M. Bouladi

Herpes zoster ophthalmicus associated with abducens palsy

The extraocular muscle palsies associated with herpes zoster ophthalmicus (HZO) are transient, self-limiting conditions, usually seen in elderly patients. There are different treatment recommendations for paralytic complications, but prognosis has generally reported to be favorable. A 75-year-old male patient presented with diplopia. Clinical history revealed left facial vesicular eruptions and pain treated by oral aciclovir 1 week following symptom onset. On examination, we observed cicatricial lesions with crusts involving left hemiface, a limitation in abduction of the left eye, and a superficial punctuate keratitis (SPK) with decreased visual acuity (4/10). Examination of the right eye was unremarkable. Hess screen test confirmed left six nerve palsy.

Bevacizumab Injection in Patients with Age-Related Macular Degeneration Associated with Poor Initial Visual Acuity

Purpose. To evaluate functional and anatomic effects of intravitreal bevacizumab in patients with neovascular AMD and initial low visual acuity. Methods. Retrospective case series of 38 eyes with neovascular AMD and initial visual acuity of 20/200 or less, treated with intravitreal bevacizumab injection. Results. Mean followup was 14.1 months ±  7.1 (range: 5 to 24 months). Mean logMAR vision at baseline was 1.38 logMAR ±  0.33, at 6 months was 1.14 logMAR ±  0.37 (P = 0.001) and at 12 months was 1.22 logMar ±  0.33 (P = 0.004). Mean baseline central retinal thickness was 431 μm ±  159.7 at 6 months was 293.43 μm  ±  122.79 (P = 10−4) and at 12 months was 293.1 μm  ±  130 (P = 0.004). Visual acuity improved in both patients with or without prior PDT treatment. Conclusions. Intravitreal bevacizumab injection may increase the chance of visual acuity gain in neovascular AMD even in cases with initial low visual acuity.

Épaisseur choroïdienne fovéolaire au SD-OCT dans la myopie forte avec ou sans néovaisseaux choroïdiens

PURPOSE To measure macular choroidal thickness (CT) using spectral-domain optical coherence tomography (SD-OCT) in eyes with myopic macular choroidal neovascularization (CNV), and to compare choroidal thickness in these eyes with highly myopic eyes without CNV. PATIENTS AND METHODS Sixty-four eyes with myopic CNV matched with 64 highly myopic eyes without CNV by age and axial length (AL) were examined between January 2010 and November 2011. OCT scans were performed with spectral-domain OCT (TOPCON OCT 2000). The reference position was changed from the vitreous to the choroid. OCT scan patterns consisted of seven sections; the subfoveal CT was measured manually between Bruchs membrane and the internal portion of the sclera in eyes with CNV and from the pigment epithelium to the scleral interface in eyes without CNV. RESULTS In the subgroup with CNV, the mean subfoveal CT was 51.71 μm ± 17.35. A statistically significant negative correlation was found between CT and AL (r=-0.615, P=0.0001). Regression analysis demonstrated a decrease of 8.4 μm per mm of AL. In the subgroup without CNV, matched with the CNV subgroup by age (P=0.597), and AL (P=0.813), the mean subfoveal CT was 93.35 μm ± 34.81 μm. The difference between the two subgroups was statistically significant (P<10(-4)). DISCUSSION Macular choroidal thickness is reduced in high myopia, especially when complicated by CNV. It has not yet been shown that choroidal thinning may be a risk factor for choroidal neovascularization, but our results may suggest that macular choroidal thinning may lead to hypoxic retinal changes resulting in secretion of VEGF and thus CNV. CONCLUSION Macular choroidal thinning observed in high myopia with CNV. These findings may suggest that choroidal changes may play a role in the pathogenesis of choroidal neovascularization.

