Journal Francais D Ophtalmologie最新文献

{"title":"NGENUITY versus ARTEVO 800 in vitreoretinal surgery: A retrospective comparison of two different three-dimensional visualization systems in a French tertiary center","authors":"J. Liberto , F. Matonti , F. Varenne , P. Kantor , J. Butterworth , V. Pagot-Mathis , P. Fournié , V. Soler","doi":"10.1016/j.jfo.2025.104713","DOIUrl":"10.1016/j.jfo.2025.104713","url":null,"abstract":"<div><h3>Purpose</h3><div>Digital heads-up three-dimensional (3D) visualization systems are now familiar in vitreoretinal surgery, with reported better technical and similar patient outcomes compared to conventional microscopes. Here, we compared the efficacy and safety of two different 3D systems.</div></div><div><h3>Methods</h3><div>A retrospective, single-center, cohort study of adults having undergone vitrectomy for treatment of rhegmatogenous retinal detachment (RRD), idiopathic epiretinal membrane (ERM), or macular hole (MH). Consecutive vitreoretinal surgeries were performed by the same surgeon using the NGENUITY system (3D-N group) or the ARTEVO 800 system (3D-A group) between April 2021 and November 2023 in our tertiary ophthalmology department (Toulouse University Hospital, France). The primary outcomes were 6-month retinal detachment (RD) recurrence rate, 3-month MH closure rate, and change in central macular thickness (CMT) at 3 months for ERMs.</div></div><div><h3>Results</h3><div>Two hundred and two surgeries on 202 eyes were included. Surgeries performed were for RRD (<em>n</em> <!-->=<!--> <!-->91/202; 45%), idiopathic ERM (<em>n</em> <!-->=<!--> <!-->82/202; 41%), or MH (<em>n</em> <!-->=<!--> <!-->29/202; 14%). Inclusion was <em>n</em> <!-->=<!--> <!-->121/202(60%) eyes in the 3D-N group and <em>n</em> <!-->=<!--> <!-->81/202(40%) eyes in the 3D-A group. Comparing 3D-N versus 3D-A groups, we found no significant differences in 6-month RD recurrence rate (17% versus 21%; <em>P</em> <!-->=<!--> <!-->0.62), MH closure rate (92% versus 88%; <em>P</em> <!-->=<!--> <!-->1.0), or decrease in CMT at 3 months (−79.5<!--> <!-->±<!--> <!-->69.1 versus −68.5<!--> <!-->±<!--> <!-->81.2<!--> <!-->μm; <em>P</em> <!-->=<!--> <!-->0.34). Subgroup analysis according to eyes operated for RRD, idiopathic ERM, or MH showed no significant differences in mean 3-month gains in best-corrected visual acuity, surgery duration, or 3-month post-operative complications between systems used.</div></div><div><h3>Conclusion</h3><div>The two 3D systems were comparable in terms of short-term anatomical and functional outcomes.</div></div><div><h3>Objectif</h3><div>Les systèmes de visualisation peropératoire numérique tridimensionnelle (3D) ont connu un développement et une diffusion récente. Nous avons comparé l’efficacité et la sécurité de deux systèmes.</div></div><div><h3>Méthodes</h3><div>Étude rétrospective de cohorte à partir de patients opérés de chirurgie vitréo-rétinienne via le système NGENUITY (groupe 3D-N) ou ARTEVO 800 (groupe 3D-A) entre 2021 et 2023 dans un centre hospitalo-universitaire. Les critères de jugement principaux étaient le taux de récidive du décollement de rétine (DR), le taux de fermeture de trou maculaire (TM) et la variation de l’épaisseur maculaire centrale (EMC) pour les membranes épirétiniennes idiopathiques (MERi).</div></div><div><h3>Résultats</h3><div>Nous avons inclus 202 yeux. Les indications opératoires étaient les suivante","PeriodicalId":14777,"journal":{"name":"Journal Francais D Ophtalmologie","volume":"49 1","pages":"Article 104713"},"PeriodicalIF":1.1,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145742760","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}

