Biomedical subjects

J-P Renard

Publications and source records attributed to J-P Renard.

13 recordsLinked to original sources

PubMed2006

[Glaucoma - structural imagery: HRT, GDX, OCT].

Confocal scanning laser tomography (HRT), scanning laser polarimetry (GDx VCC), and optical coherence tomography provide quantitative data of the retinal fiber layer and optic nerve head. They have become good complementary evaluation tools for glaucomatous optic neuropathy and their results should be analyzed with clinical data. Good knowledge of the parameters they analyze and their limitations are indispensable. To monitor progression of structural involvement, the analysis programs used need to be validated with prospective clinical studies.

Glaucoma↗

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

[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

[How to assess the stability of glaucoma? Optic nerve].

Exam of the optic nerve head and retinal nerve fibers is essential to firmly establishing whether glaucoma is stable. Stereoscopic examination of the optic disc (qualitative analysis) looks for modifications of the neuroretinal rim and of the cup, vascular modifications, and alterations of the retinal nerve fibers and of the peripapillary area. It can be usefully completed by photos. Although automatic analyzers (quantitative analysis) are clearly advantageous in the analyze of the retinal nerve fiber layers, they do not yet replace photographs or the clinical exam. In advanced stages of glaucoma, functional analysis is the most appropriate for assuring that the neuropathy is stable.

Diagnostic Techniques, Ophthalmological↗

PubMed2005

[Diagnostic laser in glaucoma: scanning laser polarimetry (GDx VCC) and confocal scanning laser tomography (HRT)].

Automated structural measurements of retinal nerve fibers and optic nerve head are possible with new lasers providing objective and reproductible data for analysis. Scanning laser polarimetry (GDx VCC), based on retardation of polarized light, assesses peripapillary nerve fiber layer thickness. Confocal scanning laser tomography yields precise topographic maps of the optic disc and peripapillary retina. The advantages, applications for glaucoma detection, both in a screening setting as well as for monitoring progression, limitations and pitfalls need to be well known and results should be analyzed with clinical data.

Disease Progression↗

PubMed2005

Direct costs of glaucoma and severity of the disease: a multinational long term study of resource utilisation in Europe.

BACKGROUND: Resource utilisation and direct costs associated with glaucoma progression in Europe are unknown. As population progressively ages, the economic impact of the disease will increase. METHODS: From a total of 1655 consecutive cases, the records of 194 patients were selected and stratified by disease severity. Record selection was based on diagnoses of primary open angle glaucoma, glaucoma suspect, ocular hypertension, or normal tension glaucoma; 5 years minimum follow up were required. Glaucoma severity was assessed using a six stage glaucoma staging system based on static threshold visual field parameters. Resource utilisation data were abstracted from the charts and unit costs were applied to estimate direct costs to the payer. Resource utilisation and estimated direct cost of treatment, per person year, were calculated. RESULTS: A statistically significant increasing linear trend (p = 0.018) in direct cost as disease severity worsened was demonstrated. The direct cost of treatment increased by an estimated 86 for each incremental step ranging from 455 euro per person year for stage 0 to 969 euro per person year for stage 4 disease. Medication costs ranged from 42% to 56% of total direct cost for all stages of disease. CONCLUSIONS: These results demonstrate for the first time in Europe that resource utilisation and direct medical costs of glaucoma management increase with worsening disease severity. Based on these findings, managing glaucoma and effectively delaying disease progression would be expected to significantly reduce the economic burden of this disease. These data are relevant to general practitioners and healthcare administrators who have a direct influence on the distribution of resources.

Adult↗

PubMed2005

[Practical assessment. Ocular hypertension].

In cases of high intraocular pressure, the patient's hypertension must first be confirmed and its characteristics delineated with a diurnal IOP curve or at least several different measures. Central corneal thickness should be measured, since a thin cornea is a risk factor of progression toward glaucomatous neuropathy. Later, the optic nerve head and retinal nerve fibers should be tested (HRT, GDx, and OCT), to determine whether the ocular hypertension is associated with other findings, and visual field analysis should be carried out (standard automated perimetry, blue-yellow perimetry, FDT), completed by a search for associated risk factors. Therapeutic decisions will be based on this workup, keeping in mind that in the majority of cases, monitoring and information are sufficient but necessary; treatment should, however, be initiated in cases of ocular hypertension with a high risk of progression.

Humans↗

PubMed2004

In vitro embryo production efficiency in cattle and its association with oocyte adenosine triphosphate content, quantity of mitochondrial DNA, and mitochondrial DNA haplogroup.

