Biomedical subjects

A Bron

Publications and source records attributed to A Bron.

At least 19 recordsLinked to original sources

PubMed2006

[Interest of cotrimoxazole in relapsing idiopathic anterior scleritis: about six cases].

INTRODUCTION: Anterior scleritis is defined as an inflammation of the sclera, located anteriorly to the equator of the eye. Cotrimoxazole is an antibiotic with an immunomodulatory action. EXEGESIS: In case of idiopathic anterior scleritis or scleritis associated with autoimmune diseases, immunosuppressive treatment is often required. We report on six patients with anterior idiopathic scleritis non sensitive to local treatment where cotrimoxazole improved or cured the symptoms. CONCLUSION: Cotrimoxazole seems to be an interesting therapeutic treatment in non threatening anterior scleritis.

Aged↗

PubMed2006

[Improvement of dry eye symptoms with polyunsaturated fatty acids].

INTRODUCTION: Polyunsaturated fatty acids (PUFAs) are involved in inflammatory pathways via prostaglandins. Conjunctival inflammation is a hallmark of all dry eye syndromes. We investigated the role of dietary n-6 and n-3 fatty acids in patients suffering from ocular dryness. PATIENTS AND METHODS: Seventy-one patients presenting with mild to moderate dry eye syndromes were randomly assigned to Nutrilarm or placebo capsules, twice a day for 6 months. The Schirmer test, BUT, fluorescein staining, and lissamin green stainings were performed at inclusion and after 1, 3, and 6 months. Furthermore, a questionnaire related to the dry eye symptoms and global discomfort was provided at every visit. RESULTS: The Schirmer test, BUT, fluorescein staining, and lissamin green stainings were improved with treatment when compared to placebo but the difference was not statistically significant. The efficacy evaluated by the patients and the investigator were nearly significant (p=0.052 and p=0.054, respectively). For some signs, such as reflex tearing and conjunctival hyperemia, the improvement reached the threshold of significance (p=0.047 and p=0.045, respectively). The same results were found with skin quality and emotional condition, which were improved (61% with treatment versus 36% with placebo). CONCLUSION: This double-masked pilot study shows that PUFAs seem to be an interesting tool to alleviate the symptoms related to dry eye syndrome. These results should be confirmed using a larger study population.

Double-Blind Method↗

PubMed2006

[Observational survey on the use of dual therapy in ocular hypertension or glaucoma treatment].

AIM: To ascertain why ophthalmologists shift therapy to a fixed-combination or non-fixed-combination drug therapy. PATIENTS AND METHODS: A prospective multicenter observational study was conducted among French ophthalmologists working in private or mixed practice. The study included adult patients with open-angle glaucoma or ocular hypertension, treated with monotherapy or dual therapy and needing to modify their initial treatment. The patients had to fill out a self-questionnaire 15 days after the change in therapy, evaluating the compliance and assessment of the new treatment. RESULTS: The analysis was made on 775 questionnaires filled out by ophthalmologists between March 1st and July 31st 2003 on 5734 patients. The mean age was 66.4+/-12.4 years and women represented 53.6% of the patients. The diagnosis had been made, on average, 7.5+/-7.3 years before. The mean initial intraocular pressure under treatment was 19.8+/-4.1 mmHg in both eyes. Initially, 58.2% of the patients had monotherapy, 40.4% dual therapy and 1.4% triple therapy. The main reasons for shifting therapy were "high intraocular pressure under treatment" for 63.5% of the patients and "simplification of the treatment" for 39.1% of the patients (several reasons per patient were accepted). Most of the patients were satisfied with their new therapy (71%), which in most cases was a fixed-combination therapy (95.2%). DISCUSSION: This study has shown that the use of at least two active principles is a common practice in the treatment of glaucoma and ocular hypertension. An additive therapy is given in order to better control the intraocular pressure, mainly with a fixed combination.

Adolescent↗

PubMed2006

[The French glaucoma and ocular hypertension 1-day study].

