Pub Date : 2026-01-01Epub Date: 2025-12-10DOI: 10.1016/j.jfo.2025.104711
H. Yıldırım , E. Sönmezay , B. Tugcu
<div><h3>Purpose</h3><div>We aimed to describe three cases of childhood cyclic esotropia and report the outcomes of botulinum toxin type A (BTA) treatment.</div></div><div><h3>Materials and methods</h3><div>Three children with cyclic esotropia manifesting in a 48-hour cycle were included in the study. BTA (5 IU) was injected into the medial rectus muscles.</div></div><div><h3>Results</h3><div>The first patient was a 9-year-old boy with esodeviation (55–50 PD at near and distance) beginning after phacoemulsification surgery for juvenile cataracts. Injection of BTA resulted in breaking the cycle, and a second BTA injection was performed for residual deviation. During the 6-year follow-up, he remained orthophoric with a stereoacuity of 40<!--> <!-->arcseconds. The second patient was a 9-year-old girl with latent nystagmus and anisometric amblyopia. She experienced diplopia and esotropia (65–45 PD at near and distance). After two BTA injections and 8 years of follow-up, she remained stable with a stereo acuity of 800 arcseconds. The third patient was a 5-year-old boy with a history of falls and right esotropia (40 PD at near and distance). Following a single BTA injection, he was found to be orthophoric with a 4-year follow-up.</div></div><div><h3>Conclusions</h3><div>Based on our cases, BTA injection was found to be an effective method for achieving long-term orthotropia. After breaking the cycle with the first BTA injection, recurrent injections may be useful for residual deviations. We believe that BTA injection should be considered the first-line treatment for cyclic esotropia.</div></div><div><h3>Objectif</h3><div>Nous décrivons trois cas d’ésotropie cyclique de l’enfant et en rapportons les résultats suite au traitement à la toxine botulique de type A (BTA).</div></div><div><h3>Matériel et méthodes</h3><div>Trois enfants atteints d’ésotropie cyclique se manifestant selon un cycle de 48<!--> <!-->h ont été inclus dans l’étude. Une dose de 5 UI de BTA a été injectée dans les muscles droits médiaux.</div></div><div><h3>Résultats</h3><div>Le premier patient était un garçon de 9 ans présentant une ésodéviation (55–50 PD de près et de loin) débutant après une chirurgie de phacoémulsification pour cataracte juvénile. L’injection de BTA a révélé une rupture du cycle et une deuxième injection de BTA a été réalisée pour une déviation résiduelle variable. Au cours des 6 années de suivi, elle est restée orthophorique avec une stéréoacuité de 40 secondes d’arc (arcsec). Le deuxième patient était une fillette de 9 ans avec un nystagmus latent et une amblyopie anisométrique. Elle avait une diplopie et une ésotropie (65–45 PD de près et de loin). Après deux injections de BTA avec un suivi de 8 ans, son état était stable avec une acuité stéréoscopique de 800 arcsecs. Le troisième patient était un garçon de 5 ans avec des antécédents de chute et une ésotropie droite (40 PD de près et de loin). Après une seule injection de BTA, il s’est avéré orthophorique avec u
{"title":"Management of childhood cyclic esotropia with botulinum toxin","authors":"H. Yıldırım , E. Sönmezay , B. Tugcu","doi":"10.1016/j.jfo.2025.104711","DOIUrl":"10.1016/j.jfo.2025.104711","url":null,"abstract":"<div><h3>Purpose</h3><div>We aimed to describe three cases of childhood cyclic esotropia and report the outcomes of botulinum toxin type A (BTA) treatment.</div></div><div><h3>Materials and methods</h3><div>Three children with cyclic esotropia manifesting in a 48-hour cycle were included in the study. BTA (5 IU) was injected into the medial rectus muscles.</div></div><div><h3>Results</h3><div>The first patient was a 9-year-old boy with esodeviation (55–50 PD at near and distance) beginning after phacoemulsification surgery for juvenile cataracts. Injection of BTA resulted in breaking the cycle, and a second BTA injection was performed for residual deviation. During the 6-year follow-up, he remained orthophoric with a stereoacuity of 40<!--> <!-->arcseconds. The second patient was a 9-year-old girl with latent nystagmus and anisometric amblyopia. She experienced diplopia and esotropia (65–45 PD at near and distance). After two BTA injections and 8 years of follow-up, she remained stable with a stereo acuity of 800 arcseconds. The third patient was a 5-year-old boy with a history of falls and right esotropia (40 PD at near and distance). Following a single BTA injection, he was found to be orthophoric with a 4-year follow-up.</div></div><div><h3>Conclusions</h3><div>Based on our cases, BTA injection was found to be an effective method for achieving long-term orthotropia. After breaking the cycle with the first BTA injection, recurrent injections may be useful for residual deviations. We believe that BTA injection should be considered the first-line treatment for cyclic esotropia.</div></div><div><h3>Objectif</h3><div>Nous décrivons trois cas d’ésotropie cyclique de l’enfant et en rapportons les résultats suite au traitement à la toxine botulique de type A (BTA).</div></div><div><h3>Matériel et méthodes</h3><div>Trois enfants atteints d’ésotropie cyclique se manifestant selon un cycle de 48<!--> <!-->h ont été inclus dans l’étude. Une dose de 5 UI de BTA a été injectée dans les muscles droits médiaux.