Pub Date : 2025-02-01DOI: 10.1016/j.jfo.2024.104385
A. Hage , P. Bastelica , A. Majoulet , M. Laurent , M. Sahyoun , N. Bouheraoua , V. Borderie , J.-P. Nordmann , M. Paques , A. Labbé , C. Baudouin
<div><h3>Purpose</h3><div>Acute postoperative endophthalmitis (APE) is a rare but severe complication of cataract surgery. During the most recent decades, the use of povidone-iodine (PVI) before surgery combined with intracameral cefuroxime has drastically reduced the incidence of endophthalmitis. The goal of this study is to describe the changes in endophthalmitis rates after cataract surgery over the past two decades in a large tertiary ophthalmology center.</div></div><div><h3>Methods</h3><div>A single-center retrospective descriptive study was conducted in the Quinze-Vingts National Ophthalmology Hospital (Paris, France). We included all eyes that underwent cataract surgery between 2000 and 2022. Cases of APE following cataract surgery were reported. The main outcome was the change in yearly incidence of APE. Rates were compared before and after the following events: application of a prophylactic protocol for local anesthesia, use of intracameral cefuroxime, and use of 2% lidocaine gel.</div></div><div><h3>Results</h3><div>We included 178,752 cataract procedures in the study. A total of 49 cases of APE were reported between 2000 and 2022 (0.027%). Endophthalmitis rates progressively decreased, particularly after the introduction of intracameral cefuroxime in surgical practice in 2011. Since an adequate protocol for topical anesthesia was adopted, and intracameral cefuroxime was used systematically, rates of APE decreased and remained as low as 0.007% for the past decade, even though the number of yearly cataract procedures almost doubled.</div></div><div><h3>Conclusion</h3><div>The incidence of endophthalmitis after cataract surgery has significantly decreased over the past twenty-three years in our tertiary care center. The use of PVI before surgery along with systematic intracameral cefuroxime has allowed us to achieve very low rates of endophthalmitis.</div></div><div><h3>Objectif</h3><div>L’endophtalmie postopératoire aiguë (EPA) est une complication de la chirurgie de cataracte rare mais sévère. Durant les dernières décennies, l’utilisation de povidone-iodée avant la chirurgie, associée à la céfuroxime intracamérulaire ont drastiquement diminuée l’incidence des endophtalmie. L’objectif est de décrire l’évolution des taux d’endophtalmie après chirurgie de la cataracte durant les 23 dernières années dans un centre ophtalmologique tertiaire.</div></div><div><h3>Méthode</h3><div>Une étude descriptive rétrospective monocentrique a été menée à l’hôpital national de la vision des Quinze-Vingts (Paris, France). Nous avons inclus tous les yeux opérés de cataracte entre 2000 et 2022. Les cas d’EPA après chirurgie de cataracte ont été rapportés. Le critère de jugement principal était l’évolution de l’incidence annuelle des EPA. Les taux ont été comparés avant et après les évènements suivants : introduction d’un protocole d’anesthésie locale, utilisation de céfuroxime intracamérulaire et application de gel de lidocaïne 2 %.</div></div><div><h3>Résul
{"title":"Changes in rates of endophthalmitis after cataract surgery over the last 23 years","authors":"A. Hage , P. Bastelica , A. Majoulet , M. Laurent , M. Sahyoun , N. Bouheraoua , V. Borderie , J.-P. Nordmann , M. Paques , A. Labbé , C. Baudouin","doi":"10.1016/j.jfo.2024.104385","DOIUrl":"10.1016/j.jfo.2024.104385","url":null,"abstract":"<div><h3>Purpose</h3><div>Acute postoperative endophthalmitis (APE) is a rare but severe complication of cataract surgery. During the most recent decades, the use of povidone-iodine (PVI) before surgery combined with intracameral cefuroxime has drastically reduced the incidence of endophthalmitis. The goal of this study is to describe the changes in endophthalmitis rates after cataract surgery over the past two decades in a large tertiary ophthalmology center.</div></div><div><h3>Methods</h3><div>A single-center retrospective descriptive study was conducted in the Quinze-Vingts National Ophthalmology Hospital (Paris, France). We included all eyes that underwent cataract surgery between 2000 and 2022. Cases of APE following cataract surgery were reported. The main outcome was the change in yearly incidence of APE. Rates were compared before and after the following events: application of a prophylactic protocol for local anesthesia, use of intracameral cefuroxime, and use of 2% lidocaine gel.</div></div><div><h3>Results</h3><div>We included 178,752 cataract procedures in the study. A total of 49 cases of APE were reported between 2000 and 2022 (0.027%). Endophthalmitis rates progressively decreased, particularly after the introduction of intracameral cefuroxime in surgical practice in 2011. Since an adequate protocol for topical anesthesia was adopted, and intracameral cefuroxime was used systematically, rates of APE decreased and remained as low as 0.007% for the past decade, even though the number of yearly cataract procedures almost doubled.</div></div><div><h3>Conclusion</h3><div>The incidence of endophthalmitis after cataract surgery has significantly decreased over the past twenty-three years in our tertiary care center. The use of PVI before surgery along with systematic intracameral cefuroxime has allowed us to achieve very low rates of endophthalmitis.</div></div><div><h3>Objectif</h3><div>L’endophtalmie postopératoire aiguë (EPA) est une complication de la chirurgie de cataracte rare mais sévère. Durant les dernières décennies, l’utilisation de povidone-iodée avant la chirurgie, associée à la céfuroxime intracamérulaire ont drastiquement diminuée l’incidence des endophtalmie. L’objectif est de décrire l’évolution des taux d’endophtalmie après chirurgie de la cataracte durant les 23 dernières années dans un centre ophtalmologique tertiaire.</div></div><div><h3>Méthode</h3><div>Une étude descriptive rétrospective monocentrique a été menée à l’hôpital national de la vision des Quinze-Vingts (Paris, France). Nous avons inclus tous les yeux opérés de cataracte entre 2000 et 2022. Les cas d’EPA après chirurgie de cataracte ont été rapportés. Le critère de jugement principal était l’évolution de l’incidence annuelle des EPA. Les taux ont été comparés avant et après les évènements suivants : introduction d’un protocole d’anesthésie locale, utilisation de céfuroxime intracamérulaire et application de gel de lidocaïne 2 %.</div></div><div><h3>Résul","PeriodicalId":14777,"journal":{"name":"Journal Francais D Ophtalmologie","volume":"48 2","pages":"Article 104385"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142828537","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 : 2025-02-01DOI: 10.1016/j.jfo.2024.104382
A. Kassotis , J. Shabto , S. Stevens , A. Coombs , M. Kazim
Objective
Hyperbaric oxygen therapy (HBOT) has emerged as a versatile tool in the management of an array of medical conditions, including tissue ischemia and delayed wound healing. Despite the incorporation of HBOT in other medical fields, HBOT is not routinely utilized in the field of ophthalmic plastic and reconstructive periorbital surgery.
Design
Case series.
Participants
A series of oculofacial cases treated with adjuvant HBOT is reviewed. The authors describe a 47-year-old man presenting with vision loss secondary to a retinal vascular event one day after orbital surgery, a 38-year-old woman presenting with acute hyaluronic acid filler-associated blindness, and a 44-year-old man presenting with orbital necrotizing fasciitis after minor trauma.
Results
In each case, HBOT was utilized as adjuvant management, with favorable outcomes despite a guarded initial prognosis.