Apport de l’OCT-SD maculaire dans le diagnostic et le pronostic de l’hypoplasie fovéolaire chez les patients ayant un nystagmus

PURPOSE To investigate whether spectral domain optical coherence tomography (SD-OCT) is helpful for the diagnosis and prognosis of foveal hypoplasia in patients with overt nystagmus. METHODS A retrospective cross-sectional study was conducted in 48 patients with overt nystagmus. All patients underwent a complete ophthalmic examination including best corrected visual acuity, biomicroscopic and fundus examinations. Spectral domain optical coherence tomography was performed using 3D OCT-2000 FA PLUS Topcon, Tokyo, Japan, for the diagnosis and grading of foveal hypoplasia, using the Thomas classification, and its possible correlation with visual acuity. RESULTS Foveal hypoplasia was diagnosed in 6 patients (12.5%). The mean age of the patients was 13.2 years (10-18 years). Mean visual acuity was 1.53/10 (0.87 LogMAR). Foveal hypoplasia was associated with aniridia in 2 patients, albinism in 3 patients and keratoconus in 1 case. On SD-OCT, foveal hypoplasia was grade 4 in 4 patients and grade 3 in 2 patients. Mean visual acuity was 2.55/10 in patients with grade 3 foveal hypoplasia and 1.22/10 in patients with grade 4 foveal hypoplasia, and the difference in visual acuity between the two groups was statistically significant (P<0.001). CONCLUSION SD-OCT plays a double role in the diagnosis and prognosis of foveal hypoplasia in patients with nystagmus.

Article originalApport de l’OCT-SD maculaire dans le diagnostic et le pronostic de l’hypoplasie fovéolaire chez les patients ayant un nystagmusRole of SD-OCT in the diagnosis and prognosis of macular hypoplasia in nystagmus patients

PURPOSE To investigate whether spectral domain optical coherence tomography (SD-OCT) is helpful for the diagnosis and prognosis of foveal hypoplasia in patients with overt nystagmus. METHODS A retrospective cross-sectional study was conducted in 48 patients with overt nystagmus. All patients underwent a complete ophthalmic examination including best corrected visual acuity, biomicroscopic and fundus examinations. Spectral domain optical coherence tomography was performed using 3D OCT-2000 FA PLUS Topcon, Tokyo, Japan, for the diagnosis and grading of foveal hypoplasia, using the Thomas classification, and its possible correlation with visual acuity. RESULTS Foveal hypoplasia was diagnosed in 6 patients (12.5%). The mean age of the patients was 13.2 years (10-18 years). Mean visual acuity was 1.53/10 (0.87 LogMAR). Foveal hypoplasia was associated with aniridia in 2 patients, albinism in 3 patients and keratoconus in 1 case. On SD-OCT, foveal hypoplasia was grade 4 in 4 patients and grade 3 in 2 patients. Mean visual acuity was 2.55/10 in patients with grade 3 foveal hypoplasia and 1.22/10 in patients with grade 4 foveal hypoplasia, and the difference in visual acuity between the two groups was statistically significant (P<0.001). CONCLUSION SD-OCT plays a double role in the diagnosis and prognosis of foveal hypoplasia in patients with nystagmus.

Macular involvement in non infectious intermediate, posterior and panuveitis

Purpose To study macular involvement in non infectious intermediate, posterior and panuveitis.

Prognostic factors for visual outcome after intravitreal bevacizumab injection for pigment epithelial detachment in AMD

Purpose To evaluate the prognostic factors for visual outcome after intravitreal bevacizumab injection in patients with pigment epithelial detachment (PED) in AMD

Intravitreal bevacizumab for the treatment of macular edema secondary to branch and central vein occlusion

Purpose To evaluate functional and anatomic response after intravitreal Bevacizumab (IVB) injections in patients with macular edema secondary to branch retinal vein occlusion (BRVO) and central retinal vein occlusion (CRVO).

Intravitreal injection of triamcinolone combined with bevacizumab for choroidal neovascularization associated with retinal pigment epithelial detachment in age-related macular degeneration

Purpose To discuss the effect and outcome of a combined intravitreal triamcinolone acetonide (IVTA) injection with intravitreal bevacizumab (IVB) in treating choroidal neovascularization (CNV) associated with retinal pigment epithelial detachment (PED) in age‐related macular degeneration (AMD).