</div></div><div><h3>Résultats</h3><div>Le premier patient était un garçon de 9 ans présentant une ésodéviation (55–50 PD de près et de loin) débutant après une chirurgie de phacoémulsification pour cataracte juvénile. L’injection de BTA a révélé une rupture du cycle et une deuxième injection de BTA a été réalisée pour une déviation résiduelle variable. Au cours des 6 années de suivi, elle est restée orthophorique avec une stéréoacuité de 40 secondes d’arc (arcsec). Le deuxième patient était une fillette de 9 ans avec un nystagmus latent et une amblyopie anisométrique. Elle avait une diplopie et une ésotropie (65–45 PD de près et de loin). Après deux injections de BTA avec un suivi de 8 ans, son état était stable avec une acuité stéréoscopique de 800 arcsecs. Le troisième patient était un garçon de 5 ans avec des antécédents de chute et une ésotropie droite (40 PD de près et de loin). Après une seule injection de BTA, il s’est avéré orthophorique avec u","PeriodicalId":14777,"journal":{"name":"Journal Francais D Ophtalmologie","volume":"49 1","pages":"Article 104711"},"PeriodicalIF":1.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145742831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01Epub Date: 2025-12-23DOI: 10.1016/j.jfo.2025.104714
I. Kaibi, Y. Maalej, M. Sehli, A. Abid, S. Gargouri, A. Trigui
<div><h3>Introduction</h3><div>The ocular manifestations of rickettsial diseases are polymorphic. The goal of our work was to characterize the ocular manifestations of rickettsial diseases and to determine the contribution of ophthalmic examination to the diagnosis.</div></div><div><h3>Methods</h3><div>We conducted a retrospective descriptive analysis including consecutive patients with ocular involvement from confirmed rickettsial disease after ruling out other infectious or inflammatory etiologies. Demographic, clinical, multimodal imaging (fluorescein angiography, optical coherence tomography [OCT]), and therapeutic intervention data were systematically analyzed.</div></div><div><h3>Results</h3><div>This study included 24 patients with serologically confirmed rickettsial ocular involvement (mean age 40 years; range 16–67). Presentation with ophthalmologic symptoms occurred in 54.2% (<em>n</em> <!-->=<!--> <!-->13), demonstrating unilateral (58.4%, <em>n</em> <!-->=<!--> <!-->14) or bilateral (41.7%, <em>n</em> <!-->=<!--> <!-->10) ocular involvement, totaling 34 affected eyes. Posterior uveitis predominated (70.5%, 24 eyes), while other significant ophthalmologic signs included fine keratic precipitates (17.6%, 6 eyes), retinitis (64.7%, 22 eyes), retinal vasculitis (20.6%, 7 eyes), and neuroretinitis (8.8%, 3 eyes). Systemic manifestations featured febrile episodes with cutaneous eruptions in 70.8% (<em>n</em> <!-->=<!--> <!-->17). All patients received antibiotic treatment. Oral corticosteroid therapy was added in 12.5% (<em>n</em> <!-->=<!--> <!-->3). Complete resolution of inflammation occurred after a mean follow-up of 3 months.</div></div><div><h3>Conclusion</h3><div>In our series, ocular manifestations in rickettsial infections presented symptomatically in only half of cases, with retinitis and retinal vasculitis emerging as the predominant findings. These observations highlight the importance of systematic posterior segment examination in suspected rickettsial cases to facilitate prompt diagnosis and therapeutic intervention.</div></div><div><h3>Introduction</h3><div>Les manifestations ophtalmologiques décrites au cours des rickettsioses sont polymorphes. Les objectifs de notre travail étaient de décrire les manifestations oculaires des rickettsioses et de déterminer l’apport de l’examen ophtalmologique dans le diagnostic.</div></div><div><h3>Méthodes</h3><div>Il s’agit d’une étude descriptive rétrospective qui avait inclus tous les patients ayant une atteinte oculaire rickettsienne confirmée et dont le bilan paraclinique avait permis d’exclure toute autre étiologie infectieuse ou inflammatoire. Les données de l’examen ophtalmologique, de l’angiographie à la fluorescéine, de la tomographie en cohérence optique et du traitement ont été recueillies.</div></div><div><h3>Résultats</h3><div>Nous avons inclus 24 patients ayant une atteinte oculaire rickettsienne confirmée. L’âge moyen de nos patients était de 40<!--> <!-->ans, allant de 16 à
{"title":"Epidemiological and clinical profiles of ocular involvement in rickettsiosis in southern Tunisia","authors":"I. Kaibi, Y. Maalej, M. Sehli, A. Abid, S. Gargouri, A. Trigui","doi":"10.1016/j.jfo.2025.104714","DOIUrl":"10.1016/j.jfo.2025.104714","url":null,"abstract":"<div><h3>Introduction</h3><div>The ocular manifestations of rickettsial diseases are polymorphic. The goal of our work was to characterize the ocular manifestations of rickettsial diseases and to determine the contribution of ophthalmic examination to the diagnosis.</div></div><div><h3>Methods</h3><div>We conducted a retrospective descriptive analysis including consecutive patients with ocular involvement from confirmed rickettsial disease after ruling out other infectious or inflammatory etiologies. Demographic, clinical, multimodal imaging (fluorescein angiography, optical coherence tomography [OCT]), and therapeutic intervention data were systematically analyzed.</div></div><div><h3>Results</h3><div>This study included 24 patients with serologically confirmed rickettsial ocular involvement (mean age 40 years; range 16–67). Presentation with ophthalmologic symptoms occurred in 54.2% (<em>n</em> <!-->=<!--> <!-->13), demonstrating unilateral (58.4%, <em>n</em> <!-->=<!--> <!-->14) or bilateral (41.7%, <em>n</em> <!-->=<!--> <!