PURPOSE: The purpose of this study was to describe the distribution and characteristics (age, duration, type, treatment, etc.) of ocular hypertension and glaucoma in French ophthalmologic practices. METHODS: The French glaucoma and ocular hypertension 1-day study is a descriptive cross-sectional "1-day" type survey, conducted among all ophthalmologists of mainland France. They had to include all patients aged 18 years and over with ocular hypertension or glaucoma who were seen on November 25th 2003. The participation rate was 24.0% (1.173 ophthalmologists). Among the 3.919 patients included, 3.896 subjects (99%) had usable data for the statistical analyses. RESULTS: The ophthalmologists reported treating 16 patients with ocular hypertension or glaucoma on average per week. Among the patients, 29.5% had ocular hypertension, 61.7% had open-angle glaucoma, 3.4% had normal tension glaucoma, and 5.5% angle-closure glaucoma. The ophthalmologists used surgery or laser treatment for 74.1% of angle-closure glaucoma, while for other pathologies, treatment with drugs only was preponderant. More than 87% of patients received one or several ocular treatments: beta-blockers (59.3%), prostaglandins (50.1%), carbonic anhydrase inhibitors (21.6%), or mydriatic sympathomimetics (6.3%). CONCLUSIONS: The characteristics of glaucoma and ocular hypertension (type of glaucoma, age, duration, etc.) correspond to those of other Western populations. The therapeutic habits of French ophthalmologists is in line with current international guidelines.

Aged↗

PubMed2006

[Analogies between atherosclerosis and age-related maculopathy: expected roles of oxysterols].

The pathogenesis of age-related macular degeneration (ARMD) is not clearly understood. Like other age-related diseases, it is associated with abnormal deposits called drusen. These drusens are localized in Bruch's membrane. Recent investigations have shown a link between drusen formation and inflammatory and immunologic reactions. The involvement of oxidative stress is supported by available data as an important contributing factor in the developement of ARMD. The data regarding the nature and the source of the deposits suggest that ARMD may share similar pathways with atherosclerosis. The role of oxydized products of cholesterol, the oxysterols, in the pathogenesis of atherosclerosis is well known. As cholesterol is a constituent of drusens, oxysterols could be involved in retinal pigment epithelium and photoreceptor lesions occurring in ARMD owing to their cytotoxic, pro-inflammatory, and pro-oxydant properties.

Atherosclerosis↗

PubMed2006

[Efficacy of first- or second-line latanoprost on intraocular pressure and ocular symptoms in patients with open-angle glaucoma or ocular hypertension].

OBJECTIVES: The aim of this study was to assess the changes in intraocular pressure (IOP) and ophthalmic symptoms with the Glaucoma Symptom Scale in patients suffering from open-angle glaucoma (OAG) or ocular hypertension (OHT) after 3 months of treatment with latanoprost. MATERIALS AND METHODS: This multicentric open study was carried out in adult patients suffering from OAG or simple OHT (naive or previously treated with monotherapy) and needing a change or initiation of anti-glaucomatous treatment. One drop of latanoprost 0.005% was instilled every evening for 12 weeks in each affected eye. Efficacy was assessed by the variation in IOP and ophthalmic symptomatology at the end of treatment. Prognosis factors associated with a relative IOP reduction of at least 30% were sought (using a logistic regression model). RESULTS: A total of 920 patients suffering from OAG (54%) or OHT (44%), either previously treated (69%) or naive (31%), were included. The male:female ratio was 0.78 and the mean age was 63+/-13 years. At inclusion, the mean IOP was 22.1+/-3.8 mmHg. After treatment, IOP was significantly decreased by 5.1+/-4 mmHg, corresponding to a 22% reduction. IOP reduction was 7.1+/-4 mmHg, corresponding to 29% in naive patients and 4.2+/-4 mmHg, corresponding to 19% in previously treated patients. A relative IOP reduction of at least 30% was reached by 47% of naive patients and 21% of previously treated patients. In previously treated patients, a relative IOP reduction of at least 30% had a greater chance of being reached in men with previous ophthalmic history and high IOP at inclusion (above 21 mmHg). IOP reduction was similar in patients with OAG and OHT. A significant improvement in ophthalmic symptoms was observed after treatment in previously treated patients. A total of 7% of the patients presented an adverse event affecting the visual system: eye irritation (2%), eye pain (2%), or eye hyperemia (1%). Compliance was good for 94% of the patients. CONCLUSION: Latanoprost given as first or second-line treatment at the recommended dose effectively decreases IOP in patients with OAG or OHT. This treatment also improves visual and nonvisual symptoms in previously treated patients and presents a good safety profile.

Antihypertensive Agents↗

PubMed2006

[Prevalence of intraocular hypertension and glaucoma in a nonselected French population].

