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To evaluate the refractive outcomes of cataract surgery in patients with nanophthalmos. In this retrospective descriptive case series, the medical records of patients with nanophthalmos (axial length<20mm) who underwent cataract surgery between 2015 and 2024 by the same surgeon (J.-S. R) at the National Vision Hospital of Quinze-Vingts were analyzed. Collected data included clinical and biometric characteristics as well as intraoperative and postoperative complications. The intraocular lens power was used to calculate the predicted postoperative refractive error using seven biometric formulas (Barrett Universal II, SRK/T, Hoffer Q, Holladay I, Haigis, EVO, Hoffer QST). For each formula, both the numerical refractive error and the mean absolute error were calculated. Six eyes of six patients (3 women, 3 men) with a mean age of 63years were included in this study. The mean axial length was 17.2±1.17mm. The Barrett Universal II and Hoffer Q formulas showed better refractive accuracy (mean absolute prediction errors respectively 0.99±0.55 D; 1.38±0.59 D; 1.99±1.13 D). For the Holladay I, Hoffer QST, SRK/T, and Haigis formulas, the mean errors were higher (respectively 3.11±1.11 D; 3.48±1.51 D; 4.19±1.35 D; 6.65±0.95 D) and showed a greater tendency toward myopic shift. One patient experienced a postoperative decrease in visual acuity (from 0.3 to 0.4 logMAR). Despite the development of complex automated models, our study suggests that the Barrett Universal II and Hoffer Q formulas, both validated for short eyes, appear to remain reliable for patients with nanophthalmos.
To evaluate the performance of an innovative, noninvasive, rapid chromatic multifocal dynamic pupillometry protocol (mPFTCo) in detecting functional retinal changes in three chronic diseases: age-related maculopathy (ARM), age-related macular degeneration (AMD), and diabetic retinopathy (DR). A cohort of 222 participants (68 controls, 18 ARM, 79 AMD, 57 DR) was tested with mPFTCo. This one-minute test per eye used a multifocal stimulus covering 40° of the visual field, divided into nine regions, each periodically modulated in luminance, with chromatic alternation (blue, red, green, gray) every 15s. Regional and spectral pupillary responses were analyzed to characterize functional deficits. Group comparisons were performed using Student's t-tests and ROC curve analyses. Compared with controls, significant regional alterations were observed in all three diseases. In AMD, pupillary responses were reduced in central and paracentral regions, particularly under red stimulation (P<0.001). In ARM, a moderate paracentral deficit was observed with blue and green stimulation (P<0.005). In DR, a diffuse deficit affected the entire visual field across all colors (P<0.001). This brief, objective, well-tolerated test showed excellent diagnostic performance (AUC=1). mPFTCo enables rapid, noninvasive topographic assessment of retinal function. It effectively discriminates between pathological profiles and identifies subclinical alterations not detected by conventional visual tests, representing a promising tool for screening, monitoring, and functional evaluation of treatments in routine clinical practice.
To assess the prevalence of light-induced toxic effects on the ocular and palpebral regions in maritime professionals chronically exposed to light radiation in the Provence-Alpes-Côte d'Azur region and to compare the results to a non-overexposed population. The study also investigates risk factors for and protective factors against ocular phototoxicity in exposed individuals. Single-center, cross-sectional comparative analysis. The study included 77 maritime professionals (overexposed group) and 70 non-overexposed individuals (control group). Participants were examined between July 2023 and June 2024 at the ophthalmology department of Sainte-Anne Military Hospital. Cross-sectional comparative analysis was performed between the two groups. Participants underwent a clinical examination, including ocular imaging, focused on ocular conditions such as conjunctival lesions, cataracts, and macular changes linked to light overexposure, and completed questionnaires on sun exposure. The study found no connection between age-related macular degeneration (AMD) and solar overexposure but highlighted the significant role of light reflection from water in other ocular conditions. Four basal cell carcinomas were found in the exposed group, consistent with the pathogenesis of these skin cancers. A higher risk of conjunctival lesions (pinguecula and/or pterygium) and cortical cataracts was noted. Macular epithelial damage was linked to increased light exposure. Protective solar equipment reduced the risk of ocular damage in certain conditions. The PHOTOPPA study is the first to compare ocular pathologies related to light overexposure in maritime professionals. It confirms the increased risk of ocular conditions, emphasizing the importance of comprehensive sun protection to reduce light-induced ocular damage and possibly prevent AMD development.