-->10) ocular involvement, totaling 34 affected eyes. Posterior uveitis predominated (70.5%, 24 eyes), while other significant ophthalmologic signs included fine keratic precipitates (17.6%, 6 eyes), retinitis (64.7%, 22 eyes), retinal vasculitis (20.6%, 7 eyes), and neuroretinitis (8.8%, 3 eyes). Systemic manifestations featured febrile episodes with cutaneous eruptions in 70.8% (<em>n</em> <!-->=<!--> <!-->17). All patients received antibiotic treatment. Oral corticosteroid therapy was added in 12.5% (<em>n</em> <!-->=<!--> <!-->3). Complete resolution of inflammation occurred after a mean follow-up of 3 months.</div></div><div><h3>Conclusion</h3><div>In our series, ocular manifestations in rickettsial infections presented symptomatically in only half of cases, with retinitis and retinal vasculitis emerging as the predominant findings. These observations highlight the importance of systematic posterior segment examination in suspected rickettsial cases to facilitate prompt diagnosis and therapeutic intervention.</div></div><div><h3>Introduction</h3><div>Les manifestations ophtalmologiques décrites au cours des rickettsioses sont polymorphes. Les objectifs de notre travail étaient de décrire les manifestations oculaires des rickettsioses et de déterminer l’apport de l’examen ophtalmologique dans le diagnostic.</div></div><div><h3>Méthodes</h3><div>Il s’agit d’une étude descriptive rétrospective qui avait inclus tous les patients ayant une atteinte oculaire rickettsienne confirmée et dont le bilan paraclinique avait permis d’exclure toute autre étiologie infectieuse ou inflammatoire. Les données de l’examen ophtalmologique, de l’angiographie à la fluorescéine, de la tomographie en cohérence optique et du traitement ont été recueillies.</div></div><div><h3>Résultats</h3><div>Nous avons inclus 24 patients ayant une atteinte oculaire rickettsienne confirmée. L’âge moyen de nos patients était de 40<!--> <!-->ans, allant de 16 à","PeriodicalId":14777,"journal":{"name":"Journal Francais D Ophtalmologie","volume":"49 1","pages":"Article 104714"},"PeriodicalIF":1.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145827712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01Epub Date: 2025-12-10DOI: 10.1016/j.jfo.2025.104724
Y. He , L. Li , J. Yuan
<div><h3>Objective</h3><div>To evaluate the clinical efficacy of intraoperative corneal releasing incisions for astigmatism correction in Catalys White Lux femtosecond laser-assisted cataract surgery and to compare the differences between intrastromal releasing incisions and anterior penetrating releasing incisions.</div></div><div><h3>Methods</h3><div>In this prospective study, 39 patients (39 eyes) with cataracts and corneal astigmatism of 0.75 D or greater were enrolled. Patients were randomly assigned to two groups based on the depth of the corneal releasing incision: Group A (intrastromal releasing incisions, with a depth of 60%) and Group B (anterior penetrating releasing incisions, with a depth of 80%). Visual acuity, correction of corneal astigmatism, and endothelial damage were compared between the two groups before and after surgery. Additionally, regression analyses were conducted on factors potentially affecting astigmatism correction, including age, corneal endothelium, and incision depth.</div></div><div><h3>Results</h3><div>All 39 patients (39 eyes) underwent successful surgery, with no adverse events such as corneal edema, perforation, or incision or intraocular infection occurring during or after the procedure. Postoperative uncorrected visual acuity improved significantly in both groups, with no statistically significant difference between them (<em>P</em> <!-->><!--> <!-->0.05). Astigmatism was corrected in all cases, with Group A showing more pronounced and earlier stabilization, although this difference was not statistically significant (<em>P</em> <!-->><!--> <!-->0.05). Endothelial damage was observed in all eyes; however, there was no significant difference between the groups at 1 week postoperatively (<em>P</em> <!-->><!--> <!-->0.05). At 1 month and 3 months postoperatively, a significant difference was noted (<em>P</em> <!--><<!--> <!-->0.05), with Group B exhibiting greater corneal damage than Group A. Logistic regression analysis indicated no significant correlation between patient age, corneal endothelium, and the success rate of astigmatism correction.</div></div><div><h3>Conclusion</h3><div>Catalys White Lux femtosecond laser-assisted cataract surgery with concurrent corneal releasing incisions for astigmatism correction is a safe and effective procedure. The intrastromal incision yields more stable postoperative outcomes and results in less corneal damage compared to the anterior penetrating incision.</div></div><div><h3>Objectif</h3><div>Évaluer l’efficacité clinique des incisions relaxantes cornéennes peropératoires pour la correction de l’astigmatisme en chirurgie de la cataracte assistée par le laser femtoseconde Catalys White Lux, et comparer les différences entre les incisions relaxantes intrastromales et les incisions relaxantes pénétrantes antérieures.</div></div><div><h3>Méthodes</h3><div>Dans cette étude prospective, 39 patients (39 yeux) atteints de cataracte et présentant un astigmatisme co
目的：评价Catalys White Lux飞秒激光辅助白内障手术术中角膜释放切口矫正散光的临床疗效，并比较角膜内释放切口与前穿透性释放切口的差异。方法：本前瞻性研究纳入39例（39只眼）白内障合并角膜散光≥0.75 D的患者。根据角膜释放切口深度将患者随机分为两组：A组（角膜内释放切口，深度60%）和B组（前穿性释放切口，深度80%）。比较两组患者手术前后的视力、角膜散光矫正情况及内皮损伤情况。此外，对年龄、角膜内皮、切口深度等可能影响散光矫正的因素进行回归分析。结果：所有39例患者（39只眼）手术成功，手术中或术后无角膜水肿、穿孔、切口或眼内感染等不良事件发生。两组术后未矫正视力均有明显改善，差异无统计学意义（P < 0.05）。所有病例的散光都得到了纠正，A组患者的散光更明显，稳定时间更早，但差异无统计学意义（P < 0.05）。所有眼均可见内皮损伤；术后1周各组间比较差异无统计学意义（P < 0.05）。结论：Catalys White Lux飞秒激光辅助白内障手术并发角膜释放切口进行散光矫正是一种安全有效的手术方法。与前穿透切口相比，间质内切口术后效果更稳定，角膜损伤更小。