{"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":"2025-12-10","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}

{"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":"2025-12-10","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}

{"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":"2025-12-10","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}

{"title":"Evaluating the quality of cataract clinical practice guidelines: A systematic review using the AGREE II instrument","authors":"M. Sanguino-Jaramillo , A. Domínguez-Vargas , J. Galeano-Lopez , G. Cadavía-Carrascal","doi":"10.1016/j.jfo.2025.104710","DOIUrl":"10.1016/j.jfo.2025.104710","url":null,"abstract":"<div><h3>Introduction</h3><div>Clinical practice guidelines (CPGs) are crucial for providing evidence-based recommendations to improve patient care. Over the past 30 years, CPG development has progressed, particularly in addressing variations in care. However, significant disparities remain, especially in low- and middle-income countries. This systematic review aims to evaluate the methodological quality of cataract-related CPGs published between 2000 and 2023 by using the AGREE II instrument.</div></div><div><h3>Methods</h3><div>A comprehensive search identified 11 CPGs meeting eligibility criteria, assessed across six domains: Scope and Purpose, Stakeholder Involvement, Rigor of Development, Clarity of Presentation, Applicability, and Editorial Independence.</div></div><div><h3>Results</h3><div>CPGs from the United States, National Institute for Health and Care Excellence (NICE), and Peru showed high scores in Rigor of Development and Scope and Purpose domains. Conversely, guidelines from Asia, Chile, and Mexico were not recommended due to deficiencies across multiple domains. Applicability emerged as the weakest domain across all CPGs, indicating challenges in translating guidelines into practice.</div></div><div><h3>Conclusions</h3><div>These findings highlight variability in CPG quality, emphasizing the need for ongoing improvements, particularly in Stakeholder Involvement and Applicability domains. Continued efforts to enhance methodological rigor and practical applicability are crucial for improving quality of care in cataract management.</div></div><div><h3>Introduction</h3><div>Les lignes directrices de pratique clinique (LPC) sont essentielles pour fournir des recommandations basées sur des preuves afin d’améliorer les soins aux patients. Au cours des 30 dernières années, le développement des LPC a progressé, notamment pour répondre aux variations dans les soins. Cependant, des disparités significatives persistent, en particulier dans les pays à revenus faible et intermédiaire. Cette revue systématique visait à évaluer la qualité méthodologique des LPC liées à la cataracte et publiées entre 2000 et 2023 en utilisant l’instrument AGREE II.</div></div><div><h3>Méthodes</h3><div>Une recherche exhaustive a identifié 11 LPC répondant aux critères d’éligibilité, évaluées dans six domaines : Portée et Objectifs, Implication des Parties Prenantes, Rigueur du Développement, Clarté de la Présentation, Applicabilité et Indépendance Éditoriale.</div></div><div><h3>Résultats</h3><div>Les LPC des États-Unis, du National Institute for Health and Care Excellence (NICE) et du Pérou ont obtenu des scores élevés dans les domaines Rigueur du Développement et Portée et Objectifs. En revanche, les lignes directrices d’Asie, du Chili et du Mexique n’ont pas été recommandées en raison de lacunes dans plusieurs domaines. L’applicabilité s’est révélée être le domaine le plus faible pour toutes les LPC, indiquant des défis dans la traduction des lignes directrice","PeriodicalId":14777,"journal":{"name":"Journal Francais D Ophtalmologie","volume":"49 1","pages":"Article 104710"},"PeriodicalIF":1.1,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145698100","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}

