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The article presents a study which aims to examine the ability of optical coherence tomography (OCT) to measure visual dysfunction progression in neuromyelitis optica (NMO). A group of 30 patients with NMO were evaluated clinically by OCT, visual field (VF), visual evoked potential (VEP), fundoscopy and visual acuity (VA). The study shows that mean VA was the same at the two evaluation times and mean VF defect slightly declined.

Purpose The aims of our study are to determine the possible efficacy of IL‐17A mAbs on Toxoplasma gondii proliferation and the benefit on intraocular inflammation in a murine model of ocular toxoplasmosis. Methods Mice infection is done by intravitreal injection of Toxoplasma gondii, PRU type II strain, and leads to severe ocular inflammation. At the same time of infection, IL‐17A mAbs is administered by intravitreal route. Intraocular inflammatory grading and histological datas are determined. Parasites counting and mRNA levels of Tbet, Foxp3, IL‐27 and ROR‐gammaT are quantified using RT‐PCR. Cytokines levels and profiles are established on murine aqueous humor using multiplex assay. Results Intraocular inflammation is significantly decreased after IL‐17A mAbs intravitreal injection in infected mice. Parasite counting shows a significant decrease after IL‐17A mAbs. mRNA levels of T‐bet, Foxp3 and IL‐27 are increased with IL‐17 abs. mRNA‐ROR‐gammaT levels are unchanged. In aqueous humor, cytokines pattern shows a Th1/Treg profile after IL‐17 mAbs intraocular injection. Conclusion IL‐17A mAbs may mitigate chorioretinitis by antagonizing the Th17 phenotype through induction of Th1 and Treg cells in the eye. T regulatory (Treg) cells secreting could play an important protective and homeostatic role in modulating hypersensitivity responses induced by Toxoplasma infection. Antagonism of Th17 by Treg cells could be a way to limit ocular lesion. These data open new in vivo therapeutic approaches by repressing the Th17 pathway using IL‐17A mAbs. [ABSTRACT FROM AUTHOR]

Purpose Optic neuritis is a demyelinating inflammation of the optic nerve. Many cases of optic neuritis are associated with multiple sclerosis or neuromyelitis optica. In some cases, a recurrence of isolated optic neuritis is observed. However this existence of entity remains controversial. Yhe present retrospective study was designed to estimate the prevalence of this condition. Methods In five university hospitals (Lille, Montpellier, Nimes, Reims and Strasbourg), between October 2005 and October 2009, the charts of patients with recurrent isolated optic neuropathy (RION) and normal cerebral magnetic resonance imaging included prospectively were reviewed. The following parameters were analyzed: date of the first relapse, age at onset, duration at the time of inclusion, recurrence after steroid withdrawal, unilateral or bilateral involvement, number of relapses, visual acuity, retinal nerve fiber layer thickness, diagnostic workup, and longterm treatment with immunosuppressive or immunomodulatory drugs. Results During the predefined period, 18 patients (15 women, 3 men; age 17–54 years at onset) matched the inclusion criteria. Between two and six relapses of optic neuropathy were observed. The median duration was 6 years. In untreated patients (n=9), a significant inverse correlation was observed between visual acuity and duration of the disease; this correlation was not found in the group of patients (n=9) with long‐term treatment Conclusion The progressive loss of vision over time in this retrospective study of recurrent isolated optic neuropathy could be related to axonal loss. A prospective cohort study is necessary to confirm this hypothesis and to evaluate the benefit of long‐term treatment on this progression. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate whether strabismus surgery improves the learning performance - calculation, reading and drawing - of school-aged children., Methods: In a case-control study, patients between the ages of 7 and 10 years with horizontal strabismus, recommended for surgical correction, were prospectively included. Reading, calculating and drawing abilities were evaluated before and 3 months after corrective strabismus surgery using standardized tests. Cases were compared to control patients: patients with a surgical indication postponed due to the COVID lockdown., Results: Forty-two operated patients and 42 controls between the ages of 7 and 10 years with horizontal strabismus were included. The average reading speed was 65.8 words per minute pre-operatively compared to 80.6 words per minute post-operatively (p = 0.0038). The average drawing score was 71.1 pre-operatively compared to 84.3 post-operatively (p = 0.012). The average calculation score was 3.2 pre-operatively compared to 3.4 post-operatively (p = 0.363). Improvement given by strabismus surgery was confirmed avoiding the learning effect by comparison with the control group. The improvements observed were more significant in the youngest patients and esotropia., Conclusions: This study highlights that strabismus surgery significantly improved the children's reading fluency and drawing task execution. These encouraging data should be taken into account when considering the indications for strabismus surgery., (© 2023 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)

Despite the advantages that robot-assisted surgery can offer to patient care, its use in ophthalmic surgery has not yet progressed to the extent seen in other fields. As such, its use remains limited to research environments, both basic and clinical. The technical specifications for such ophthalmic surgical robots are highly challenging, but rapid progress has been made in recent years, and recent developments in this field ensure that the use of this technology in operating theatres will soon be a real possibility. Fully automated ocular microsurgery, carried out by a robot under the supervision of a surgeon, is likely to become our new reality. This review discusses the use of robot-assisted ophthalmic surgery, the recent progress in the field, and the necessary future developments which must occur before its use in operating theatres becomes routine., Competing Interests: The authors declare that they have no conflict of interest., (Thieme. All rights reserved.)