{"title":"Catalys White Lux femtosecond laser-assisted corneal relaxing incisions for astigmatism correction in cataract surgery","authors":"Y. He , L. Li , J. Yuan","doi":"10.1016/j.jfo.2025.104724","DOIUrl":"10.1016/j.jfo.2025.104724","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the clinical efficacy of intraoperative corneal releasing incisions for astigmatism correction in Catalys White Lux femtosecond laser-assisted cataract surgery and to compare the differences between intrastromal releasing incisions and anterior penetrating releasing incisions.</div></div><div><h3>Methods</h3><div>In this prospective study, 39 patients (39 eyes) with cataracts and corneal astigmatism of 0.75 D or greater were enrolled. Patients were randomly assigned to two groups based on the depth of the corneal releasing incision: Group A (intrastromal releasing incisions, with a depth of 60%) and Group B (anterior penetrating releasing incisions, with a depth of 80%). Visual acuity, correction of corneal astigmatism, and endothelial damage were compared between the two groups before and after surgery. Additionally, regression analyses were conducted on factors potentially affecting astigmatism correction, including age, corneal endothelium, and incision depth.</div></div><div><h3>Results</h3><div>All 39 patients (39 eyes) underwent successful surgery, with no adverse events such as corneal edema, perforation, or incision or intraocular infection occurring during or after the procedure. Postoperative uncorrected visual acuity improved significantly in both groups, with no statistically significant difference between them (<em>P</em> <!-->><!--> <!-->0.05). Astigmatism was corrected in all cases, with Group A showing more pronounced and earlier stabilization, although this difference was not statistically significant (<em>P</em> <!-->><!--> <!-->0.05). Endothelial damage was observed in all eyes; however, there was no significant difference between the groups at 1 week postoperatively (<em>P</em> <!-->><!--> <!-->0.05). At 1 month and 3 months postoperatively, a significant difference was noted (<em>P</em> <!--><<!--> <!-->0.05), with Group B exhibiting greater corneal damage than Group A. Logistic regression analysis indicated no significant correlation between patient age, corneal endothelium, and the success rate of astigmatism correction.</div></div><div><h3>Conclusion</h3><div>Catalys White Lux femtosecond laser-assisted cataract surgery with concurrent corneal releasing incisions for astigmatism correction is a safe and effective procedure. The intrastromal incision yields more stable postoperative outcomes and results in less corneal damage compared to the anterior penetrating incision.</div></div><div><h3>Objectif</h3><div>Évaluer l’efficacité clinique des incisions relaxantes cornéennes peropératoires pour la correction de l’astigmatisme en chirurgie de la cataracte assistée par le laser femtoseconde Catalys White Lux, et comparer les différences entre les incisions relaxantes intrastromales et les incisions relaxantes pénétrantes antérieures.</div></div><div><h3>Méthodes</h3><div>Dans cette étude prospective, 39 patients (39 yeux) atteints de cataracte et présentant un astigmatisme co","PeriodicalId":14777,"journal":{"name":"Journal Francais D Ophtalmologie","volume":"49 1","pages":"Article 104724"},"PeriodicalIF":1.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145742838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01Epub Date: 2025-12-10DOI: 10.1016/j.jfo.2025.104712
G. Karataş , F. Kırık , M.E. Karataş , A. Çakır , H. Özdemir
<div><h3>Purpose</h3><div>To compare the diagnostic reasoning and case-based problem-solving abilities of ChatGPT o3-mini-high and DeepSeek-R1 in ophthalmological cases with text-based questions.</div></div><div><h3>Methods</h3><div>Fifty-five consecutive text-based case-solving questions from nine ophthalmology subspecialties were posed to two reasoning-capable LLMs, ChatGPT o3-mini-high and DeepSeek-R1. For each case, the multi-component diagnostic reasoning approach described by Elstein was applied. Overall diagnostic accuracy, diagnostic agreement between the models, reasoning competence, subspecialty-specific performance, and the tendency to request additional prompts were recorded. Two expert ophthalmologists then independently rated each model's diagnostic reasoning ability for all questions, using the Global Quality Score, a five-point scale (1<!--> <!-->=<!--> <!-->poor; 5<!--> <!-->=<!--> <!-->excellent).</div></div><div><h3>Results</h3><div>ChatGPT o3-mini-high correctly answered 80% of the questions, whereas DeepSeek-R1 achieved a correct response rate of 54.5% (<em>P</em> <!--><<!--> <!-->0.001), and Cohen's kappa coefficient was 0.462. ChatGPT o3-mini-high tended to request additional prompts for responses to fewer questions (2 vs. 12; <em>P</em>: 0.013). For both LLMs, the highest accuracy was observed in the retina/vitreous-related cases, while the lowest accuracy was noted in glaucoma-related cases. When Elstein's medical reasoning components were evaluated with the GQS, ChatGPT o3-mini-high achieved a median score of 4.5 (IQR 2.5–5.0), whereas DeepSeek-R1 achieved 2.5 (IQR 1.0–4.5) (<em>P</em> <!--><<!--> <!-->0.001). The weighted kappa was 0.407, indicating moderate agreement between the two models.</div></div><div><h3>Conclusion</h3><div>This study provides evidence that ChatGPT o3-mini-high demonstrates superior diagnostic accuracy and reasoning capabilities in the analysis of ophthalmologic cases compared to DeepSeek-R1.