AIMS: To measure intraocular pressure (IOP) in a large human sample and to assess the prevalence of glaucoma with elevated IOP and ocular hypertension (OHT) in this population. METHODS: We measured IOP in 2,074 subjects (men: women: 1,384: 690). If the IOP was higher than 20 mmHg, a photograph of the optic disc was taken and the visual field was examined. The optic nerve head and the visual field were evaluated in 395 individuals. RESULTS: In men aged 18-39 years, mean IOP was 15.5+/-3.1 mmHg and 16.4+/-3.5 mmHg after 60 years of age. In women, IOP reached 14.5+/-3.3 and 15.9+/-3.1 mmHg, respectively. IOP greater than 21 mmHg was found in 10.1% of males and 6.4% of females. The prevalence of OHT increased with age: from 5.3% to 15.5% in men and from 3% to 7.5% in women for the same age ranges. A diagnosis of glaucoma with elevated IOP was made in 2.2% of males and 3.0% of females. The prevalence of glaucoma increased with age from 0.8% to 5.7% in men and from 0.6% to 4.7% in women under 40 years and over 60 years of age, respectively. DISCUSSION: This study confirms the increase in IOP with age and the role of aging in the prevalence of OHT and glaucoma with elevated IOP. CONCLUSION: This transversal study shows the feasibility of intraocular hypertension and glaucoma screening and prevalence assessment in a nonselected large population in France.

Adolescent↗

PubMed2006

[Prevalence and description of treatment with intraocular pressure-lowering topical medications in continental France].

PURPOSE: The first objective of the present study was to estimate the prevalence of patients treated for glaucoma or ocular hypertension (OHT) with an IOP (intraocular pressure) -lowering topical medication. Subjects were 40 years old and living in continental France. The second objective was to describe the type of therapy, compliance, and the quality of life of the subjects treated. METHODS: This study was a telephone survey conducted in a general population on a representative sample of 5726 subjects in 2004. Subjects treated for glaucoma or OHT were defined as those declaring use of eye drops for more than 1 month and mentioning one of the 52 registered IOP-lowering topical medications and/or stating that they were taking eye drops for glaucoma or OHT. Quality of life was measured using the GlauQOL-17 questionnaire. RESULTS: 237 subjects (4.1%) corresponded to this definition. The prevalence increased with age, from 0.7% in subjects aged 40-44 years to 10.6% in those aged 80 years or more. The age-standardized prevalence was higher in the Paris area (5.3%), the Mediterranean (4.5%), and the Southwest (4.7%), and lower in rural areas (3.2%), and in subjects with less than high school education (2.9%). Beta-blockers (49.5%) and prostaglandins (37.4%) were the most frequent treatments, followed by carbonic anhydrase inhibitors (15.3%), sympathomimetics (5.7%), and myotics (1.3%). Compliance was not total in 39% of the patients (22% of those treated with once-a-day dosage). DISCUSSION: The results of the present study are in line with French health authority data and with the results of the French "Glaucoma and intraocular high pressure, one day" study results. Moreover, the lower prevalence in regions with low medical density, low socioeconomic level, and rural areas, suggest that glaucoma or OHT might be underdiagnosed. CONCLUSION: On the basis of this first nationwide study, it can be estimated that the prevalence of subjects treated with IOP-lowering topical medications is about 1.2 million in France. The number of daily doses appears to influence compliance.

Adult↗

PubMed2006

[Glaucoma in the young patient; clinical particularities].

The world of glaucoma is constantly evolving with new data to be taken into account alongside the fundamental values. We report a new classification of angle closure and easy-to-retain statistics, both diagnostic and therapeutic, for daily practice.

Glaucoma↗

PubMed2006

[Management of ocular hypertension and chronic open-angle glaucoma by French ophthalmologists: the role of target intraocular pressure].

PURPOSE: A low level of intraocular pressure (IOP) can reduce or even stop the progression of glaucoma. It is essential to limit conversion from ocular hypertension (OHT) to glaucoma. The IOP value that protects the visual field and the optic nerve is called target IOP. This study analyzes how French ophthalmologists determine the target IOP level. MATERIAL AND METHODS: The main objective of this prospective, multicenter national survey was to analyze the management of OHT or glaucoma patients and to evaluate the importance of target IOP in the therapeutic strategy. RESULTS: A total of 972 ophthalmologists included 11.177 patients from May 2002 to March 2004. In 68.7% of cases, the practitioner determined the target IOP level using the following methods: a target of 15 mmHg or 17 mmHg or a reduction of the IOP level in percentage (EGS guidelines). This mean target IOP ranged from 14.3 to 17.3 mmHg. DISCUSSION: The estimation of target IOP is used by the majority of French ophthalmologists. CONCLUSION: This study shows that the determination of target IOP is becoming increasingly important in the therapeutic decision and follow-up in the routine practice of French ophthalmologists.

Aged↗

PubMed2005

[Ocular proprioception and developmental dyslexia. Sixty clinical observations].