Vergence disorders are generally treated by office-based vergence/accommodative therapy. Novel technologies now make it possible to include patients in their own care and increase efficiency. Eye movement ability analysis (EMAA) is a software designed to treat binocular vision disorders, combining the use of virtual reality (VR) and eye tracking. The objective of this study is to evaluate, in routine practice and in real-life settings, the safety and efficacy of EMAA in the rehabilitation of vergence disorders. Retrospectively, the elements of an orthoptic assessment (fusional vergences, near point of convergence [NPC], heterophoria, stereoacuity) performed by French orthoptists in their routine practice, were evaluated before and after rehabilitation by EMAA. Symptoms, adverse effects, compliance and use of telecare were also recorded. After vision therapy, 80% of participants had improved near positive fusional vergence by at least 10 prism diopters. More generally, fusional vergence (near positive: P<0.001; near negative: P=0.014), NPC (P<0.001) and symptoms improved (after rehabilitation, 94% were headache-free, 95% asthenopia-free and 96% eye pain-free). Seventy-two percent of patients completed their follow-up. Seventeen percent of rehabilitation sessions were carried out using telecare. No serious adverse events and very few non-serious adverse events (3%) were reported. This study demonstrates the safety and efficacy of EMAA.
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To study the epidemiological, clinical, and therapeutic aspects of a cohort of French patients with thyroid eye disease (TED). We conducted a retrospective, single-center study over a 4-year period, including all patients referred to our tertiary referral center for TED. Patients without TED or with incomplete data were excluded. A total of 100 patients were included (77% women), with a mean age of 43.5years (range: 25 to 90years). Among them, 47% were smokers, 16% had a personal history of autoimmune diseases, and 24% had a family history of autoimmune conditions. One-third of the patients were euthyroid at the time of consultation, and one-third had undergone radical thyroid treatment. The most common symptoms were upper eyelid retraction (48%) and exophthalmos (42%). In our cohort, 5% of patients had associated myasthenia, most often presenting with ptosis. Among these, 80% had pure ocular myasthenia. An active form (CAS≥3) was found in 15% of the patients, primarily treated with corticosteroid boluses. Six patients had severe forms with optic neuropathy, requiring medical and surgical management in the majority of cases. Approximately half of the patients underwent surgical management (orbital decompression, strabismus surgery, eyelid surgery), either alone or sequentially. TED is a condition predominantly affecting women, typically presenting with upper eyelid retraction and/or exophthalmos. Approximately 5% of patients have associated myasthenia and compressive optic neuropathy. An active/inflammatory form is present in 15% of patients.
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To review the literature on neuro-ophthalmologic complications associated with radiofrequency ablation (RFA) for trigeminal neuralgia (TN) and, in light of current evidence, to present and analyze a case of combined autonomic and cranial neuropathy following the procedure. A narrative literature review was conducted on neuro-ophthalmologic complications associated with RFA for TN. Published reports were analyzed with attention to involved cranial nerves, mechanisms of injury, clinical presentation, management strategies, and visual outcomes. In addition, a single case was retrospectively reviewed based on medical records, including clinical findings, neuro-ophthalmologic examination data, treatment interventions, and follow-up documentation. Data were synthesized in the context of existing literature. Published literature indicates that neuro-ophthalmologic complications after RFA for TN are rare but may occur due to the proximity of the trigeminal ganglion to adjacent cranial and autonomic structures. Most reported cases involve isolated cranial nerve deficits, whereas simultaneous multiple nerves and sympathetic involvement is uncommon. In the present case, a 66-year-old female developed diplopia, corneal anesthesia, and anisocoria following RFA. Neuro-ophthalmologic evaluation demonstrated right trochlear nerve palsy, ophthalmic nerve (V1) dysfunction, and sympathetic involvement. Conservative management was initiated. During follow-up, ophthalmic nerve dysfunction resolved by week five, while full recovery of trochlear and sympathetic dysfunction occurred by month five. Radiofrequency ablation for TN is generally safe but may rarely cause neuro-ophthalmologic complications due to proximity of cranial and autonomic structures. Early recognition and ophthalmologic follow-up are essential. This case highlights rare combined trochlear, ophthalmic, and sympathetic involvement after RFA.