Conclusions
HBOT shows promise as part of a treatment regimen for a variety of conditions in oculoplastic and reconstructive surgery.
Objectif
L’oxygénothérapie hyperbare (OHB) est devenue un outil polyvalent dans la prise en charge d’un large éventail de pathologies, notamment l’ischémie tissulaire et le retard de cicatrisation des plaies. Malgré l’incorporation de l’OHB dans d’autres domaines médicaux, l’OHB n’est pas systématiquement utilisée dans le domaine de la chirurgie ophtalmique plastique et reconstructive périorbitaire.
Méthode/participants
Une série de cas oculofaciaux traités avec OHB adjuvante est passée en revue. Les auteurs décrivent un homme de 47 ans présentant une perte de vision secondaire à un événement vasculaire rétinien un jour après une chirurgie orbitaire, une femme de 38 ans atteinte d’une cécité aiguë associée aux produits de comblement à l’acide hyaluronique et un homme de 44 ans affichant une fasciite nécrosante orbitaire après un traumatisme mineur.
Résultats
Dans chaque cas, l’OHB a été utilisée comme traitement adjuvant avec des résultats favorables malgré un pronostic initial réservé.
Conclusions
L’OHB s’avère prometteuse dans le cadre d’un schéma thérapeutique pour diverses affections en chirurgie oculoplastique et reconstructive.
{"title":"Utilization of hyperbaric oxygen therapy in oculoplastic surgery: A case series","authors":"A. Kassotis , J. Shabto , S. Stevens , A. Coombs , M. Kazim","doi":"10.1016/j.jfo.2024.104382","DOIUrl":"10.1016/j.jfo.2024.104382","url":null,"abstract":"<div><h3>Objective</h3><div>Hyperbaric oxygen therapy (HBOT) has emerged as a versatile tool in the management of an array of medical conditions, including tissue ischemia and delayed wound healing. Despite the incorporation of HBOT in other medical fields, HBOT is not routinely utilized in the field of ophthalmic plastic and reconstructive periorbital surgery.</div></div><div><h3>Design</h3><div>Case series.</div></div><div><h3>Participants</h3><div>A series of oculofacial cases treated with adjuvant HBOT is reviewed. The authors describe a 47-year-old man presenting with vision loss secondary to a retinal vascular event one day after orbital surgery, a 38-year-old woman presenting with acute hyaluronic acid filler-associated blindness, and a 44-year-old man presenting with orbital necrotizing fasciitis after minor trauma.</div></div><div><h3>Results</h3><div>In each case, HBOT was utilized as adjuvant management, with favorable outcomes despite a guarded initial prognosis.</div></div><div><h3>Conclusions</h3><div>HBOT shows promise as part of a treatment regimen for a variety of conditions in oculoplastic and reconstructive surgery.</div></div><div><h3>Objectif</h3><div>L’oxygénothérapie hyperbare (OHB) est devenue un outil polyvalent dans la prise en charge d’un large éventail de pathologies, notamment l’ischémie tissulaire et le retard de cicatrisation des plaies. Malgré l’incorporation de l’OHB dans d’autres domaines médicaux, l’OHB n’est pas systématiquement utilisée dans le domaine de la chirurgie ophtalmique plastique et reconstructive périorbitaire.</div></div><div><h3>Méthode/participants</h3><div>Une série de cas oculofaciaux traités avec OHB adjuvante est passée en revue. Les auteurs décrivent un homme de 47 ans présentant une perte de vision secondaire à un événement vasculaire rétinien un jour après une chirurgie orbitaire, une femme de 38 ans atteinte d’une cécité aiguë associée aux produits de comblement à l’acide hyaluronique et un homme de 44 ans affichant une fasciite nécrosante orbitaire après un traumatisme mineur.</div></div><div><h3>Résultats</h3><div>Dans chaque cas, l’OHB a été utilisée comme traitement adjuvant avec des résultats favorables malgré un pronostic initial réservé.</div></div><div><h3>Conclusions</h3><div>L’OHB s’avère prometteuse dans le cadre d’un schéma thérapeutique pour diverses affections en chirurgie oculoplastique et reconstructive.</div></div>","PeriodicalId":14777,"journal":{"name":"Journal Francais D Ophtalmologie","volume":"48 2","pages":"Article 104382"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824208","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 : 2025-02-01DOI: 10.1016/j.jfo.2024.104390
L. Giralt , A. Parrado-Carrillo , N. Vidal-Robau , A. Casablanca-Piñera , J. Nogués-Castell , L. Miguel-Escuder , A. Moll-Udina , O. Balagué , M. Sainz-de-la-Maza , V. Llorenç , I. Aldecoa , A. Adán
<div><h3>Objective</h3><div>To review the clinical utility of endoretinal biopsies in diagnostically undefined cases of vitreoretinal lymphoma (VRL) with negative vitreous cytology.</div></div><div><h3>Methods</h3><div>Retrospective case series including all consecutive patients who underwent endoretinal biopsies in a tertiary care center, Hospital Clinic of Barcelona (Spain), between 2014 and 2020.</div></div><div><h3>Results</h3><div>A total of 5 patients were included in this study. Four were male and one was female, with a mean age at diagnosis of 49<!--> <!-->years. Two patients had a past medical history of extraocular involvement, both having experienced complete remission of diffuse large B-cell lymphomas (DLBCL). All patients presented retinitis-like lesions characterized by substantial retinal thickening and infiltrative deposits below the retinal pigment epithelium (RPE). Retinal biopsies clarifying the diagnosis of VRL were established in four out of the five patients. Immunohistochemical results confirmed DLBCL, enabling the diagnosis of intraocular secondary DLBCL in two patients and primary ocular DLBCL in the other two. No postoperative complications were reported.</div></div><div><h3>Conclusions</h3><div>Endoretinal biopsies clarified the diagnosis of vitreoretinal lymphoma (VRL) in 4 of 5 patients. This is a high rate of diagnosis, which is clinically meaningful, since it influences management. Our case series underscores the efficacy of employing retinal biopsy in cases where vitreous biopsy results prove inconclusive within the challenging context of suspicion of VRL.</div></div><div><h3>Objectif</h3><div>Examiner l’utilité clinique des biopsies endorétiniennes dans des cas de lymphome vitréorétinien (LVR) indéfinis avec des cytologies vitréennes négatives.</div></div><div><h3>Méthodes</h3><div>Série de cas rétrospective incluant tous les patients consécutifs ayant subi des biopsies endorétiniennes au centre hospitalier tertiaire Hôpital Clinique de Barcelone (Espagne) entre 2014 et 2020.</div></div><div><h3>Résultats</h3><div>Dans cette étude, quatre hommes et une femme ont été inclus, et l’âge moyen au moment du diagnostic était de 49 ans. Deux patients avaient des antécédents médicaux d’implication extraoculaire, et tous deux ont connu une rémission complète de lymphome diffus à grandes cellules B (LDGCB). Tous les patients présentaient des lésions ressemblant à une rétinite, caractérisées par un épaississement substantiel de la rétine et des dépôts infiltrants sous l’épithélium pigmentaire de la rétine (EPR). Les biopsies rétiniennes ont permis le diagnostic de LVR chez quatre des cinq patients. Les résultats immunohistochimiques ont confirmé un LDGCB, permettant le diagnostic de LDGCB intraoculaire secondaire chez deux patients et de LDGCB oculaire primaire chez les deux autres. Aucune complication postopératoire n’a été signalée.</div></div><div><h3>Conclusions</h3><div>Les biopsies endorétiniennes ont permis de clarifie