PURPOSE: The objective of this study is to assess proprioception anomalies in postural deficiency syndrome in a group of children suffering from reading impairment. MATERIAL AND METHODS: Sixty male patients with an average age of 11 years and 9 months were included in the study. Initially, they were given a standardized neuropsychological examination, which confirmed the diagnosis of reading impairment. Then after filling out a questionnaire seeking a proprioceptive anomaly, the patients were subjected to a clinical ocular and postural examination consisting of nine precisely described steps. RESULTS: All of the patients recruited for the study presented clinical signs confirming a proprioception disorder found as a part of postural deficiency syndrome. CONCLUSION: This study opens a new direction for research concerning the origin and treatment of at least some reading-impaired children.

Adolescent↗

PubMed2005

[Dermatosis and infectious dermatitis of the eyelid].

Lid infections are very frequent and for the most part are isolated and benign clinical conditions. Rarely they occur during a severe systemic disease and present a poor prognosis. In this review, we describe the most frequent presentations and detail the available medical and surgical treatments.

Bacterial Infections↗

PubMed2005

[Study of ocular surface involvement in diabetic patients].

INTRODUCTION: Diabetes mellitus leads to microvascular complications and altered basement membranes, which are partly responsible for ocular complications. Corneal nerve impairment is involved in ocular surface disease as well. We examined the possible relation between ocular surface signs and retinal or neuronal degenerative complications due to diabetes. PATIENTS AND METHODS: Diabetics and control subjects were compared for corneal sensitivity and tear function parameters such as the Schirmer test, tear film break-up time (BUT), and fluorescein and lissamine green stainings. The relation of the duration of the disease, the stage of retinopathy, metabolic control (HbA1c), and diabetic peripheral neuropathy with ocular surface disorders were noted. RESULTS: Twelve healthy patients were compared to 48 diabetics. The Schirmer test value, BUT, and fluorescein and lissamine green impregnations were significantly modified in diabetics compared to controls (p<0.0001), with no relation to the duration of the disease or metabolic control. The mean corneal sensitivity was significantly lower in diabetic patients (p<0.01), diabetics with peripheral neuropathy (p=0.00008), and diabetics with preproliferative retinopathy (p=0.0003). Tear function parameters were more frequently altered in patients presenting preproliferative retinopathy and peripheral neuropathy (p<0.001). CONCLUSIONS: Diabetes can lead to ocular surface impairments with qualitative and quantitative tear disorders, all of which seem to evolve in close relation with retinopathy and peripheral neuropathy. These lacrymal and corneoconjunctival abnormalities, even if not currently mentioned by diabetic patients, can result in severe neurotrophic complications.

Basement Membrane↗

PubMed2005

Long term effect on IOP of a stainless steel glaucoma drainage implant (Ex-PRESS) in combined surgery with phacoemulsification.

AIM: To evaluate the efficacy and safety of a stainless steel miniature glaucoma drainage device (Ex-PRESS R50) for the surgical treatment of primary open angle glaucoma (POAG) and cataract when combined with phacoemulsification. METHODS: Clinical, prospective, multicentre, single treatment arm, non-randomised, non-masked study. The Ex-PRESS device was implanted at the limbus under a conjunctival flap. Phacoemulsification cataract extraction and in the bag IOL implantation were performed through clear cornea temporally. PRIMARY OUTCOME: IOP change; secondary outcomes: side effects and VA changes. RESULTS: 26 eyes of 25 patients were implanted with the device. The mean (SD) follow up was 23.9 (10.4) months and the mean age was 75.1 (7.1) years. 17/26 eyes have more than 3 years of follow up. One case was discontinued because of device removal, one because of death, and three were lost to follow up. EFFICACY: preoperative IOP was 21 (4) mm Hg; at 1, 2, and 3 years IOP was 15.3 (3.1) mm Hg (35% reduction), 16.6 (2.7) mm Hg (29% reduction), and 16 (2.6) mm Hg (22% reduction) respectively. Kaplan-Meyer determined overall success rate (IOP < or = 21 mm Hg at the last visit with or without medications) as 76.9%. The number of antiglaucoma medications was reduced by 95% at year 1. Only six patients (23%) were taking IOP lowering treatment at their last visit, five with one medication and one with two medications. Side effects: early postoperative complications were clinically mild and included six cases of hypotony (IOP <5 mm Hg), three cases of hyphaema (<2 mm) with no clinically significant further effects. Long term complications were two cases (7.7%) of device rotation (one treated by reposition) and three cases (11.5%) of conjunctival erosion at 2 and 3 years. CONCLUSIONS: The Ex-PRESS implant, combined with phacoemulsification cataract extraction, is clinically safe and effective, maintaining in the long term a large reduction in IOP and in the number of antiglaucoma medications.

