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Retinal vein occlusion (RVO) is the most common vascular retinopathy after diabetic retinopathy. They include central retinal vein occlusions (CRVOs) and branch retinal vein occlusions (BRVOs). Macular edema (MO) marks a major turning point in the evolution of the disease, in fact, it is the main cause of reduced visual acuity. Scientific advances have been able to shed light on the main agent involved in the mechanisms of modulation of vascular permeability, namely, vascular endothelial growth factor (VEGF) which is found in significant quantities in the vitreous cavity and aqueous humor of patients with retinal microangiopathies, such as RVO. Thus, the development of substances capable of counteracting angiogenic factors seems clear in the treatment of microangiopathies. Today, in our context, Bevacizumab, although it does not have marketing authorization (MA) for this indication, is the most accessible anti-VEGF molecule. It is a recombinant humanized monoclonal antibody that selectively binds to VEGF, inhibiting its action. The study that we have assembled around this theme is a non-interventional analytical retrospective study compiled in our department involving 30 cases (32 eyes) and spanning a period of 24 months. The results of our study showed an improvement in visual acuity of around 25 letters according to the Early Treatment Diabetic Retinopathy Study (EDTRS) scale with a reduction in the average centro-foveolar thickness of the order of 180 μm, 12 months after the 1st intravitreal injection of Bevacizumab. This work aims to highlight the effectiveness of Bevacizumab on visual acuity and macular thickness in macular edema secondary to retinal vein occlusion and to remove part of the mystery surrounding this pathology, which at day today, has not yet revealed all its secrets. [ABSTRACT FROM AUTHOR]

La choriorétinite séreuse centrale (CRSC) est une maculopathie du sujet jeune, assez fréquente, caractérisée par la présence d'un décollement séreux rétinien (DSR), associé à des modifications de l'épithélium pigmentaire. Il a été suggéré que la CRSC pourrait résulter d'une hyperactivation des récepteurs de minéralocorticoïdes au niveau des vaisseaux choroïdiens. Nous avons donc évalué l'efficacité et la tolérance de l'éplérénone, un antagoniste des récepteurs aux minéralocorticoïdes, dans le traitement de la CRSC chronique. Huit patients ont été recrutés, entre juillet 2016 et août 2018 à l'hôpital militaire Moulay-Ismail de Meknes. Souffrant de CRSC chronique évoluant depuis au moins trois mois avec retentissement sur l'acuité visuelle, ils ont reçu de l'éplérone à la dose de 50 mg/j le premier mois puis 25 mg/j pendant deux mois. L'acuité visuelle (estimée par le logarithme de l'angle minimum de résolution [logMAR]) et l'épaisseur centrale de la rétine étaient évaluées avant traitement puis à un et à trois mois. Une nette amélioration de l'acuité visuelle est observée chez tous les patients, la valeur moyenne passant de 0,9 à l'admission à 0,225 à un mois et à 0,125 à trois mois. L'épaisseur centrale moyenne de la rétine a diminué : 347 ± 94 μm avant traitement, 246 ± 42 μm à un mois et 216 ± 26 μm à trois. Trois patients présentaient une disparition complète du DSR à un mois, et deux autres à trois mois. Notre étude montre ainsi que l'éplérénone induit une amélioration anatomique et fonctionnelle de la CRSC chronique, et peut être envisagé en remplacement des deux traitements aujourd'hui utilisés : la photocoagulation focale au laser argon et la photothérapie dynamique à la vertéporfine. [ABSTRACT FROM AUTHOR]

A 25-year-old woman presented with blurry vision, headache, nausea, and syncope. Humphrey visual field testing revealed bitemporal defects, but magnetic resonance imaging was negative for chiasmal pathology. Macular optical coherence tomography showed focal parafoveal disruption of the photoreceptor inner segment/outer segment junction and infrared imaging showed hyporeflective macular lesions in both eyes. Our case demonstrates a diagnosis of acute macular neuroretinopathy that presented with bitemporal visual field defects. To our knowledge, bitemporal visual field loss, mimicking chiasmal pathology, has not been reported previously in association with acute macular neuroretinopathy.