Purpose: The sense of vision is responsible for 90% of the information obtained by the motorist. Improvement in binocular visual acuity (VA) and visual field (VF) achieved after strabismus surgery could have beneficial effects on driving. Our study sought to identify functional improvements (VA and VF) and improvements in driving ability following strabismus surgery., Methods: In a prospective cohort study, the following parameters are analyzed before and 3 months after strabismus surgery: simulated driving performance (including eye movements and actions on vehicle control), binocular VA, binocular VF, and self-confidence during driving., Results: Twenty patients participated in the study. The mean preoperative logMAR binocular VA and stereopsis do not significantly differ from the postoperative. The mean Esterman VF score increases from 91.3 (±17.2) preoperatively to 96.9 (±13.9) postoperatively ( P = 0.045). The mean self-confidence directed at driving scores decreases from 20.5 (±10.3) points before surgery to 11.0 (±6.0) points after surgery ( P < 0.001). The distance at which the road signs are identified is significantly higher after surgery. The average speed of the vehicle and the speed near the targets (30 m) increase significantly after strabismus surgery. A significant decrease in ocular movements near targets is also observed. The number of brake pedal depressions and the rate of brake pedal depressions slightly decrease after surgery., Conclusions: This study demonstrates the potential beneficial effects of strabismus surgery on driving ability, with significant improvements in self-confidence during driving, VF, and driving on a simulator., Translational Relevance: This was the first study to use a driving simulator in strabismus., Competing Interests: Disclosure: D. Derhy, None; S. Lithfous, None; C. Speeg, None; D. Gaucher, None; O. Despres, None; A. Dufour, None; T. Bourcier, None; A. Sauer, None, (Copyright 2020 The Authors.)

The regular use of cannabis generates pronounced cognitive disorders, especially in users who begin before the age of 15-16. However, less is known about the impact of regular cannabis on visual function, especially in the case of early onset. Cannabinoid receptors (CB1) are expressed in areas of the visual system, like the thalamus and primary cortex, which might originate sensory disorders. Hence, we measured contrast sensitivity (CS) in three groups, i.e. cannabis users with late onset of cannabis use (after 16 years old), cannabis users with early onset". We used a constant method which allowed us to control for biased responses. Stimuli were presented at high and low spatial frequencies and in both static and dynamic conditions (8Hz). As contrast sensitivity is measured behaviorally based on an explicit response and could thus be impacted by attentional or vigilance disorders, participants' attention and vigilance were carefully monitored by means of the D2 test, CPT-AX for attention and pupillography for vigilance. Cannabis users with early onset were significantly impaired only at low spatial frequency. This effect was independent of response bias, vigilance and attention. These results show for the first time that early cannabis use impacts contrast sensitivity at low spatial frequency., (Copyright © 2017 Elsevier B.V. and ECNP. All rights reserved.)

Purpose: This study aims to investigate the feasibility of pterygium surgery using the DaVinci Si HD robotic surgical system, and to describe a porcine model for pterygium surgery and evaluate its usefulness., Methods: The pterygium models were constructed using enucleated pig eyes and cold cuts. Robotically-assisted pterygium surgeries in nonliving biological pterygium models were performed using the DaVinci Si HD robotic surgical system. Twelve models were prepared, and 12 pterygium excision and conjunctival autografts were performed., Results: The DaVinci system provided the necessary dexterity to perform delicate ocular surface surgery and robotic tools were safe for the tissues. The mean duration of the surgical procedures was 36 minutes. There were no intraoperative complications and no unexpected events., Conclusions: Robotic-assisted pterygium surgery is technically feasible for porcine eyes using the DaVinci Si HD robotic surgical system. The pterygium model that we describe could be of interest for surgical training., Translational Relevance: Little research has been done in robotic microsurgery. Animal experimentation will allow the advantages of robotic-assisted microsurgery to be identified, while underlining the improvements and innovations necessary for clinical use.

We report the case of a 38-year-old woman with a history of migraine who experienced an association of recurrent unilateral facial pain and Pourfour du Petit syndrome. The episodes occurred for between a few seconds and up to 3 minutes up to 6 times a day mimicking short-lasting unilateral neuralgiform headaches with cranial autonomic symptoms. No lesional cause was found and the use of topiramate led to a nearly complete disappearance of the episodes. This new entity raises the question of a novel autonomic dysfunction in short-lasting unilateral neuralgiform headaches with cranial autonomic symptoms or an unexpected presentation of migraine., (© 2013 American Headache Society.)