{"title":"Endoretinal biopsy outcomes in suspected vitreoretinal lymphoma after inconclusive vitreous cytology","authors":"L. Giralt , A. Parrado-Carrillo , N. Vidal-Robau , A. Casablanca-Piñera , J. Nogués-Castell , L. Miguel-Escuder , A. Moll-Udina , O. Balagué , M. Sainz-de-la-Maza , V. Llorenç , I. Aldecoa , A. Adán","doi":"10.1016/j.jfo.2024.104390","DOIUrl":"10.1016/j.jfo.2024.104390","url":null,"abstract":"<div><h3>Objective</h3><div>To review the clinical utility of endoretinal biopsies in diagnostically undefined cases of vitreoretinal lymphoma (VRL) with negative vitreous cytology.</div></div><div><h3>Methods</h3><div>Retrospective case series including all consecutive patients who underwent endoretinal biopsies in a tertiary care center, Hospital Clinic of Barcelona (Spain), between 2014 and 2020.</div></div><div><h3>Results</h3><div>A total of 5 patients were included in this study. Four were male and one was female, with a mean age at diagnosis of 49<!--> <!-->years. Two patients had a past medical history of extraocular involvement, both having experienced complete remission of diffuse large B-cell lymphomas (DLBCL). All patients presented retinitis-like lesions characterized by substantial retinal thickening and infiltrative deposits below the retinal pigment epithelium (RPE). Retinal biopsies clarifying the diagnosis of VRL were established in four out of the five patients. Immunohistochemical results confirmed DLBCL, enabling the diagnosis of intraocular secondary DLBCL in two patients and primary ocular DLBCL in the other two. No postoperative complications were reported.</div></div><div><h3>Conclusions</h3><div>Endoretinal biopsies clarified the diagnosis of vitreoretinal lymphoma (VRL) in 4 of 5 patients. This is a high rate of diagnosis, which is clinically meaningful, since it influences management. Our case series underscores the efficacy of employing retinal biopsy in cases where vitreous biopsy results prove inconclusive within the challenging context of suspicion of VRL.</div></div><div><h3>Objectif</h3><div>Examiner l’utilité clinique des biopsies endorétiniennes dans des cas de lymphome vitréorétinien (LVR) indéfinis avec des cytologies vitréennes négatives.</div></div><div><h3>Méthodes</h3><div>Série de cas rétrospective incluant tous les patients consécutifs ayant subi des biopsies endorétiniennes au centre hospitalier tertiaire Hôpital Clinique de Barcelone (Espagne) entre 2014 et 2020.</div></div><div><h3>Résultats</h3><div>Dans cette étude, quatre hommes et une femme ont été inclus, et l’âge moyen au moment du diagnostic était de 49 ans. Deux patients avaient des antécédents médicaux d’implication extraoculaire, et tous deux ont connu une rémission complète de lymphome diffus à grandes cellules B (LDGCB). Tous les patients présentaient des lésions ressemblant à une rétinite, caractérisées par un épaississement substantiel de la rétine et des dépôts infiltrants sous l’épithélium pigmentaire de la rétine (EPR). Les biopsies rétiniennes ont permis le diagnostic de LVR chez quatre des cinq patients. Les résultats immunohistochimiques ont confirmé un LDGCB, permettant le diagnostic de LDGCB intraoculaire secondaire chez deux patients et de LDGCB oculaire primaire chez les deux autres. Aucune complication postopératoire n’a été signalée.</div></div><div><h3>Conclusions</h3><div>Les biopsies endorétiniennes ont permis de clarifie","PeriodicalId":14777,"journal":{"name":"Journal Francais D Ophtalmologie","volume":"48 2","pages":"Article 104390"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864208","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 : 2025-02-01DOI: 10.1016/j.jfo.2024.104370
T.A. Macky, M. Attya, M.M. Soliman
<div><h3>Purpose</h3><div>To evaluate the outcomes of pars plana vitrectomy (PPV) for full thickness macular holes (FTMH) in ocular Behçet's disease.</div></div><div><h3>Methods</h3><div>Eyes with FTMH as confirmed on optical coherence tomography in patients with active ocular Behçet's disease (AOBD) were included in this study. These eyes underwent PPV, epiretinal membrane (ERM) removal, internal limiting membrane (ILM) peel, and a tamponade injection. Postoperative visual improvement and macular hole closure at 6<!--> <!-->months was recorded.</div></div><div><h3>Results</h3><div>Fifteen FTMHs in 14 patients with AOBD were included, with a mean age of 29.3<!--> <!-->years (25–38), and 13 were males. All patients presented best corrected visual acuity (BCVA) of 0.05 decimals or worse; mean 0.04<!--> <!-->±<!--> <!-->0.01 (0.02–0.05). All eyes underwent PPV, 11 eyes needed phacoemulsification, and the ILM was not peeled in one eye. Three eyes had total retinal detachment (RD) and needed silicone oil as a tamponade; the rest received SF6. Macular hole closure was achieved in 14 eyes with a single procedure, and the failed eye was the one with no peeling of the ILM. In the 14 eyes with successful outcomes, a thick ERM and ILM were noted and removed. All patients were followed for at least six months; mean 13<!--> <!-->months (6–48). The mean BCVA improved to 0.15<!--> <!-->±<!--> <!-->0.02 decimals (0.1–0.4) in the first 3<!--> <!-->months in eyes with successful closure. All patients had recurrent activity during the follow-up period and responded to systemic and local treatment, but with visual loss due to macular ischemia; at 6<!--> <!-->months, BCVA was 0.06<!--> <!-->±<!--> <!-->0.03 decimals (0.03–0.07).</div></div><div><h3>Conclusion</h3><div>FTMH can occur in AOBD and can progress to RD in the absence of myopia. PPV, ERM removal, ILM peel, and either gas or silicone oil injection gives excellent anatomic results with significant visual improvement. However, full visual recovery is frequently undermined by the associated retinal ischemia and recurrent inflammation.</div></div><div><h3>Objectif</h3><div>Évaluer les résultats de la vitrectomie par la pars plana (PPV) pour les trous maculaires de pleine épaisseur (FTMH) dans la maladie de Behçet.</div></div><div><h3>Méthodes</h3><div>Les yeux atteints de FTMH confirmés par tomographie par cohérence optique chez des patients atteints de la maladie de Behçet oculaire active (AOBD) ont été inclus dans cette étude. Ces yeux ont subi une PPV, une ablation de membrane épirétinienne (ERM), un pelage de la membrane limitante interne (ILM) et un tamponnement. L’amélioration visuelle postopératoire et la fermeture du trou maculaire à 6 mois ont été enregistrées.</div></div><div><h3>Résultats</h3><div>Quinze FTMH chez 14 patients atteints d’AOBD ont été inclus (13 étaient des hommes), avec un âge moyen de 29,3 ans (25 à 38 ans). Tous les patients présentaient la meilleure acuité visuelle corrigée (MAVC) d