Mitochondria have a broad range of functions that affect reproduction, and structural as well as quantitative variation in mtDNA has been associated with gamete quality and reproductive success. To investigate the mitochondria effect on in vitro embryo production, we collected oocytes by ultrasound-guided follicular aspiration from donor cows known to differ in the developmental capacity, measured by the blastocyst formation rate, of their oocytes. To evaluate the potential effects of mtDNA and mitochondrial function on oocyte quality, the donor cows' mtDNA control region was sequenced and, after pairwise comparisons of polymorphisms, animals were grouped into two major haplogroups. The number of mtDNA molecules per oocyte was quantified by real-time PCR, and the adenosine triphosphate (ATP) content was measured in each oocyte to identify variations between haplogroups. Overall, ATP stocks in oocytes of the two haplogroups differed significantly (P < 0.05; means +/- SEM) both at the germinal vesicle and metaphase II stages (2.8 +/- 0.06 pmol vs. 2.6 +/- 0.07 pmol and 2.9 +/- 0.1 pmol vs. 2.3 +/- 0.06 pmol, respectively). The proportion of development to blastocyst was significantly different between haplogroups (22.3 +/- 2.1 % vs. 36.7 +/- 2.9 %). The number of mtDNA molecules per oocyte was highly variable (377 327 +/- 14 104, ranging from 2.0 x 10(3) to 1.2 x 10(6)) but not significantly different between the two haplogroups; significant differences were observed between animals without any apparent relationship to blastocyst production. These data suggest that mitochondria and mtDNA haplogroup affect the developmental capacity of bovine oocytes in vitro.

Adenosine Triphosphate↗

PubMed2004

[Editorial].

Explore the source record for details and available documents.

France↗

PubMed2004

[Treatment of acute angle-closure glaucoma].

Treatment of acute angle-closure glaucoma is now better adapted for each stage of the disease. The urgent necessity to lower intraocular pressure is normally achieved using medical therapy followed by laser peripheral iridotomy and sometimes by filtration surgery. Early argon laser peripheral iridoplasty is effective and safe in some cases, allowing a very early peripheral iridotomy to be performed and avoiding systemic treatment. When surgery is required, lens extraction must be considered. In all cases, IOP control and regular gonioscopic examination the 1st Year are essential to detect peripheral anterior synechiae.

Acute Disease↗

PubMed2004

Genetic identity of clones and methods to explore DNA.

Cloning by nuclear transfer has made it possible to produce genetically identical animals in terms of nuclear DNA content. Recent molecular biology tools are offering scientific ways to get an insight into the identity issues, by exploring and comparing genomes of cloned animals in order to test their genetic identity and methylation differences. We have initiated a study to compare genomic DNA of bovine adult clones, of normal phenotype. We have used, in parallel, the AFLP technique (amplification fragment length polymorphism) and one of its variant, MSAP (methylation-sensitive amplification polymorphism). We are also investigating other techniques leading to the detection of sequence polymorphisms between two genomes based on genomes hybridisation. We chose the representational difference analysis (RDA) methods that can be combined with mismatch-specific recognition or mismatch binding property of some proteins (CEL I, MutS). We plan to use these RDA methods for genome-wide detection of subtle mutations, then to focus on changes affecting the methylation status of promoting genomic regions in abnormal clones. This will be achieved using MSAP with NotI and applying, in parallel, the RLGS (restriction landmark genome scanning) technique. This study will hopefully improve the molecular and functional characterizations of these "new animals."

Adenosine Triphosphatases↗

PubMed2003

[Familial recurrent bilateral panuveitis: efficiency of alpha interferon].

INTRODUCTION: There is no consensus for the treatment of severe recurrent uveitis. Immunosuppressive drugs have inconstant efficiency and may result in serious adverse effects. We report the cases of two brothers suffering from severe recurrent idiopathic panuveitis dramatically improved following alpha interferon therapy. EXEGESIS: Two 28 and 32 years old brothers presented with an idiopathic recurrent panuveitis for 4 and 5 years respectively. They both had a HLA B5 haplotype. However they had no clinical symptoms of Behçet's disease. In both cases panuveitis recurred three or four times yearly despite corticosteroid and cyclosporin therapies. The treatment with alpha interferon improved visual acuity in both cases. The older brother had no recurrence throughout the period of treatment and after a 1 year follow-up. The other one was improved and the ocular lesions have been stabilised for nine months follow-up. CONCLUSION: - Alpha interferon therapy seems efficient in severe idiopathic panuveitis. This treatment is well tolerated without ophthalmologic adverse effects. The optimal posology and the duration of treatment need to be determined.

Adult↗

PubMed2003

[Glaucoma and quality of life].

Glaucoma is a serious ocular disorder potentially leading to blindness. Measuring the quality of life of patients with glaucoma is important because it makes it possible to evaluate the impact of the disease and its treatment on the patient's everyday life. Hitherto, this was done using generic scales, or those developed for other diseases; but no scale suitable for glaucoma was available. The recently developed GlauQOL scale is now available. We present the short version of this questionnaire adapted to individual use within an ophthalmology consultation setting.

Glaucoma↗