</div></div><div><h3>Objectif</h3><div>Comparer les capacités de raisonnement diagnostique et de résolution de problèmes basées sur des cas cliniques de ChatGPT o3-mini-high et DeepSeek-R1 dans des cas ophtalmologiques à l’aide de questions textuelles.</div></div><div><h3>Méthodes</h3><div>Cinquante-cinq questions consécutives de résolution de cas, issues de neuf sous-spécialités en ophtalmologie, ont été soumises à deux modèles de langage de grande envergure dotés de capacités de raisonnement, ChatGPT o3-mini-high et DeepSeek-R1. Pour chaque cas, une approche de raisonnement diagnostique multi-composante, telle que décrite par Elstein, a été appliquée. L’exactitude diagnostique globale, le degré d’accord entre les modèles, la compétence en raisonnement, les performances spécifiques à chaque sous-spécialité, ainsi que la tendance à solliciter des compléments d’information ont été enregistrés. Deux ophtalmologistes experts ont ensuite évalué indépendamment les capacités de raisonnement diagnostique de ch
{"title":"Comparative performance of ChatGPT o3-mini-high and DeepSeek-R1 in ophthalmology: An evaluation of diagnostic reasoning and case-based problem solving","authors":"G. Karataş , F. Kırık , M.E. Karataş , A. Çakır , H. Özdemir","doi":"10.1016/j.jfo.2025.104712","DOIUrl":"10.1016/j.jfo.2025.104712","url":null,"abstract":"<div><h3>Purpose</h3><div>To compare the diagnostic reasoning and case-based problem-solving abilities of ChatGPT o3-mini-high and DeepSeek-R1 in ophthalmological cases with text-based questions.</div></div><div><h3>Methods</h3><div>Fifty-five consecutive text-based case-solving questions from nine ophthalmology subspecialties were posed to two reasoning-capable LLMs, ChatGPT o3-mini-high and DeepSeek-R1. For each case, the multi-component diagnostic reasoning approach described by Elstein was applied. Overall diagnostic accuracy, diagnostic agreement between the models, reasoning competence, subspecialty-specific performance, and the tendency to request additional prompts were recorded. Two expert ophthalmologists then independently rated each model's diagnostic reasoning ability for all questions, using the Global Quality Score, a five-point scale (1<!--> <!-->=<!--> <!-->poor; 5<!--> <!-->=<!--> <!-->excellent).</div></div><div><h3>Results</h3><div>ChatGPT o3-mini-high correctly answered 80% of the questions, whereas DeepSeek-R1 achieved a correct response rate of 54.5% (<em>P</em> <!--><<!--> <!-->0.001), and Cohen's kappa coefficient was 0.462. ChatGPT o3-mini-high tended to request additional prompts for responses to fewer questions (2 vs. 12; <em>P</em>: 0.013). For both LLMs, the highest accuracy was observed in the retina/vitreous-related cases, while the lowest accuracy was noted in glaucoma-related cases. When Elstein's medical reasoning components were evaluated with the GQS, ChatGPT o3-mini-high achieved a median score of 4.5 (IQR 2.5–5.0), whereas DeepSeek-R1 achieved 2.5 (IQR 1.0–4.5) (<em>P</em> <!--><<!--> <!-->0.001). The weighted kappa was 0.407, indicating moderate agreement between the two models.</div></div><div><h3>Conclusion</h3><div>This study provides evidence that ChatGPT o3-mini-high demonstrates superior diagnostic accuracy and reasoning capabilities in the analysis of ophthalmologic cases compared to DeepSeek-R1.</div></div><div><h3>Objectif</h3><div>Comparer les capacités de raisonnement diagnostique et de résolution de problèmes basées sur des cas cliniques de ChatGPT o3-mini-high et DeepSeek-R1 dans des cas ophtalmologiques à l’aide de questions textuelles.</div></div><div><h3>Méthodes</h3><div>Cinquante-cinq questions consécutives de résolution de cas, issues de neuf sous-spécialités en ophtalmologie, ont été soumises à deux modèles de langage de grande envergure dotés de capacités de raisonnement, ChatGPT o3-mini-high et DeepSeek-R1. Pour chaque cas, une approche de raisonnement diagnostique multi-composante, telle que décrite par Elstein, a été appliquée. L’exactitude diagnostique globale, le degré d’accord entre les modèles, la compétence en raisonnement, les performances spécifiques à chaque sous-spécialité, ainsi que la tendance à solliciter des compléments d’information ont été enregistrés. Deux ophtalmologistes experts ont ensuite évalué indépendamment les capacités de raisonnement diagnostique de ch","PeriodicalId":14777,"journal":{"name":"Journal Francais D Ophtalmologie","volume":"49 1","pages":"Article 104712"},"PeriodicalIF":1.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145742841","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01Epub Date: 2025-12-11DOI: 10.1016/j.jfo.2025.104721
E. Salcedo, T. Torrent
{"title":"Insulin eye drops as an effective alternative in persistent nodular episcleritis","authors":"E. Salcedo, T. Torrent","doi":"10.1016/j.jfo.2025.104721","DOIUrl":"10.1016/j.jfo.2025.104721","url":null,"abstract":"","PeriodicalId":14777,"journal":{"name":"Journal Francais D Ophtalmologie","volume":"49 1","pages":"Article 104721"},"PeriodicalIF":1.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145742681","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01Epub Date: 2025-12-17DOI: 10.1016/j.jfo.2025.104731
P. Navarro-Torres, A. Romero-Titos
