtalmie apparaissant trĂšs progressivement. La motricitĂ© oculaire est progressivement altĂ©rĂ©e, en relation avec lâinfiltration intracĂŽnale et la diplopie est une cause frĂ©quente de consultation. LâIRM orbitaire ne permet pas toujours de visualiser lâinfiltration intracĂŽnale, en arriĂšre du pĂŽle postĂ©rieur de lâĆil. La biopsie nâest utile que lorsque le bilan est nĂ©gatif. Elle permet alors le plus souvent de mettre en Ă©vidence les cellules nĂ©oplasiques. Conclusion.â Ainsi, devant une Ă©nophtalmie unilatĂ©rale dâapparition progressive, il faut savoir Ă©voquer une origine nĂ©oplasique, et chez une femme, rechercher en premier lieu un cancer du sein. Pour en savoir plus [1] Hamedani M, et al. Surv Ophthalmol 2007;52:457â73
265 Modifications de la composition en acides gras du meibum et de la surface oculaire de patients souffrant de dysfonctionnement meibomien aprĂšs traitement par minocycline
International audienc
Differences in meibomian fatty acid composition in patients with meibomian gland dysfunction and aqueous-deficient dry eye
International audienceTo evaluate the differences in meibomian fatty acid composition in healthy subjects and in patients suffering from meibomian gland dysfunction or aqueous-deficient dry eye
The contribution of tear osmolarity measurement to ocular surface assessment in contact lens wearers
Purpose: To determine whether tear osmolarity using the TearLabTM Osmolarity System contributes to the assessment of the ocular surface in contact lens (CL) wearers.Methods: Data were collected from 44 CL wearers (28 tolerant and 16 intolerant) and 34 healthy subjects. Every patient underwent a thorough ophthalmic examination and tear osmolarity test, conjunctival impression cytology and meibomian lipid sampling. Symptoms, break-up time (BUT), tear osmolarity, conjunctival expression of HLA-DR and meibomian fatty acid composition were evaluated.Results: Tear osmolarity was significantly higher in the controls compared to tolerant and intolerant CL wearers (p=0.0007). Flow cytometry results expressed in antibody-binding capacity (ABC) units and percentage of positive cells revealed a significant difference between intolerant CL wearers group and control group (p<0.0001). Furthermore, comparisons between tolerant and intolerant CL wearers showed only a significant difference for mean fluorescence levels expressed in ABC (p<0.0001). Moreover, impression cytology analysis showed similar values in the tolerant CL wearers and the control group. Material of CL (hydrogel) was significantly correlated with the percentage of positive cells both in tolerant and intolerant CL wearers. BUT was significantly shorter in intolerant and tolerant CL wearers subjects than in healthy subjects (p<0.0001), whereas there was no significant difference in meibomian fatty acid composition (p=0.98) between groups.Conclusions: CL wear is responsible for ocular surface alterations whose patterns are very similar to those reported in dry eye syndrome. However, the yield of tear osmolarity with TearLabTM in assessing ocular surface disorders in CL wearers deserves further investigation
Ocular surface response in contact lens wearers
 Purpose: To evaluate the ocular surface changes induced by contact lens wear. Methods: Data of 7 tolerant contact lens wearers, 7 non-tolerant contact lens wearers and 7 healthy subjects were collected. Every patient underwent a thorough ophthalmic examination and tear osmolarity test, conjunctival impression cytology and meibomian lipid sampling. Symptoms, Break-Up Time (BUT), tear osmolarity, conjunctival expression of human leucocyte antigen (HLA) DR and meibomian fatty acid composition were evaluated. Results: Twenty one subjects (8 men and 13 women) were included (42 eyes). Symptoms reported by tolerant and non-tolerant contact lens wearers were as follows: superficial foreign body sensation (29% vs 21%), burning (14% vs 21%) and ocular dryness (28% vs 78%). No symptoms were reported by healthy subjects. There was no significant difference in tear osmolarity (p=0.63) and meibomian fatty acid composition (p=0.97) in both groups. Break-up time was significantly lower in tolerant (p<0.05) and non-tolerant (p<0.0001) contact lens wearers than in healthy subjects. The HLA-DR expression was significantly higher in non-tolerant (50%) contact lens wearers than in healthy subjects (16%) (p<0.01). Conclusions: Contact lens wear is responsible for ocular surface alterations which lead to intolerance. These patterns are very similar to those reported in dry eye symptoms
Ocular surface assessment in soft contact lens wearers; the contribution of tear osmolarity among other tests.
Purpose: To determine whether tear osmolarity contributes to the assessment of the ocular surface in soft contact lens (CL) wearers. Methods: Prospective, case-control series in 44 CL wearers (28 tolerant and 16 intolerant) and 34 healthy subjects. Every patient underwent a thorough ophthalmic examination with a tear osmolarity test (TearLab System), conjunctival impression cytology and meibomian lipid sampling. Symptoms, break-up time (BUT), tear osmolarity, conjunctival expression of HLA-DR and meibomian fatty acid composition were evaluated. Results: Tear osmolarity did not differ between controls and CL wearers (pâ=â0.23). Flow cytometry results expressed in antibody-binding capacity (ABC) units and percentage of positive cells revealed a significant difference between the intolerant CL wearer group and the control group (pâ<â0.0001). Comparisons between tolerant and intolerant CL wearers showed only a significant difference for mean fluorescence levels expressed in ABC units (pâ<â0.0001). The BUT was significantly shorter in intolerant and tolerant CL wearers subjects than in healthy subjects (pâ<â0.0001), whereas there was no significant difference in meibomian fatty acid composition (pâ=â0.99) between the two groups. Conclusion: Contact lens wear is responsible for ocular surface alterations whose patterns are very similar to those reported in early dry-eye syndrome. However, tear osmolarity was not modified in these selected CL wearers. The yield of tear osmolarity with TearLabâą in assessing ocular surface disorders in CL wearers deserves further investigation