{"title":"Functional and anatomic outcomes of pars plana vitrectomy for macular holes in ocular Behçet's disease","authors":"T.A. Macky, M. Attya, M.M. Soliman","doi":"10.1016/j.jfo.2024.104370","DOIUrl":"10.1016/j.jfo.2024.104370","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the outcomes of pars plana vitrectomy (PPV) for full thickness macular holes (FTMH) in ocular Behçet's disease.</div></div><div><h3>Methods</h3><div>Eyes with FTMH as confirmed on optical coherence tomography in patients with active ocular Behçet's disease (AOBD) were included in this study. These eyes underwent PPV, epiretinal membrane (ERM) removal, internal limiting membrane (ILM) peel, and a tamponade injection. Postoperative visual improvement and macular hole closure at 6<!--> <!-->months was recorded.</div></div><div><h3>Results</h3><div>Fifteen FTMHs in 14 patients with AOBD were included, with a mean age of 29.3<!--> <!-->years (25–38), and 13 were males. All patients presented best corrected visual acuity (BCVA) of 0.05 decimals or worse; mean 0.04<!--> <!-->±<!--> <!-->0.01 (0.02–0.05). All eyes underwent PPV, 11 eyes needed phacoemulsification, and the ILM was not peeled in one eye. Three eyes had total retinal detachment (RD) and needed silicone oil as a tamponade; the rest received SF6. Macular hole closure was achieved in 14 eyes with a single procedure, and the failed eye was the one with no peeling of the ILM. In the 14 eyes with successful outcomes, a thick ERM and ILM were noted and removed. All patients were followed for at least six months; mean 13<!--> <!-->months (6–48). The mean BCVA improved to 0.15<!--> <!-->±<!--> <!-->0.02 decimals (0.1–0.4) in the first 3<!--> <!-->months in eyes with successful closure. All patients had recurrent activity during the follow-up period and responded to systemic and local treatment, but with visual loss due to macular ischemia; at 6<!--> <!-->months, BCVA was 0.06<!--> <!-->±<!--> <!-->0.03 decimals (0.03–0.07).</div></div><div><h3>Conclusion</h3><div>FTMH can occur in AOBD and can progress to RD in the absence of myopia. PPV, ERM removal, ILM peel, and either gas or silicone oil injection gives excellent anatomic results with significant visual improvement. However, full visual recovery is frequently undermined by the associated retinal ischemia and recurrent inflammation.</div></div><div><h3>Objectif</h3><div>Évaluer les résultats de la vitrectomie par la pars plana (PPV) pour les trous maculaires de pleine épaisseur (FTMH) dans la maladie de Behçet.</div></div><div><h3>Méthodes</h3><div>Les yeux atteints de FTMH confirmés par tomographie par cohérence optique chez des patients atteints de la maladie de Behçet oculaire active (AOBD) ont été inclus dans cette étude. Ces yeux ont subi une PPV, une ablation de membrane épirétinienne (ERM), un pelage de la membrane limitante interne (ILM) et un tamponnement. L’amélioration visuelle postopératoire et la fermeture du trou maculaire à 6 mois ont été enregistrées.</div></div><div><h3>Résultats</h3><div>Quinze FTMH chez 14 patients atteints d’AOBD ont été inclus (13 étaient des hommes), avec un âge moyen de 29,3 ans (25 à 38 ans). Tous les patients présentaient la meilleure acuité visuelle corrigée (MAVC) d","PeriodicalId":14777,"journal":{"name":"Journal Francais D Ophtalmologie","volume":"48 2","pages":"Article 104370"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142791827","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 : 2025-02-01DOI: 10.1016/j.jfo.2024.104378
M.-G. Sfaxi , A. Miguel , M. Seker , J.-C. Quintyn
Notre société connaît actuellement et depuis quelques années un vieillissement de sa population. En parallèle, nous pouvons observer une augmentation des résidents en EHPAD. Le contexte d’épidémie mondiale et des restrictions sanitaires mis en place pour y faire face a mis en évidence la fragilité des personnes âgées et la nécessité d’effectuer des consultations à distance pour permettre une continuité des soins. De décembre 2020 à juillet 2022, un bilan ophtalmologique avec le protocole RNM a été proposé aux résidents de 11 EHPAD situés dans la Manche et le Calvados. Deux cent vingt-deux patients d’âge moyen de 83 ans ont bénéficié d’une consultation. À la suite de notre intervention, l’acuité visuelle moyenne logMar a été améliorée de façon statistiquement significative de 0,76 à 0,61 (p < 0,0001) en vision de loin. Une pathologie ophtalmologique a été mis en évidence chez 143 patients (64 %). Ce projet a offert à une population isolée et dépendante, qui ne pouvait accéder aux consultations médicales traditionnelles en cabinet, la possibilité de rétablir un accès complet au suivi médical. La détection précoce des problèmes de vision chez les personnes âgées peut aider à prévenir des complications potentiellement graves et à améliorer la qualité de vie globale de cette population. La téléconsultation se présente comme une alternative valable à la consultation traditionnelle, particulièrement chez les patients fortement dépendants et institutionnalisés.
For several years, our society has been experiencing an aging of the population. Concurrently, there has been an observable increase in the population of nursing homes (EHPAD). The context of a global epidemic and the public health measures implemented to address it have underscored the vulnerability of our elderly population and the need for remote consultations to ensure continuity of care. From December 2020 to July 2022, an ophthalmological assessment with the RNM protocol was offered to residents of 11 EHPADs located in Manche and Calvados. Two hundred twenty-two patients, with a mean age of 83, underwent an eye examination. Following our intervention, the average logMar visual acuity was statistically significantly improved from 0.76 to 0.61 (P < 0.0001) for distance vision. Ophthalmological pathology was identified in 143 patients (64%). This project provided an isolated, dependent population, unable to access traditional in-person physician visits, the opportunity to fully restore access to medical follow-up. Early detection of vision problems in the elderly can help prevent potentially serious complications and improve the overall quality of life for these individuals. Telemedicine proves to be a valid alternative to traditional in-person visits, particularly for heavily dependent and institutionalized patients.