To evaluate the differences and interchangeability of white-to-white (WTW) distance and anterior chamber depth (ACD) measurements among three devices: Anterion (Heidelberg Engineering, Heidelberg, Germany), IOL Master 700 (Carl Zeiss Meditec, Jena, Germany), and Pentacam (Oculus, Wetzlar, Germany). A randomized sample of 275 healthy subjects was selected. Measurements were taken of the right eye of all participants. WTW and ACD were measured using Anterion, Pentacam, and IOL Master 700. Differences between instruments were analyzed using the Friedman test, and device interchangeability was assessed using the Bland-Altman plots. A total of 275 eyes of 275 subjects were evaluated. With regard to WTW analysis, statistically significant differences were found when comparing the three instruments (P<0.001). The highest values were obtained with IOL Master 700, followed by Anterion and Pentacam. For ACD, significant differences were also found among the three devices (P<0.001). The highest ACD measurements were obtained with Anterion, followed by Pentacam and IOL Master 700. Significant differences in WTW and ACD measurements were found when comparing the three devices. The clinical relevance of these differences and the interchangeability of the instruments should be individually considered.
To develop an international consensus on terminology for adult pathologic myopia based on contemporary imaging, with emphasis on optical coherence tomography (OCT). An international panel of 32 experts in myopia and retinal disease from 13 countries was assembled. The writing group reviewed existing classification systems and the published literature and developed candidate statements organized into six domains: atrophic, mechanical expansion, tractional, neovascular, optic nerve, and retinal detachment. A Delphi process with anonymous voting was used. Consensus was defined a priori as ≥75% agreement (Agree or Strongly Agree). Statements not reaching consensus were revised based on structured feedback and re-voted. Forty-four consensus statements were developed that met the predefined threshold for agreement after iterative revision. The mean agreement was 90.6% (median 92.5%). The framework emphasizes structural definitions derived from OCT and multimodal imaging rather than fundus appearance. The nomenclature system organizes manifestations of pathologic myopia into six domains reflecting distinct but often overlapping anatomical and biomechanical processes. Key elements include the central role of choroidal thinning in visual function, recognition of focal chorioretinal loss as a structural endpoint across multiple pathways, and integration of mechanical, tractional, and vascular mechanisms in disease expression. This consensus establishes a unified, imaging-based lexicon for adult pathologic myopia grounded in structural anatomy and contemporary imaging. By organizing disease features into six domains and defining entities using OCT, the framework reduces ambiguity, improves reproducibility, and provides a foundation for future classification systems, clinical studies, and therapeutic trials.
Macular edema is a significant cause of vision loss in uveitis. Effective control of underlying inflammation is essential to treating macular edema in non-infectious uveitis, typically with corticosteroids. In this study, we examine the use of sequential dexamethasone and fluocinolone acetonide steroid intravitreal implants to promote rapid improvement and sustained control in non-infectious uveitic macular edema. Sixteen eyes from eleven patients with recurrent uveitic macular edema who received sequential intravitreal dexamethasone and fluocinolone acetonide implants were studied via retrospective chart review in 3-month intervals over a 24-month observation window. All patients had received at least one prior dexamethasone implant, which was used both therapeutically and to assess the intraocular-pressure response to an intravitreal corticosteroid before proceeding to the fluocinolone acetonide implant. The primary outcome was the recurrence rate of clinically significant macular edema after treatment. Chart review was performed to identify recurrences and need for additional anti-inflammatory treatment. We also evaluated change in visual acuity, intraocular pressure, and central subfield thickness throughout the study duration. Twelve eyes (75%) did not experience a recurrence in clinically significant macular edema after treatment with both intravitreal injections. The rate of retreatment (25%) was reduced compared to patients who only received dexamethasone. There was a rapid and sustained improvement in macular edema, though there was no statistically significant improvement in visual acuity. Intraocular pressure initially increased but stabilized after the first 3-month interval. Sequential administration of dexamethasone and fluocinolone acetonide intravitreal implants reduces the rate of significant macular edema recurrences in non-infectious uveitis. There is a significant quantitative improvement in macular edema, and further studies may demonstrate a noticeable benefit in visual acuity and quality of life with fewer retreatments.