{"title":"Role of topical insulin in the management of resistant neurotrophic corneal ulcers","authors":"S. Ben Addou Idrissi , M. Filali Sadouk MD , H. Moutei MD, PhD , A. Bennis MD , F. Chraibi MD , M. Abdellaoui MD , I. Benatiya Andaloussi MD","doi":"10.1016/j.jfo.2025.104709","DOIUrl":"10.1016/j.jfo.2025.104709","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aims to evaluate the clinical outcomes of patients with refractory neurotrophic keratitis (NK) who were unresponsive to standard therapies and treated with topical insulin.</div></div><div><h3>Methods</h3><div>In this prospective analysis, 16 eyes with stage 2 or 3 NK were treated with topical insulin. These patients had been refractory to standard medical treatment. Informed consent was obtained from patients before starting treatment. Each patient applied topical insulin drops (10 units/1<!--> <!-->mL) six times a day, along with prophylactic fluoroquinolone drops. Treatment was continued until the persistent NK resolved, and anterior segment photos were taken regularly.</div></div><div><h3>Results</h3><div>The study included 16 eyes of 15 patients with a mean age of 59 years. Initial visual acuity was poor, averaging 1.7 log MAR. Topical insulin treatment led to significant improvements: 75% of patients showed improved visual acuity with a mean gain of 0.5 log MAR. The mean healing time for ulcers was 12.3 days, with a healing rate of 93.75%. No complications or side effects were reported.</div></div><div><h3>Conclusions</h3><div>Several studies have explored the use of topical insulin in treating neurotrophic corneal ulcers, employing various concentrations. Our study is the first to use a concentration of 10<!--> <!-->IU/mL. Our findings suggest that topical insulin therapy could be an effective treatment for refractory neurotrophic keratitis (NK) due to its high efficacy, accessibility, and low cost. While our study may have identified an optimal insulin concentration, further research with larger sample sizes is needed, including investigations into other causes of refractory corneal ulcers.</div></div><div><h3>Objectif</h3><div>Cette étude vise à évaluer les résultats cliniques de patients atteints de kératite neurotrophique (KN) réfractaire, qui ne répondaient pas aux traitements standards et ont été traités par insuline topique.</div></div><div><h3>Méthodes</h3><div>Dans cette analyse prospective, 16 yeux atteints de KN aux stades 2 et 3 ont été traités par insuline topique après avoir été réfractaires aux traitements médicaux standards. Un consentement éclairé a été obtenu avant le début du traitement. Chaque patient a appliqué des gouttes d’insuline topique (10 unités/1 mL) six fois par jour, en association avec des collyres prophylactiques à base de fluoroquinolones. Le traitement a été poursuivi jusqu’à la résolution de la KN persistante, avec une documentation photographique régulière du segment antérieur.</div></div><div><h3>Résultats</h3><div>L’étude a inclus 16 yeux de 15 patients, avec un âge moyen de 59 ans. L’acuité visuelle initiale était faible, avec une moyenne de 1,7 log MAR. Le traitement par insuline topique a conduit à des améliorations significatives : 75 % des patients ont montré une amélioration de l’acuité visuelle, avec un gain moyen de 0,5 log MAR. Le temps moyen de cicatrisat","PeriodicalId":14777,"journal":{"name":"Journal Francais D Ophtalmologie","volume":"49 1","pages":"Article 104709"},"PeriodicalIF":1.1,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145697410","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}

{"title":"Stries de Haab séquellaires d’un glaucome congénital : apport de l’OCT du segment antérieur","authors":"M. Minot , M. Ismedon , D. Denis , T. David , A. Aziz","doi":"10.1016/j.jfo.2025.104722","DOIUrl":"10.1016/j.jfo.2025.104722","url":null,"abstract":"","PeriodicalId":14777,"journal":{"name":"Journal Francais D Ophtalmologie","volume":"49 1","pages":"Article 104722"},"PeriodicalIF":1.1,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145697721","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}