{"title":"Projet doré, dépistage des pathologies oculaires chez les résidents en établissements d’hébergement pour personnes âgées dépendantes","authors":"M.-G. Sfaxi , A. Miguel , M. Seker , J.-C. Quintyn","doi":"10.1016/j.jfo.2024.104378","DOIUrl":"10.1016/j.jfo.2024.104378","url":null,"abstract":"<div><div>Notre société connaît actuellement et depuis quelques années un vieillissement de sa population. En parallèle, nous pouvons observer une augmentation des résidents en EHPAD. Le contexte d’épidémie mondiale et des restrictions sanitaires mis en place pour y faire face a mis en évidence la fragilité des personnes âgées et la nécessité d’effectuer des consultations à distance pour permettre une continuité des soins. De décembre 2020 à juillet 2022, un bilan ophtalmologique avec le protocole RNM a été proposé aux résidents de 11 EHPAD situés dans la Manche et le Calvados. Deux cent vingt-deux patients d’âge moyen de 83 ans ont bénéficié d’une consultation. À la suite de notre intervention, l’acuité visuelle moyenne logMar a été améliorée de façon statistiquement significative de 0,76 à 0,61 (<em>p</em> <!--><<!--> <!-->0,0001) en vision de loin. Une pathologie ophtalmologique a été mis en évidence chez 143 patients (64 %). Ce projet a offert à une population isolée et dépendante, qui ne pouvait accéder aux consultations médicales traditionnelles en cabinet, la possibilité de rétablir un accès complet au suivi médical. La détection précoce des problèmes de vision chez les personnes âgées peut aider à prévenir des complications potentiellement graves et à améliorer la qualité de vie globale de cette population. La téléconsultation se présente comme une alternative valable à la consultation traditionnelle, particulièrement chez les patients fortement dépendants et institutionnalisés.</div></div><div><div>For several years, our society has been experiencing an aging of the population. Concurrently, there has been an observable increase in the population of nursing homes (EHPAD). The context of a global epidemic and the public health measures implemented to address it have underscored the vulnerability of our elderly population and the need for remote consultations to ensure continuity of care. From December 2020 to July 2022, an ophthalmological assessment with the RNM protocol was offered to residents of 11 EHPADs located in Manche and Calvados. Two hundred twenty-two patients, with a mean age of 83, underwent an eye examination. Following our intervention, the average logMar visual acuity was statistically significantly improved from 0.76 to 0.61 (<em>P</em> <!--><<!--> <!-->0.0001) for distance vision. Ophthalmological pathology was identified in 143 patients (64%). This project provided an isolated, dependent population, unable to access traditional in-person physician visits, the opportunity to fully restore access to medical follow-up. Early detection of vision problems in the elderly can help prevent potentially serious complications and improve the overall quality of life for these individuals. Telemedicine proves to be a valid alternative to traditional in-person visits, particularly for heavily dependent and institutionalized patients.</div></div>","PeriodicalId":14777,"journal":{"name":"Journal Francais D Ophtalmologie","volume":"48 2","pages":"Article 104378"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845906","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 : 2025-02-01DOI: 10.1016/j.jfo.2024.104383
R. Yaïci , M. Sanogo , F. Lefebvre , S. Ní Dhubhghaill , W. Aclimandos , R. Asoklis , H. Atilla , C. Creuzot-Garcher , D. Curtin , B. Cvenkel , L. Flanagan , T.T. Kivelä , A. Maino , R. Martínez-Costa , S. Priglinger , H. Prior Filipe , M. Stopa , B. Strong , J. Sturmer , M.-J. Tassignon , T. Bourcier
<div><h3>Objectif</h3><div>Cette étude vise à présenter et analyser les résultats de la cohorte française dans une enquête de l’European Board of Ophthalmology (EBO) sur la formation à la chirurgie de la cataracte en Europe, mettant en lumière les particularités de la formation française.</div></div><div><h3>Matériels et méthodes</h3><div>Un questionnaire électronique de 23 questions a été envoyé aux internes candidats à l’examen de l’EBO de 2018 à 2022. Les réponses des participants français ont été spécifiquement collectées et analysées.</div></div><div><h3>Résultats</h3><div>Sur 122 ophtalmologistes français répondants, l’âge moyen était de 31,0<!--> <!-->±<!--> <!-->2,8 ans avec une répartition égale entre hommes et femmes. Les séances de formation pré-patient les plus fréquentes étaient sur simulateurs de réalité virtuelle (8,6<!--> <!-->±<!--> <!-->8,2 séances). Les répondants français déclaraient un nombre moyen plus élevé de chirurgies partielles (124,1<!--> <!-->±<!--> <!-->94,8) et complètes (96,4<!--> <!-->±<!--> <!-->93,1), avec une confiance accrue (échelle de 0 à 10) dans l’exécution de chirurgies simples (7,3<!--> <!-->±<!--> <!-->2,4) et complexes (5,51<!--> <!-->±<!--> <!-->2,6), ainsi que dans la gestion de ruptures capsulaires postérieures (7,2<!--> <!-->±<!--> <!-->2,5) ou réalisation de sutures cornéennes (3,9<!--> <!-->±<!--> <!-->2,7) par rapport à la moyenne des participants européens.</div></div><div><h3>Discussion</h3><div>Dans le paysage européen, la formation française en chirurgie de la cataracte s’inscrit dans un modèle de « chirurgie pour tous », sans disparité de genre. Des variations régionales marquent cependant le paysage français, contrastant avec d’autres nations européennes comme l’Espagne ou l’Allemagne.</div></div><div><h3>Conclusion</h3><div>Pour une harmonisation des formations en chirurgie de la cataracte en Europe, il est conseillé d’établir des recommandations et stratégies éducatives, y compris la standardisation des formations pré-patients pour assurer la validation des compétences chirurgicales.</div></div><div><h3>Objective</h3><div>This study aims to present and analyze the results of the French cohort in a European Board of Ophthalmology (EBO) survey on cataract surgical training in Europe, highlighting the particularities of French training.</div></div><div><h3>Materials and methods</h3><div>A 23-question electronic questionnaire was sent to interns applying for the EBO examination from 2018 to 2022. Responses from French participants were specifically collected and analyzed.</div></div><div><h3>Results</h3><div>Of 122 responding French ophthalmologists, the mean age was 31.0<!--> <!-->±<!--> <!-->2.8 years with an equal distribution between men and women. The most frequent pre-patient training sessions were on virtual reality simulators (8.6<!--> <!-->±<!--> <!-->8.2 sessions). French respondents reported a higher average number of partial (124.1<!--> <!-->±<!--> <!-->94.8) and complete (96.4<!