{"title":"Type 3 big bubble and interface hemorrhage in DALK: AS-OCT follow-up and management","authors":"P. Navarro-Torres, A. Romero-Titos","doi":"10.1016/j.jfo.2025.104731","DOIUrl":"10.1016/j.jfo.2025.104731","url":null,"abstract":"","PeriodicalId":14777,"journal":{"name":"Journal Francais D Ophtalmologie","volume":"49 1","pages":"Article 104731"},"PeriodicalIF":1.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145781167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01Epub Date: 2025-12-17DOI: 10.1016/j.jfo.2025.104717
H. Aboubakar , V.A. Dohvoma , S.R. Ebana Mvogo , J.A. Ndongo , G. Koki , E. Epee , C. Ebana Mvogo
<div><h3>But</h3><div>Étudier les aspects tomographiques de la macula des albinos et rechercher leur corrélation avec l’acuité visuelle.</div></div><div><h3>Patients et méthodes</h3><div>Nous avons réalisé une étude cas-témoins qui a inclus les sujets albinos (cas) et les mélanodermes (témoins), appariés en âge et en sexe. Tous les sujets ont bénéficié d’un examen ophtalmologique et de l’OCT maculaire de type spectral-domain (OCT-SD). Les données ont été analysées avec le logiciel SPSS version 22. Le seuil de significativité était <em>p</em> <!--><<!--> <!-->0,05.</div></div><div><h3>Résultats</h3><div>Au total, nous avons inclus 100 personnes (50 albinos et 50 mélanodermes). La moyenne d’âge était de 25,84<!--> <!-->±<!--> <!-->9,02 ans avec les extrêmes de 16 et 58 ans et la sex-ratio de 0,5. L’albinisme oculo-cutané de type 2 (AOC2) était prédominant (82 %). L’acuité visuelle moyenne de loin corrigée du groupe albinos était de 0,63 logMAR. L’épaisseur fovéolaire moyenne était de 281,16<!--> <!-->±<!--> <!-->10,55<!--> <!-->μm chez les albinos et de 196,86<!--> <!-->±<!--> <!-->19,14<!--> <!-->μm chez les mélanodermes ; (<em>p</em> <!--><<!--> <!-->0,00001). L’épaisseur parafovéale moyenne était de 282,61<!--> <!-->±<!--> <!-->13,49<!--> <!-->μm chez l’albinos et de 333,63<!--> <!-->±<!--> <!-->9,73<!--> <!-->μm chez le mélanoderme ; (<em>p</em> <!--><<!--> <!-->0,00001). L’acuité visuelle corrigée était corrélée à l’épaisseur parafovéale (<em>r</em> <!-->=<!--> <!-->−0,41 ; <em>p</em> <!--><<!--> <!-->0,0001). Tous les sujets albinos avaient une hypoplasie fovéolaire. La baisse de l’acuité visuelle était proportionnelle à la sévérité de l’hypoplasie fovéolaire.</div></div><div><h3>Conclusion</h3><div>Les sujets albinos présentent une hypoplasie fovéolaire qui est corrélée à leur acuité visuelle.</div></div><div><h3>Purpose</h3><div>To study the tomographic aspects of the macula in albinos and their correlation with visual acuity.</div></div><div><h3>Patients and method</h3><div>We conducted a case-control study including albinos (cases) and non-albinos (controls). They were age- and sex-matched. All subjects underwent an ophthalmological examination and spectral-domain macular OCT. Data were analyzed using SPSS version 22. The significance level was set at <em>P</em> <!--><<!--> <!-->0.05.</div></div><div><h3>Results</h3><div>We included 50 albinos (cases) and 50 non-albinos (controls). The mean age was 25.84<!--> <!-->±<!--> <!-->9.02, and the sex ratio 0.5. The mean corrected visual acuity of the albino group was 0.63 logMAR. The mean foveal thickness was 281.16<!--> <!-->±<!--> <!-->10.55<!--> <!-->μm for cases and 196.86<!--> <!-->±<!--> <!-->19.14<!--> <!-->μm for controls (<em>P</em> <!--><<!--> <!-->0.00001). The mean central macular thickness was 284.79<!--> <!-->±<!--> <!-->17.78<!--> <!-->μm and 256.17<!--> <!-->±<!--> <!-->17.78<!--> <!-->μm respectively in cases and controls (<em>P</em> <!--><<!--> <!-->0.00001
{"title":"Tomographie par cohérence optique maculaire du sujet albinos : étude cas-témoins à l’hôpital Central de Yaoundé","authors":"H. Aboubakar , V.A. Dohvoma , S.R. Ebana Mvogo , J.A. Ndongo , G. Koki , E. Epee , C. Ebana Mvogo","doi":"10.1016/j.jfo.2025.104717","DOIUrl":"10.1016/j.jfo.2025.104717","url":null,"abstract":"<div><h3>But</h3><div>Étudier les aspects tomographiques de la macula des albinos et rechercher leur corrélation avec l’acuité visuelle.</div></div><div><h3>Patients et méthodes</h3><div>Nous avons réalisé une étude cas-témoins qui a inclus les sujets albinos (cas) et les mélanodermes (témoins), appariés en âge et en sexe. Tous les sujets ont bénéficié d’un examen ophtalmologique et de l’OCT maculaire de type spectral-domain (OCT-SD). Les données ont été analysées avec le logiciel SPSS version 22. Le seuil de significativité était <em>p</em> <!--><<!--> <!-->0,05.</div></div><div><h3>Résultats</h3><div>Au total, nous avons inclus 100 personnes (50 albinos et 50 mélanodermes). La moyenne d’âge était de 25,84<!--> <!-->±<!--> <!-->9,02 ans avec les extrêmes de 16 et 58 ans et la sex-ratio de 0,5. L’albinisme oculo-cutané de type 2 (AOC2) était prédominant (82 %). L’acuité visuelle moyenne de loin corrigée du groupe albinos était de 0,63 logMAR. L’épaisseur fovéolaire moyenne était de 281,16<!--> <!-->±<!--> <!-->10,55<!--> <!-->μm chez les albinos et de 196,86<!--> <!-->±<!--> <!-->19,14<!--> <!-->μm chez les mélanodermes ; (<em>p</em> <!--><<!--> <!-->0,00001). L’épaisseur parafovéale moyenne était de 282,61<!--> <!-->±<!--> <!-->13,49<!--> <!-->μm chez l’albinos et de 333,63<!--> <!-->±<!--> <!-->9,73<!--> <!-->μm chez le mélanoderme ; (<em>p</em> <!--><<!--> <!-->0,00001). L’acuité visuelle corrigée était corrélée à l’épaisseur parafovéale (<em>r</em> <!-->=<!--> <!-->−0,41 ; <em>p</em> <!--><<!--> <!-->0,0001). Tous les sujets albinos avaient une hypoplasie fovéolaire. La baisse de l’acuité visuelle était proportionnelle à la sévérité de l’hypoplasie fovéolaire.</div></div><div><h3>Conclusion</h3><div>Les sujets albinos présentent une hypoplasie fovéolaire qui est corrélée à leur acuité visuelle.