Aged↗

PubMed2004

[A screening questionnaire for determining risk of Creuzfeldt-Jacob disease transmission during ophthalmic examination].

INTRODUCTION: The risk of prion transmission during an ophthalmic examination concerns all ophthalmologists screening patients at risk, a procedure normally based on collecting past history and clinical data. PATIENTS AND METHODS: The authors proposed a shortened version of a questionnaire where the patient provides only the past history by answering three questions, which are then validated by the ophthalmologist. RESULTS: This procedure was proposed to 500 patients. Only five patients answered one of the questions positively, and the ophthalmologist did not use any contact device during their examination. Of these five patients, none was confirmed to be at risk for prion transmission. CONCLUSION: This questionnaire seems to be a suitable way to compensate the lack of time and reduced staff in ophthalmology, whatever the ophthalmic practice may be.

Creutzfeldt-Jakob Syndrome↗

PubMed2004

[Treating severe dry eye syndromes with autologous serum].

BACKGROUND: Dry eye syndrome with tear deficiency can be improved with artificial tears, which can be associated with topical anti-inflammatory agents. Autologous serum can provide the ocular surface with beneficial growth factors and vitamins. PATIENTS AND METHODS: Twenty-one patients suffering from severe dry eye due to Sjögren's syndrome were treated with 20% autologous serum for 2 Months. The Schirmer I test, break-up time, and fluorescein and lissamine green stainings were performed before and after treatment. Subjective complaints such as burning, foreign body sensation, dryness and photophobia were assessed by a questionnaire as well as a face score reflecting the current condition of patients' eyes. RESULTS: Lissamine green and fluorescein scores improved significantly as well as subjective symptoms of burning, foreign body sensation and dryness (p<0.05). The face score was significantly improved. Bacterial culture of serum delivered to the patients all remained negative. DISCUSSION: Autologous serum provides growth factors and vitamins that are useful for an altered ocular surface due to Sjögren's disease. However, some problems still remain: risk of contamination, arbitrary dilution of autologous serum, and a current lack of regulations for use of autologous serum. A close collaboration between ophthalmologists and the Etablissement Français du Sang (French Blood Bank) is mandatory because autologous serum should be considered as a useful tool to treat severe ocular surface disorders. CONCLUSION: The use of autologous serum improved symptoms and objective signs caused by severe Sjögren's syndrome. Currently, a lack of clear regulations prevents its widespread use in severe ocular surface disorders.

Blood Transfusion, Autologous↗

PubMed2004

[Contribution of large clinical studies to daily practices].

OHTS, CIGTS, EMGT, AGIS, CNTG: many multicenter, randomized and double-blind studies have been published in the last few years, greatly expanding our knowledge of glaucoma. Although for ophthalmologists this research is essential for their daily clinical practice, its interpretation must remain nuanced, if only because the scores evaluating the progression of this ocular pathology in terms of the optic disc and visual field cannot be compared from one study to another.

Aged↗

PubMed2004

[Comparison of once-daily nonpreserved timolol and timolol maleate gel-forming solution associated with latanoprost].

AIM: To compare the efficacy and safety of a single daily instillation of nonpreserved timolol to a timolol maleate gel-forming solution in patients with chronic glaucoma or ocular hypertension already treated with latanoprost. PATIENTS AND METHODS: A randomized, prospective, multicenter, open, parallel-group clinical trial was undertaken with 73 patients with chronic glaucoma treated with latanoprost and a timolol maleate gel-forming solution. In 36 patients, the previous regimen was substituted by nonpreserved timolol given instead of timolol maleate gel for 3 months. The changes in intraocular pressure (IOP) were recorded as well as local and systemic tolerance and patient compliance. RESULTS: At 3 months, both regimens were found equivalent in maintaining IOP control between D0 and D84. The difference with baseline was -0.08 +/- 2.22 mmHg and -0.38 +/- 2.41 mmHg in the nonpreserved timolol group and in the timolol maleate gel-forming solution group, respectively (CI 95% [-0.79; 1.38]). After 84 days of treatment, blurred vision (5.9%) and eyelid deposits (5.9%) were reduced in the preservative-free timolol group compared to the other group (respectively, 33.3% and 24.2%). These differences were statistically significant for both signs (blurred vision: p < 0.0001 and for eyelid deposits: p = 0.03). CONCLUSION: This short-term study has demonstrated the equivalence of nonpreserved timolol to timolol maleate gel-forming solution in terms of IOP control. Moreover, the local tolerance of nonpreserved timolol was better.

Aged↗