{"title":"Formation à la chirurgie de la cataracte en France : analyse des résultats de l’enquête de l’European Board of Ophthalmology dans la cohorte française","authors":"R. Yaïci , M. Sanogo , F. Lefebvre , S. Ní Dhubhghaill , W. Aclimandos , R. Asoklis , H. Atilla , C. Creuzot-Garcher , D. Curtin , B. Cvenkel , L. Flanagan , T.T. Kivelä , A. Maino , R. Martínez-Costa , S. Priglinger , H. Prior Filipe , M. Stopa , B. Strong , J. Sturmer , M.-J. Tassignon , T. Bourcier","doi":"10.1016/j.jfo.2024.104383","DOIUrl":"10.1016/j.jfo.2024.104383","url":null,"abstract":"<div><h3>Objectif</h3><div>Cette étude vise à présenter et analyser les résultats de la cohorte française dans une enquête de l’European Board of Ophthalmology (EBO) sur la formation à la chirurgie de la cataracte en Europe, mettant en lumière les particularités de la formation française.</div></div><div><h3>Matériels et méthodes</h3><div>Un questionnaire électronique de 23 questions a été envoyé aux internes candidats à l’examen de l’EBO de 2018 à 2022. Les réponses des participants français ont été spécifiquement collectées et analysées.</div></div><div><h3>Résultats</h3><div>Sur 122 ophtalmologistes français répondants, l’âge moyen était de 31,0<!--> <!-->±<!--> <!-->2,8 ans avec une répartition égale entre hommes et femmes. Les séances de formation pré-patient les plus fréquentes étaient sur simulateurs de réalité virtuelle (8,6<!--> <!-->±<!--> <!-->8,2 séances). Les répondants français déclaraient un nombre moyen plus élevé de chirurgies partielles (124,1<!--> <!-->±<!--> <!-->94,8) et complètes (96,4<!--> <!-->±<!--> <!-->93,1), avec une confiance accrue (échelle de 0 à 10) dans l’exécution de chirurgies simples (7,3<!--> <!-->±<!--> <!-->2,4) et complexes (5,51<!--> <!-->±<!--> <!-->2,6), ainsi que dans la gestion de ruptures capsulaires postérieures (7,2<!--> <!-->±<!--> <!-->2,5) ou réalisation de sutures cornéennes (3,9<!--> <!-->±<!--> <!-->2,7) par rapport à la moyenne des participants européens.</div></div><div><h3>Discussion</h3><div>Dans le paysage européen, la formation française en chirurgie de la cataracte s’inscrit dans un modèle de « chirurgie pour tous », sans disparité de genre. Des variations régionales marquent cependant le paysage français, contrastant avec d’autres nations européennes comme l’Espagne ou l’Allemagne.</div></div><div><h3>Conclusion</h3><div>Pour une harmonisation des formations en chirurgie de la cataracte en Europe, il est conseillé d’établir des recommandations et stratégies éducatives, y compris la standardisation des formations pré-patients pour assurer la validation des compétences chirurgicales.</div></div><div><h3>Objective</h3><div>This study aims to present and analyze the results of the French cohort in a European Board of Ophthalmology (EBO) survey on cataract surgical training in Europe, highlighting the particularities of French training.</div></div><div><h3>Materials and methods</h3><div>A 23-question electronic questionnaire was sent to interns applying for the EBO examination from 2018 to 2022. Responses from French participants were specifically collected and analyzed.</div></div><div><h3>Results</h3><div>Of 122 responding French ophthalmologists, the mean age was 31.0<!--> <!-->±<!--> <!-->2.8 years with an equal distribution between men and women. The most frequent pre-patient training sessions were on virtual reality simulators (8.6<!--> <!-->±<!--> <!-->8.2 sessions). French respondents reported a higher average number of partial (124.1<!--> <!-->±<!--> <!-->94.8) and complete (96.4<!","PeriodicalId":14777,"journal":{"name":"Journal Francais D Ophtalmologie","volume":"48 2","pages":"Article 104383"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.jfo.2024.104371
I. Zone-Abid , K. Maaloul , N. Hamza , O. Hdiji , C. Mhiri , A. Trigui
<div><h3>Purpose</h3><div>To study retinal layers on OCT in patients with multiple sclerosis (MS) and look for correlations with clinical and electrophysiological characteristics.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional study including MS patients aged between 18 and 60 years and a reference group of healthy, age- and gender-matched, control participants. A neurological examination with assessment of disability by the Expanded Disability Status Scale (EDSS), an ophthalmological examination, a spectral-domain OCT, and visual evoked potentials (VEP) were performed.</div></div><div><h3>Results</h3><div>Fifty-one patients with MS and 30 control subjects were included in the study. The mean age of our patients was 38 years, and the sex ratio (male/female) was 0.49. Mean total thickness of the peripapillary retinal nerve fiber layer (pRNFL) and mean thicknesses in the individual quadrants were significantly lower than those of control subjects (<em>P</em> <!--><<!--> <!-->0.001). All mean thicknesses of the various retinal layers were reduced compared to those of control eyes, but the difference was statistically significant only for the inner plexiform layer (IPL), the inner nuclear layer (INL) and the outer plexiform layer (OPL). We found a significant relationship between pRNFL atrophy as well as ganglion cell inner plexiform layer (GCIPL) atrophy and history of MS-ON (multiple sclerosis-optic neuritis) (<em>P</em> <!--><<!--> <!-->0.001). pRNFL was preserved in the primary progressive form of MS, while it was atrophied in relapsing-remitting and secondary progressive forms. There was no significant change in inner retinal layer thicknesses according to duration of MS progression. We found a significant correlation between pRNFL atrophy in the superior (R<!--> <!-->=<!--> <!-->–0.22, <em>P</em> <!-->=<!--> <!-->0.03), inferior (R<!--> <!-->=<!--> <!-->–0.28, <em>P</em> <!-->=<!--> <!-->0.005) and temporal (R<!--> <!-->=<!--> <!-->–0.21, <em>P</em> <!-->=<!--> <!-->0.03) quadrants and the EDSS score. The difference in the thickness of the other retinal layers was significant for the GCIPL in patients with a high EDSS score (>3). There was no significant difference in the thickness of the various retinal layers between eyes of patients on first- or a second-line treatment. We found a correlation between visual acuity and pRNFL (R<!--> <!-->=<!--> <!-->0.446, <em>P</em> <!--><<!--> <!-->0.001) and GCIPL thickness (R<!--> <!-->=<!--> <!-->0.343, <em>P</em> <!-->=<!--> <!-->0.001). There was a correlation between the increase of P100 wave latency in VEP and pRNFL atrophy (R<!--> <!-->=<!--> <!-->–0.32, <em>P</em> <!-->=<!--> <!-->0.01). A correlation between pRNFL atrophy and the decrease in the amplitude of the P100 wave was only seen in MS-ON eyes (R<!--> <!-->=<!--> <!-->0.41, <em>P</em> <!-->=<!--> <!-->0.03).</div></div><div><h3>Conclusions</h3><div>Correlations between pRNFL and GCIPL atrophy and clinical and
{"title":"Optical coherence tomography in multiple sclerosis: A Tunisian tertiary center study","authors":"I. Zone-Abid , K. Maaloul , N. Hamza , O. Hdiji , C. Mhiri , A. Trigui","doi":"10.1016/j.jfo.2024.104371","DOIUrl":"10.1016/j.jfo.2024.104371","url":null,"abstract":"<div><h3>Purpose</h3><div>To study retinal layers on OCT in patients with multiple sclerosis (MS) and look for correlations with clinical and electrophysiological characteristics.</div></div><div><h3>Methods</h3><div>We conducted a cross-sectional study including MS patients aged between 18 and 60 years and a reference group of healthy, age- and gender-matched, control participants. A neurological examination with assessment of disability by the Expanded Disability Status Scale (EDSS), an ophthalmological examination, a spectral-domain OCT, and visual evoked potentials (VEP) were performed.</div></div><div><h3>Results</h3><div>Fifty-one patients with MS and 30 control subjects were included in the study. The mean age of our patients was 38 years, and the sex ratio (male/female) was 0.49. Mean total thickness of the peripapillary retinal nerve fiber layer (pRNFL) and mean thicknesses in the individual quadrants were significantly lower than those of control subjects (<em>P</em> <!--><<!--> <!-->0.001). All mean thicknesses of the various retinal layers were reduced compared to those of control eyes, but the difference was statistically significant only for the inner plexiform layer (IPL), the inner nuclear layer (INL) and the outer plexiform layer (OPL). We found a significant relationship between pRNFL atrophy as well as ganglion cell inner plexiform layer (GCIPL) atrophy and history of MS-ON (multiple sclerosis-optic neuritis) (<em>P</em> <!