{"title":"Recul et résection combinés sur le même muscle oculomoteur : une alternative à la fadenoperation. Technique et résultats dans les éso- et exotropies","authors":"D. Thouvenin, L. Lequeux, C. Bonifas, I. Deboutte","doi":"10.1016/j.jfo.2025.104708","DOIUrl":"10.1016/j.jfo.2025.104708","url":null,"abstract":"<div><h3>Introduction</h3><div>La technique de recul et résection combinés sur le même muscle (RRC) est proposée depuis quelques années pour traiter les muscles hyperactifs. Nous avons récemment publié nos résultats à court terme avec cette technique utilisée dans les ésotropies et exotropies. Nous exposons les résultats à plus long terme de nos deux séries.</div></div><div><h3>Méthodes</h3><div>Le RRC consiste en un large recul, qui diminue la force active et passive du muscle et réduit fortement l’arc de contact, comme la fadenoperation. Le risque de surcorrection et d’hypoaction musculaire est limité en combinant une résection musculaire réglée selon le test d’élongation musculaire. Nous décrivons en détail le mode d’action, et la technique chirurgicale ainsi que le dosage selon le muscle et le type de strabisme.</div></div><div><h3>Résultats</h3><div>Dans les ésotropies toniques pures, la technique a été comparée à la fadenoperation. Si elle est aussi efficace à 6 mois, nous observons une plus grande stabilité à 5 ans avec le RRC (90 % de succès) contre 55 % avec la faden. Dans les exotropies, sur 100 cas d’exotropies opérés en RRC du DL, nos résultats avec plus de 2 ans de recul sont supérieurs à ceux habituellement obtenus (83 % de succès sur CT alterné et 100 % d’amélioration des scores de contrôle).</div></div><div><h3>Conclusion</h3><div>Au vu de ces résultats encourageants, nous pensons que cette technique, qui permet élégamment de traiter les aspects toniques et anatomiques du strabisme concomitant en un seul geste chirurgical simple, devrait entrer dans notre arsenal thérapeutique chirurgical des strabismes concomitants.</div></div><div><h3>Introduction</h3><div>The surgical procedure of combined resection and resection of the same muscle (CRR) has been proposed thus far for overactive muscles. We recently published our short-term results with this technique used in esotropia and in exotropia. We present the long-term results of these two series.</div></div><div><h3>Methods</h3><div>CRR consists of a large recession, which decreases the active and passive force of the muscle and greatly reduces the arc of contact, like posterior fixation sutures. The risk of overcorrection and muscle underaction are limited by combining a muscle resection adjusted according to the Quantified Passive Duction Test. We describe in detail the method of action, as well as the surgical technique and titration according to the muscle and the type of strabismus.</div></div><div><h3>Results</h3><div>In purely constant esotropia, the technique was compared to posterior fixation sutures on the medial rectus. While equally effective at 6 months, we observe greater stability at 5 years with CRR (90% success vs. 55% with posterior fixation sutures). For exotropia, in 100 cases of exotropia operated with CRR of the lateral rectus, our results with more than 2 years of follow-up are superior to those usually obtained, with 83% success on alternating cover test and 10","PeriodicalId":14777,"journal":{"name":"Journal Francais D Ophtalmologie","volume":"49 1","pages":"Article 104708"},"PeriodicalIF":1.1,"publicationDate":"2025-12-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145698099","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}

{"title":"Colobome maculaire unilatéral","authors":"A. Boujaada, Y. Tlemcani Younes, L. Robbana, K. El Majdoubi Idrissi, L. Serghini, E. Abdellah","doi":"10.1016/j.jfo.2024.104270","DOIUrl":"10.1016/j.jfo.2024.104270","url":null,"abstract":"","PeriodicalId":14777,"journal":{"name":"Journal Francais D Ophtalmologie","volume":"48 10","pages":"Article 104270"},"PeriodicalIF":1.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145668528","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}

{"title":"Acute posterior multifocal placoid pigment epitheliopathy complicated by a stroke, leading to the diagnoses of lupus anticoagulant and hypercysteinemia","authors":"M. Zayani, S. Abada","doi":"10.1016/j.jfo.2025.104570","DOIUrl":"10.1016/j.jfo.2025.104570","url":null,"abstract":"<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) ","PeriodicalId":14777,"journal":{"name":"Journal Francais D Ophtalmologie","volume":"48 10","pages":"Article 104570"},"PeriodicalIF":1.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145677760","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}