</div></div><div><h3>Purpose</h3><div>To study the tomographic aspects of the macula in albinos and their correlation with visual acuity.</div></div><div><h3>Patients and method</h3><div>We conducted a case-control study including albinos (cases) and non-albinos (controls). They were age- and sex-matched. All subjects underwent an ophthalmological examination and spectral-domain macular OCT. Data were analyzed using SPSS version 22. The significance level was set at <em>P</em> <!--><<!--> <!-->0.05.</div></div><div><h3>Results</h3><div>We included 50 albinos (cases) and 50 non-albinos (controls). The mean age was 25.84<!--> <!-->±<!--> <!-->9.02, and the sex ratio 0.5. The mean corrected visual acuity of the albino group was 0.63 logMAR. The mean foveal thickness was 281.16<!--> <!-->±<!--> <!-->10.55<!--> <!-->μm for cases and 196.86<!--> <!-->±<!--> <!-->19.14<!--> <!-->μm for controls (<em>P</em> <!--><<!--> <!-->0.00001). The mean central macular thickness was 284.79<!--> <!-->±<!--> <!-->17.78<!--> <!-->μm and 256.17<!--> <!-->±<!--> <!-->17.78<!--> <!-->μm respectively in cases and controls (<em>P</em> <!--><<!--> <!-->0.00001","PeriodicalId":14777,"journal":{"name":"Journal Francais D Ophtalmologie","volume":"49 1","pages":"Article 104717"},"PeriodicalIF":1.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145781175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-01-01Epub Date: 2025-12-17DOI: 10.1016/j.jfo.2025.104726
D.S. Choudhary , U. Vijay , J. Khan , K. Kumari , A. Choudhary , A. Dhakad
<div><h3>Purpose</h3><div>To study Bowman's membrane lenticule as a novel surgical method for treatment in cases of peripheral ulcerative keratitis.</div></div><div><h3>Method</h3><div>The study was a hospital-based, single center, prospective interventional study. The study was evaluated in 30 eyes of 30 patients associated with peripheral ulcerative keratitis (PUK). For treatment, Bowman's membrane (BM) lenticule was tucked under the edges of the lesion after formation of recess around gutter. Best-corrected visual acuity (BCVA), mean epithelization time (MET), and corneal contour were measured and compared.</div></div><div><h3>Results</h3><div>The study enrolled a total of 30 eyes of 30 patients associated with PUK, out of which 19 were males and 11 females. The mean age of patients in the study was 50.80<!--> <!-->±<!--> <!-->10.85<!--> <!-->years. The mean BCVA changed from 0.311<!--> <!-->±<!--> <!-->0.202 decimal units preoperatively to 0.118<!--> <!-->±<!--> <!-->0.127 decimal units postoperatively, the MET was 2.30<!--> <!-->±<!--> <!-->0.530<!--> <!-->weeks and the mean corneal thickness changed from a preoperative value of 233.60<!--> <!-->±<!--> <!-->115.138 microns to 433.667<!--> <!-->±<!--> <!-->46.571 microns postoperatively.</div></div><div><h3>Conclusion</h3><div>BM lenticule is a novel surgical technique which is very forcible and staunch method to treat patients suffering from PUK, including perforations. This treatment method adds to the thickness of the cornea reasonably sufficiently, reduces inflammation by acting as barrier between raw surface and inflammatory mediators, promotes nerve growth and reinforces healing process.</div></div><div><h3>Objectif</h3><div>Étudier des lenticules de couche de Bowman comme nouvelle méthode chirurgicale pour le traitement des kératites ulcéreuses périphériques.</div></div><div><h3>Méthode</h3><div>Il s’agit d’une étude interventionnelle prospective monocentrique, menée en milieu hospitalier. L’étude a porté sur 30 yeux de 30 patients atteints de kératite ulcéreuse périphérique (KUP). Pour le traitement, un lenticule de Bowman a été inséré sous les bords de la lésion après la création d’une poche. L’acuité visuelle corrigée (AVCC), le temps moyen d’épithélialisation (TME), et le contour cornéen ont été mesurés et comparés.</div></div><div><h3>Résultats</h3><div>L’étude a inclus 30 yeux de 30 patients atteints de KUP, dont 19 hommes et 11 femmes. L’âge moyen des patients était de 50,80<!--> <!-->±<!--> <!-->10,85<!--> <!-->ans. L’acuité visuelle corrigée moyenne (AVCM) est passée de 0,311<!--> <!-->±<!--> <!-->0,202 unités décimales en préopératoire à 0,118<!--> <!-->±<!--> <!-->0,127 unités décimales en postopératoire. La durée moyenne de convalescence (DMC) était de 2,30<!--> <!-->±<!--> <!-->0,530 semaines et l’épaisseur cornéenne moyenne est passée de 233,60<!--> <!-->±<!--> <!-->115,138 microns en préopératoire à 433,667<!--> <!-->±<!--> <!-->46,571 microns en postopératoire.</div></d
{"title":"Manually dissected Bowman's layer lenticule: Novel surgical technique for peripheral ulcerative keratitis and perforations","authors":"D.S. Choudhary , U. Vijay , J. Khan , K. Kumari , A. Choudhary , A. Dhakad","doi":"10.1016/j.jfo.2025.104726","DOIUrl":"10.1016/j.jfo.2025.104726","url":null,"abstract":"<div><h3>Purpose</h3><div>To study Bowman's membrane lenticule as a novel surgical method for treatment in cases of peripheral ulcerative keratitis.</div></div><div><h3>Method</h3><div>The study was a hospital-based, single center, prospective interventional study. The study was evaluated in 30 eyes of 30 patients associated with peripheral ulcerative keratitis (PUK). For treatment, Bowman's membrane (BM) lenticule was tucked under the edges of the lesion after formation of recess around gutter. Best-corrected visual acuity (BCVA), mean epithelization time (MET), and corneal contour were measured and compared.</div></div><div><h3>Results</h3><div>The study enrolled a total of 30 eyes of 30 patients associated with PUK, out of which 19 were males and 11 females. The mean age of patients in the study was 50.80<!