--><<!--> <!-->0.001). pRNFL was preserved in the primary progressive form of MS, while it was atrophied in relapsing-remitting and secondary progressive forms. There was no significant change in inner retinal layer thicknesses according to duration of MS progression. We found a significant correlation between pRNFL atrophy in the superior (R<!--> <!-->=<!--> <!-->–0.22, <em>P</em> <!-->=<!--> <!-->0.03), inferior (R<!--> <!-->=<!--> <!-->–0.28, <em>P</em> <!-->=<!--> <!-->0.005) and temporal (R<!--> <!-->=<!--> <!-->–0.21, <em>P</em> <!-->=<!--> <!-->0.03) quadrants and the EDSS score. The difference in the thickness of the other retinal layers was significant for the GCIPL in patients with a high EDSS score (>3). There was no significant difference in the thickness of the various retinal layers between eyes of patients on first- or a second-line treatment. We found a correlation between visual acuity and pRNFL (R<!--> <!-->=<!--> <!-->0.446, <em>P</em> <!--><<!--> <!-->0.001) and GCIPL thickness (R<!--> <!-->=<!--> <!-->0.343, <em>P</em> <!-->=<!--> <!-->0.001). There was a correlation between the increase of P100 wave latency in VEP and pRNFL atrophy (R<!--> <!-->=<!--> <!-->–0.32, <em>P</em> <!-->=<!--> <!-->0.01). A correlation between pRNFL atrophy and the decrease in the amplitude of the P100 wave was only seen in MS-ON eyes (R<!--> <!-->=<!--> <!-->0.41, <em>P</em> <!-->=<!--> <!-->0.03).</div></div><div><h3>Conclusions</h3><div>Correlations between pRNFL and GCIPL atrophy and clinical and","PeriodicalId":14777,"journal":{"name":"Journal Francais D Ophtalmologie","volume":"48 2","pages":"Article 104371"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813055","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 : 2025-02-01DOI: 10.1016/j.jfo.2024.104380
R. Alvarado-Villacorta, N. Ramos-Betancourt, J.H. Davila-Alquisiras, K.A. Vazquez-Romo
<div><h3>Purpose</h3><div>To evaluate the clinical outcomes of topical 5-fluorouracil (5-FU) 1% as first-line therapy for giant ocular surface squamous neoplasia (OSSN).</div></div><div><h3>Materials and methods</h3><div>This was a non-comparative cohort study. We included patients with biopsy-proven giant OSSN in a tertiary-care setting. Giant OSSN was defined as a single lesion<!--> <!-->≥<!--> <!-->15<!--> <!-->mm in the largest basal dimension or an extent of<!--> <!-->≥<!--> <!-->6 clock hours of limbal involvement. Topical 5-FU 1% was administered QID for one week, followed by a three-week drug holiday. This treatment cycle was repeated until resolution. Resolution rate was the primary outcome measure, where complete resolution was defined clinically and by tomography. Secondary outcomes were time to resolution and frequency of recurrence and side effects.</div></div><div><h3>Results</h3><div>Twenty-seven eyes (27 patients) were included; the majority (19, 70%) were men, with a mean age of 69.2<!--> <!-->±<!--> <!-->15.7 years. Corneal/conjunctival intraepithelial neoplasia was diagnosed in 88%, and squamous cell carcinoma (SCC) in the remaining 12% of cases. The rate of complete resolution was 77.8% (21/27) after a mean of 5.1<!--> <!-->±<!--> <!-->2.1 cycles. The median time to complete resolution was 5 months (CI95% 4–6 months). During a mean follow-up of 10.2<!--> <!-->±<!--> <!-->2.9 months, recurrence was observed in one patient (4.8%) and four (14.8%) reported side effects. Patients with partial resolution were older and had a higher frequency of SCC diagnosis than those with complete resolution.</div></div><div><h3>Conclusion</h3><div>Topical 5-FU 1% appears to be useful as first-line therapy for giant OSSN, with good tolerance and a low frequency of recurrence. More studies with larger sample sizes and longer follow-up are needed.</div></div><div><h3>Objectif</h3><div>Évaluer les résultats cliniques du 5-fluorouracile (5-FU) topique à 1 % comme traitement de première intention des néoplasies squameuses géantes de la surface oculaire (OSSN).</div></div><div><h3>Matériel et méthodes</h3><div>Étude de cohorte non comparative. Nous avons inclus des patients atteints d’un OSSN géant prouvé par biopsie dans un établissement de soins tertiaires. L’OSSN géant est défini comme une lésion unique<!--> <!-->≥<!--> <!-->15<!--> <!-->mm au niveau du plus grand diamètre basal ou une étendue<!--> <!-->≥<!--> <!-->6<!--> <!-->heures d’horloge de l’atteinte limbique. Le 5-FU topique à 1 % a été administré quatre fois par jour pendant une semaine, suivie d’une pause de trois semaines. Ce cycle de traitement a été répété jusqu’à la résolution. Le taux de résolution était le principal critère de jugement, la résolution complète étant définie comme l’absence de lésions sur le plan clinique et tomographique. Les résultats secondaires étaient le délai de résolution et la fréquence des récidives et des effets secondaires.</div></div><div><h3>Résultats</h3>
{"title":"Topical 5-fluorouracil 1% as first-line therapy for giant ocular surface squamous neoplasia","authors":"R. Alvarado-Villacorta, N. Ramos-Betancourt, J.H. Davila-Alquisiras, K.A. Vazquez-Romo","doi":"10.1016/j.jfo.2024.104380","DOIUrl":"10.1016/j.jfo.2024.104380","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the clinical outcomes of topical 5-fluorouracil (5-FU) 1% as first-line therapy for giant ocular surface squamous neoplasia (OSSN).</div></div><div><h3>Materials and methods</h3><div>This was a non-comparative cohort study. We included patients with biopsy-proven giant OSSN in a tertiary-care setting. Giant OSSN was defined as a single lesion<!--> <!-->≥<!--> <!-->15<!--> <!-->mm in the largest basal dimension or an extent of<!--> <!-->≥<!--> <!-->6 clock hours of limbal involvement. Topical 5-FU 1% was administered QID for one week, followed by a three-week drug holiday. This treatment cycle was repeated until resolution. Resolution rate was the primary outcome measure, where complete resolution was defined clinically and by tomography. Secondary outcomes were time to resolution and frequency of recurrence and side effects.</div></div><div><h3>Results</h3><div>Twenty-seven eyes (27 patients) were included; the majority (19, 70%) were men, with a mean age of 69.2<!--> <!-->±<!--> <!-->15.7 years. Corneal/conjunctival intraepithelial neoplasia was diagnosed in 88%, and squamous cell carcinoma (SCC) in the remaining 12% of cases. The rate of complete resolution was 77.8% (21/27) after a mean of 5.1<!--> <!-->±<!--> <!-->2.1 cycles. The median time to complete resolution was 5 months (CI95% 4–6 months). During a mean follow-up of 10.2<!--> <!-->±<!--> <!-->2.9 months, recurrence was observed in one patient (4.8%) and four (14.8%) reported side effects. Patients with partial resolution were older and had a higher frequency of SCC diagnosis than those with complete resolution.</div></div><div><h3>Conclusion</h3><div>Topical 5-FU 1% appears to be useful as first-line therapy for giant OSSN, with good tolerance and a low frequency of recurrence. More studies with larger sample sizes and longer follow-up are needed.</div></div><div><h3>Objectif</h3><div>Évaluer les résultats cliniques du 5-fluorouracile (5-FU) topique à 1 % comme traitement de première intention des néoplasies squameuses géantes de la surface oculaire (OSSN).</div></div><div><h3>Matériel et méthodes</h3><div>Étude de cohorte non comparative. Nous avons inclus des patients atteints d’un OSSN géant prouvé par biopsie dans un établissement de soins tertiaires. L’OSSN géant est défini comme une lésion unique<!--> <!-->≥<!--> <!-->15<!--> <!-->mm au niveau du plus grand diamètre basal ou une étendue<!--> <!-->≥<!--> <!-->6<!--> <!-->heures d’horloge de l’atteinte limbique. Le 5-FU topique à 1 % a été administré quatre fois par jour pendant une semaine, suivie d’une pause de trois semaines. Ce cycle de traitement a été répété jusqu’à la résolution. Le taux de résolution était le principal critère de jugement, la résolution complète étant définie comme l’absence de lésions sur le plan clinique et tomographique. Les résultats secondaires étaient le délai de résolution et la fréquence des récidives et des effets secondaires.</div></div><div><h3>Résultats</h3>","PeriodicalId":14777,"journal":{"name":"Journal Francais D Ophtalmologie","volume":"48 2","pages":"Article 104380"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818087","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 : 2025-02-01DOI: 10.1016/j.jfo.2024.104381