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To describe qualitative optical coherence tomography angiography (OCTA) changes in age-related macular degeneration (AMD) macular neovascularization (MNV) treated with faricimab. This was a retrospective study including 30 eyes with active AMD-related Type 1 MNV, resistant to traditional anti-vascular endothelial growth factor (VEGF) agents, receiving intravitreal faricimab. Complete ophthalmological evaluation, consisting of best corrected visual acuity (BCVA), traditional multimodal imaging, and OCTA scans, was performed at baseline and at the last examination. OCTA high-flow networks corresponding to MNV were qualitatively and quantitatively analyzed to assess morphological changes. Furthermore, the correlation between MNV OCTA pattern and presence/absence of exudation signs on spectral domain OCT (SD-OCT) was evaluated. On baseline OCTA, 11/30 eyes showed a sea fan pattern, 13/30 a medusa pattern, and the remaining 6/30 an indistinct pattern. At the last follow-up, in 12/30 eyes, the MNV pattern remained unchanged. In these 12 cases, SD-OCT revealed the exudative signs in 11/12 eyes (one with intra-retinal fluid, ten with sub-retinal fluid) at the final evaluation. In the remaining 18/30, MNV pattern changed to a dead tree type with no exudation signs at the last follow-up in 17/18 eyes. The mean interval of intravitreal injection was significantly extended from 4 to 7.2±2.3 weeks (p < 0.0001) with BCVA stabilization. At the last follow-up the dead tree OCTA pattern resulted to be significantly related to the absence of exudation sings (p < 0.0001). Our study reveals that the initial MNV pattern frequently moves toward a dead tree pattern after switching from traditional anti-VEGF agents to faricimab therapy.
To characterize childhood non-infectious uveitis (NIU) patients who developed demyelinating lesions during TNF-α blocker therapy and to investigate potential risk factors associated with this pathology. This retrospective single-center cohort study included pediatric NIU patients treated with TNF-α blockers who had undergone brain magnetic resonance imaging (MRI) at any time during the course of the disease. Demographic and clinical characteristics, the ocular complication score (OCS), and imaging data were reviewed. The study cohort included 45 patients with a mean age of 13.8±4.46 (5-22) years. The mean duration of TNF-α blocker treatment within the study period was 44±27.9 months. The OCS did not significantly change from baseline to final visit (P=0.10). Brain MRI was performed before initiation of TNF-α blocker therapy in 21 (46.6%) patients and during treatment in 24 (53.4%). All demyelinating lesions were detected on MRIs obtained after TNF-α blocker initiation (median: 52 months; range 18-84). Central nervous system (CNS) demyelinating lesions were identified in 4 (8.8%) patients; two were diagnosed with multiple sclerosis, and two with radiologically isolated syndrome. CNS demyelination was uncommon but clinically relevant in pediatric NIU patients receiving TNF-α blockers. Demyelinating lesions may be associated with pars planitis, neurologic symptoms, and/or a family history of demyelinating disease. During treatment, CNS MRI may be considered when new neurologic symptoms accompany an uncontrolled uveitis flare, particularly in the presence of newly developed ocular inflammatory findings.
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The goal of this study was to assess the agreement between visual field (VF) and probability maps generated from swept-source optical coherence tomography (SS-OCT) in various stages of glaucoma. This cross-sectional study included patients who underwent VF testing and SS-OCT at the same visit. Patients were classified into early, moderate, and advanced glaucoma according to the Hodapp-Parrish-Anderson criteria. The VF pattern deviation maps were partitioned into 10 defined areas, while the probability maps were divided into 6 defined areas. Areas exhibiting significant defects on the probability map were compared with the corresponding VF defect areas. The agreement between VF and the probability map results was assessed. In early glaucoma, moderate agreement was found between the peripapillary defect on the probability map and the nasal step defect on the VF in both hemifields. As the glaucoma stage progressed, the number of areas showing agreement and the level of agreement between the areas increased. In moderate glaucoma patients, the areas of agreement in both hemifields correspond to the arcuate scotoma pattern. In advanced glaucoma, the probability map and VF showed substantial and almost perfect agreement between many areas corresponding to the ring scotoma pattern. In early, moderate, and advanced glaucoma, a significant agreement was found between the defects on the VF and on the probability map. These findings suggest that probability maps may serve as a promising complementary tool in the assessment of patients with glaucoma and in supporting the evaluation of disease progression, particularly in cases where reliable VFs cannot be obtained.