--> <!-->±<!--> <!-->10.85<!--> <!-->years. The mean BCVA changed from 0.311<!--> <!-->±<!--> <!-->0.202 decimal units preoperatively to 0.118<!--> <!-->±<!--> <!-->0.127 decimal units postoperatively, the MET was 2.30<!--> <!-->±<!--> <!-->0.530<!--> <!-->weeks and the mean corneal thickness changed from a preoperative value of 233.60<!--> <!-->±<!--> <!-->115.138 microns to 433.667<!--> <!-->±<!--> <!-->46.571 microns postoperatively.</div></div><div><h3>Conclusion</h3><div>BM lenticule is a novel surgical technique which is very forcible and staunch method to treat patients suffering from PUK, including perforations. This treatment method adds to the thickness of the cornea reasonably sufficiently, reduces inflammation by acting as barrier between raw surface and inflammatory mediators, promotes nerve growth and reinforces healing process.</div></div><div><h3>Objectif</h3><div>Étudier des lenticules de couche de Bowman comme nouvelle méthode chirurgicale pour le traitement des kératites ulcéreuses périphériques.</div></div><div><h3>Méthode</h3><div>Il s’agit d’une étude interventionnelle prospective monocentrique, menée en milieu hospitalier. L’étude a porté sur 30 yeux de 30 patients atteints de kératite ulcéreuse périphérique (KUP). Pour le traitement, un lenticule de Bowman a été inséré sous les bords de la lésion après la création d’une poche. L’acuité visuelle corrigée (AVCC), le temps moyen d’épithélialisation (TME), et le contour cornéen ont été mesurés et comparés.</div></div><div><h3>Résultats</h3><div>L’étude a inclus 30 yeux de 30 patients atteints de KUP, dont 19 hommes et 11 femmes. L’âge moyen des patients était de 50,80<!--> <!-->±<!--> <!-->10,85<!--> <!-->ans. L’acuité visuelle corrigée moyenne (AVCM) est passée de 0,311<!--> <!-->±<!--> <!-->0,202 unités décimales en préopératoire à 0,118<!--> <!-->±<!--> <!-->0,127 unités décimales en postopératoire. La durée moyenne de convalescence (DMC) était de 2,30<!--> <!-->±<!--> <!-->0,530 semaines et l’épaisseur cornéenne moyenne est passée de 233,60<!--> <!-->±<!--> <!-->115,138 microns en préopératoire à 433,667<!--> <!-->±<!--> <!-->46,571 microns en postopératoire.</div></d","PeriodicalId":14777,"journal":{"name":"Journal Francais D Ophtalmologie","volume":"49 1","pages":"Article 104726"},"PeriodicalIF":1.1,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145781184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-12-03DOI: 10.1016/j.jfo.2025.104570
M. Zayani, S. Abada
<div><h3>Purpose</h3><div>To report a case of acute posterior multifocal placoid pigment epitheliopathy (APMPPE) complicated by a stroke, leading to the diagnoses of lupus anticoagulant and hypercysteinemia.</div></div><div><h3>Methods</h3><div>Case report.</div></div><div><h3>Results</h3><div>A 28-year-old man complained of blurry vision and red eyes. On exam, his visual acuity was 20/25 in both eyes. Slit lamp examination demonstrated anterior uveitis, vitritis and multifocal, yellowish, subretinal, placoid lesions within the posterior pole. On fundus fluorescein angiography (FFA), the placoid lesions appeared hypofluorescent in the early phases and became hyperfluorescent in the late frames. On indocyanine green angiography (ICGA), hypofluorescent spots were present across all phases of the exam. Spectral-domain optical coherence tomography (SDOCT) demonstrated disruption of the outer retinal and ellipsoid zone. These features were consistent with the diagnosis of APMPPE. A uveitis work-up was unremarkable. Treatment with dexamethasone eye drops was initiated. Eight weeks after initial presentation, the patient was admitted on the neurology service for an acute episode of right-sided weakness as well as dysarthria. Magnetic resonance imaging (MRI) showed a small subacute infarct in the left posterior limb of the internal capsule and a small aneurysm of the right middle cerebral artery. An extensive laboratory work-up revealed hypercysteinemia with lupus anticoagulant detected by diluted Russell Viper Venom Time (dRVVT). The patient was started on anticoagulant medication and a statin. His symptoms improved, and the neurological examination was normal at a follow-up visit three months later.</div></div><div><h3>Conclusion</h3><div>APMPPE is a well-established disease, and neurological complications are rare. Cerebral vasculitis and strokes are the most commonly reported neurological lesions. The search for antiphospholipid syndrome and hypercysteinemia in the first-line work-up of APMPPE should be considered.</div></div><div><h3>Objectif</h3><div>Décrire le cas d’un patient présentant une épithéliopathie en plaque compliquée d’un accident vasculaire cérébral révélateur d’un lupus anticoagulant et d’une hyperhomocystéinémie.</div></div><div><h3>Méthodes</h3><div>Étude d’un cas clinique.</div></div><div><h3>Résultats</h3><div>Un patient âgé de 28 ans consultait pour un flou visuel associé à une rougeur oculaire. À l’examen, son acuité visuelle était de 20/25 aux deux yeux. En lampe à fente, on notait une uvéite antérieure, une hyalite et des lésions en plaques jaunâtres, multifocales, de siège sous-rétinien au pôle postérieur. L’angiographie à la fluorescéine révélait des lésions placoïdes hypofluorescentes aux temps précoces et hyperfluorescentes aux temps tardifs. Sur l’angiographie au vert d’indocyanine, ces mêmes lésions restaient hypofluorescentes jusqu’aux temps tardifs. La tomographie par cohérence optique dans le domaine spectral (SDOCT)
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