L. Doğan , Z. Özer Özcan , İ. Edhem Yılmaz
<div><h3>Purpose</h3><div>To evaluate the appropriateness, understandability, actionability, and readability of responses provided by ChatGPT-3.5, Bard, and Bing Chat to frequently asked questions about keratorefractive surgery (KRS).</div></div><div><h3>Method</h3><div>Thirty-eight frequently asked questions about KRS were directed three times to a fresh ChatGPT-3.5, Bard, and Bing Chat interfaces. Two experienced refractive surgeons categorized the chatbots’ responses according to their appropriateness and the accuracy of the responses was assessed using the Structure of the Observed Learning Outcome (SOLO) taxonomy. Flesch Reading Ease (FRE) and Coleman-Liau Index (CLI) were used to evaluate the readability of the responses of chatbots. Furthermore, the understandability scores of responses were evaluated using the Patient Education Materials Assessment Tool (PEMAT).</div></div><div><h3>Results</h3><div>The appropriateness of the ChatGPT-3.5, Bard, and Bing Chat responses was 86.8% (33/38), 84.2% (32/38), and 81.5% (31/38), respectively (<em>P</em> <!-->><!--> <!-->0.05). According to the SOLO test, ChatGPT-3.5 (3.91<!--> <!-->±<!--> <!-->0.44) achieved the highest mean accuracy and followed by Bard (3.64<!--> <!-->±<!--> <!-->0.61) and Bing Chat (3.19<!--> <!-->±<!--> <!-->0.55). For understandability (mean PEMAT-U score the ChatGPT-3.5: 68.5%, Bard: 78.6%, and Bing Chat: 67.1%, <em>P</em> <!--><<!--> <!-->0.05), and actionability (mean PEMAT-A score the ChatGPT-3.5: 62.6%, Bard: 72.4%, and Bing Chat: 60.9%, <em>P</em> <!--><<!--> <!-->0.05) the Bard scored better than the other chatbots. Two readability analyses showed that Bing had the highest readability, followed by the ChatGPT-3.5 and Bard, however, the understandability and readability scores were more challenging than the recommended level.</div></div><div><h3>Conclusion</h3><div>Artificial intelligence supported chatbots have the potential to provide detailed and appropriate responses at acceptable levels in KRS. Chatbots, while promising for patient education in KRS, require further progress, especially in readability and understandability aspects.</div></div><div><h3>Objectif</h3><div>Évaluer la pertinence, la compréhensibilité, l’applicabilité et la lisibilité des réponses fournies par ChatGPT-3.5, Bard et Bing Chat aux questions fréquemment posées sur la chirurgie kératoréfractive (CKR).</div></div><div><h3>Méthode</h3><div>Trente-huit questions fréquemment posées sur la CKR ont été adressées trois fois à des interfaces de ChatGPT-3.5, Bard et Bing Chat. Deux chirurgiens réfractifs expérimentés ont catégorisé les réponses des chatbots selon leur pertinence et l’exactitude des réponses a été évaluée à l’aide de la taxonomie SOLO (<em>Structure of the Observed Learning Outcome</em>). L’indice de facilité de lecture de Flesch (FRE) et l’indice de Coleman-Liau (CLI) ont été utilisés pour évaluer la lisibilité des réponses des chatbots. De plus, les scores de compréhensibilité
{"title":"The promising role of chatbots in keratorefractive surgery patient education","authors":"L. Doğan , Z. Özer Özcan , İ. Edhem Yılmaz","doi":"10.1016/j.jfo.2024.104381","DOIUrl":"10.1016/j.jfo.2024.104381","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the appropriateness, understandability, actionability, and readability of responses provided by ChatGPT-3.5, Bard, and Bing Chat to frequently asked questions about keratorefractive surgery (KRS).</div></div><div><h3>Method</h3><div>Thirty-eight frequently asked questions about KRS were directed three times to a fresh ChatGPT-3.5, Bard, and Bing Chat interfaces. Two experienced refractive surgeons categorized the chatbots’ responses according to their appropriateness and the accuracy of the responses was assessed using the Structure of the Observed Learning Outcome (SOLO) taxonomy. Flesch Reading Ease (FRE) and Coleman-Liau Index (CLI) were used to evaluate the readability of the responses of chatbots. Furthermore, the understandability scores of responses were evaluated using the Patient Education Materials Assessment Tool (PEMAT).</div></div><div><h3>Results</h3><div>The appropriateness of the ChatGPT-3.5, Bard, and Bing Chat responses was 86.8% (33/38), 84.2% (32/38), and 81.5% (31/38), respectively (<em>P</em> <!-->><!--> <!-->0.05). According to the SOLO test, ChatGPT-3.5 (3.91<!--> <!-->±<!--> <!-->0.44) achieved the highest mean accuracy and followed by Bard (3.64<!--> <!-->±<!--> <!-->0.61) and Bing Chat (3.19<!--> <!-->±<!--> <!-->0.55). For understandability (mean PEMAT-U score the ChatGPT-3.5: 68.5%, Bard: 78.6%, and Bing Chat: 67.1%, <em>P</em> <!--><<!--> <!-->0.05), and actionability (mean PEMAT-A score the ChatGPT-3.5: 62.6%, Bard: 72.4%, and Bing Chat: 60.9%, <em>P</em> <!--><<!--> <!-->0.05) the Bard scored better than the other chatbots. Two readability analyses showed that Bing had the highest readability, followed by the ChatGPT-3.5 and Bard, however, the understandability and readability scores were more challenging than the recommended level.</div></div><div><h3>Conclusion</h3><div>Artificial intelligence supported chatbots have the potential to provide detailed and appropriate responses at acceptable levels in KRS. Chatbots, while promising for patient education in KRS, require further progress, especially in readability and understandability aspects.</div></div><div><h3>Objectif</h3><div>Évaluer la pertinence, la compréhensibilité, l’applicabilité et la lisibilité des réponses fournies par ChatGPT-3.5, Bard et Bing Chat aux questions fréquemment posées sur la chirurgie kératoréfractive (CKR).</div></div><div><h3>Méthode</h3><div>Trente-huit questions fréquemment posées sur la CKR ont été adressées trois fois à des interfaces de ChatGPT-3.5, Bard et Bing Chat. Deux chirurgiens réfractifs expérimentés ont catégorisé les réponses des chatbots selon leur pertinence et l’exactitude des réponses a été évaluée à l’aide de la taxonomie SOLO (<em>Structure of the Observed Learning Outcome</em>). L’indice de facilité de lecture de Flesch (FRE) et l’indice de Coleman-Liau (CLI) ont été utilisés pour évaluer la lisibilité des réponses des chatbots. De plus, les scores de compréhensibilité","PeriodicalId":14777,"journal":{"name":"Journal Francais D Ophtalmologie","volume":"48 2","pages":"Article 104381"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824197","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}
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