Background: Neuromyelitis optica (NMO) is an inflammatory disease associated with optic neuritis and myelitis. Recently, several studies showed that optical coherence tomography (OCT) could be an interesting method for the evaluation of disease severity; however, to date there are no studies with a longitudinal follow-up of visual function in NMO. The aim of this study was to assess the ability of OCT to evaluate the progression of visual dysfunction in NMO., Patients and Methods: A group of 30 NMO patients (thus, 60 eyes), comprised of 20 women and 10 men with a mean age of 43.7 +/- 12.3 years, were prospectively evaluated clinically and by a whole neuro-ophthalmological work-up, including: visual acuity (VA), fundoscopy, visual evoked potential (VEP), visual field (VF) and optical coherence tomography (OCT). All patients were tested at baseline (after a mean disease duration of 6.1 years) and after a mean time of follow-up of 18 months (range: 12-36 months)., Results: Mean VA was similar at the two evaluation times (0.77 +/- 0.36 versus 0.77 +/- 0.35). The mean VF defect decreased slightly, but the difference was not significant (-5.9 +/- 1.3 dB versus -5.3 +/- 1.3 dB). In contrast, the mean retinal thickness seen on OCT decreased from 87.4 +/- 23.3 µm to 79.7 +/- 22.4 µm (p = 0.006). These modifications were only observed in eyes with a past or a recent history of optic neuritis (-15.1 µm; p < 0.001) and not in eyes without any history of optic neuritis (-2.4 µm; not significant). Also, they occurred independently of the occurrence of relapses (n = 13) and especially optic neuritis episodes; however, the number of optic neuritis episodes was low (n = 5)., Conclusion: OCT seems to be a more sensitive test than VA or VF for monitoring ophthalmological function in NMO and it seems to be helpful for the detection of infra-clinical episodes in patients with a past history of optic neuritis. Our results suggest that this easily performed technique should be used in the follow-up of NMO, but complementary studies are warranted to confirm its interest at an individual level.

Purpose: To report the results and safety of sutureless intrascleral haptic fixation in traumatized eyes and to compare this procedure with retropupillary iris-claw intraocular lens (IOL) fixation., Setting: University Hospital of Strasbourg, Strasbourg, France., Design: Interventional case series., Methods: Patients with traumatic cataract and severely damaged capsular bags were divided into 2 groups (Group 1: intrascleral IOLs [Acrysof MN60 AC]; Group 2: retropupillary iris-claw IOLs [Verisyse]). The main outcome was the final visual acuity. The surgically induced astigmatism (SIA) was calculated by the vectorial method., Results: Twenty-six eyes of 23 patients were studied, 8 eyes in Group 1 and 18 eyes in Group 2. The mean follow-up was 14 months. There was no difference in corrected distance visual acuity (CDVA) at the time of the surgery (P>.05). The mean CDVA (logMAR) was 1.68 ± 1.15 (SD) preoperatively and 0.55 ± 0.9 postoperatively in Group 1 (P = .03) and 1.11 ± 1.13 and 0.32 ± 0.47, respectively, in Group 2 (P = .003). The final CDVA was not different between groups (P>.05). The mean SIA was 1.91 ± 1.66 diopters (D) in Group 1 and 2.74 ± 1.92 D in Group 2 (P>.05). No intraoperative complications occurred in Group 2; a haptic broke in Group 1. Macular edema occurred in both groups., Conclusions: Sutureless intrascleral IOLs corrected posttraumatic aphakia. The SIA was comparable between groups. This procedure should be considered after trauma when other implantation techniques are not possible., (Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.)

Background: Neuromyelitis optica (NMO) is an inflammatory disease with combined features of optic neuritis and myelitis. This pathologic entity may induce severe disability, including visual loss and paraplegia. Other than clinical follow-up, there is no marker for severity of the disease., Objectives: To evaluate the use of optical coherence tomography (OCT) in NMO and to determine whether this new technique could be a good marker of axonal loss in NMO., Design: Cross-sectional study., Participants: Thirty-five patients with NMO or at a high risk for NMO (having optic neuritis or myelitis and who are positive for NMO antibody) were prospectively studied. Fifteen healthy individuals served as control subjects., Main Outcome Measure: All patients underwent a complete ophthalmologic evaluation, including OCT, funduscopy, and visual field, visual acuity, and visual evoked potential testing. Expanded Disability Status Scale scores were assessed but without the visual data. Correlations between the visual test results and demographic or clinical characteristics were evaluated., Results: Optical coherence tomography and visual field data were available for only 32 patients because 3 patients were blind. The mean retinal nerve fiber layer thickness was significantly reduced in patients with NMO compared with controls (P < .001). We found good correlation between the OCT results and visual field testing. We also found weak correlation between OCT results and both visual acuity and visual evoked potential latencies. We did not find any correlation between OCT results and age, sex, or disease duration. In contrast, retinal nerve fiber layer thickness was closely correlated with the Expanded Disability Status Scale score (P < .001)., Conclusions: Optical coherence tomography results are significantly altered in patients with NMO. Optical coherence tomography is easy to perform, and the results are well correlated with visual acuity and visual field findings. It could be considered a marker of axonal loss because we found good correlation between OCT and the Expanded Disability Status Scale score. These preliminary results will need to be confirmed in a longitudinal prospective study.