Abstract: Susac syndrome is a mysterious vasculopathy affecting brain, retina and inner ear in young women. Main features of the disease are increasingly recognized: subacute encephalopathy often mimicking psychosis and frequently heralded with unusual ophthalmic migraine; frequent subclinical meningitis; brain MRI with multiple and bilateral white and gray matter nuclei lesions, with prominent involvement of corpus callosum; bilateral involvement of central retina artery branches, not only with occlusions but also with peculiar leakage of fluorescein through arteriolar walls on late stages of angiography; non-specific bilateral cochleovestibular symptoms with audiogram showing perception hypoacousia that predominates on low frequencies. Outcome, prognosis, pathogenesis and a rational basis for treatment are discussed in this review. A key message for the clinician should be to perform brain MRI, audiogram and retinal angiography whatever the mode of entry, in order not to miss one (or two) features of this syndrome triad. [Copyright &y& Elsevier]

Summary: We report on 2 cases associating retinal (RH) and cerebral hemorrhages (CH), which first suggested the diagnosis of shaken baby syndrome (SBS). After an etiologic search, the diagnosis was corrected: the first case was a late hemorrhagic disease of the newborn and the second case hemophilia A. RH is a major feature of SBS, although not pathognomonic. There is no specific RH of SBS but they usually affect the posterior retinal pole. Typically, RHs of SBS are present in both eyes, although unilateral RHs do not exclude the diagnosis of SBS. The relationship between RH and CH has been reported in SBS but also in other diseases. Thus, one must search for hemostasis abnormalities, even though the clinical presentation suggests SBS. Ignoring SBS as well as coming to the conclusion of SBS too quickly should be avoided. Diagnostic difficulties may be related to the number of physicians involved and their interpretation of the facts. These 2 cases underline the need for working as a team that includes hematologists able to interpret coagulation parameters. [ABSTRACT FROM AUTHOR]

Abstract: Purpose: Age-related macular degeneration is the commonest overall cause of irreversible blindness in patients aged 50 or over in the Western world. Current knowledge and key points: Because of the interaction of genetic and environmental origin, the pathogenesis of this affection remains imperfectly elucidated. The disease has been traditionally classified into early and late stages with its dry and wet forms. In association with fluorescein angiography, essential for diagnosis, green indocyanin angiography and optical coherence tomography made it possible to better know the clinical forms of the disease. Patients with age-related maculopathy should consider taking a dietary supplement such as that used in the age-related eye disease study. Exudative age-related macular degeneration is approached depending on the type and localisation of the choroidal new vessels. Laser photocoagulation has only been shown to be beneficial for extra and juxtafoveal classic lesions. Photodynamic therapy with verteporfin is effective in the management of eyes with subfoveal predominantly classic lesions. The encouraging results of new therapeutic with antiangiogenic aiming against vascular endothelial growth factor are a hope to preserve the sight of our patients. Future prospects and projects: In the future, many therapeutics inhibiting neo-vessels will widen our therapeutic options in the treatment of exsudative age-related macular degeneration. [Copyright &y& Elsevier]

Abstract: Introduction: Central serous chorioretinopathy is an uncommon retinal disease, whose pathogenesis is largely unknown. It is characterized by an accumulation of subretinal fluid at the posterior pole of the fundus, creating a circumscribed area of serous retinal detachment. It manifests generally as a visual loss or an abnormal colour vision. It is often idiopathic but may also be associated with numerous pathological situations, with frequent exposure to corticosteroids. Exegesis: We report on two patients with central serous chorioretinopathy. The first female patient had been treated with steroids for a systemic lupus erythematosus for fifteen years, and the second male patient had been treated with steroids for an idiopathic hypereosinophilic syndrome for a few months. Visual loss led to a diagnosis of central serous chorioretinopathy. Lowering of steroids doses was followed by a clinical improvement in both cases. Conclusion: Similarly to cataract or glaucoma, central serous chorioretinopathy belongs to the potential ocular side-effect of steroid treatment, and thus deserves to be known by internists. [Copyright &y& Elsevier]

Abstract: Retinal dystrophies are rarely curable diseases and several avenues of research are being pursued, such replacement therapies and pharmacological treatment. Among them, the transplantation of functional retinal cells has been envisaged in order to restore vision in patients who have these diseases by repopulating the damaged retina and/or by rescuing retinal neurons from further degeneration. Over the past few years, identification and characterization of stem cells has opened new avenues in cell-replacement therapy. Since retinal stem cells are already present during embryonic development, they persist in the adult mammalian eye only in the ciliary marginal zone, even a stem cell potential has been described for the Müller glia in the retina. This result opened possibilities of regeneration by mobilizing endogenous stem cells to respond to injury. Regarding the transplantation studies, in all experiments using different types of stem cells (retinal progenitors, neural stem cells, bone marrow-derived stem cells and ES cells), despite their incorporation within the host''s retina, the transplanted cells failed to express retina-specific markers and to establish synaptic connections. Therefore, the true potential of the different stem cells in retina repair can only be realized with more information about mechanisms that regulate their proliferation and differentiation; and by development of techniques that allow their prospective identification and enrichment. [Copyright &y& Elsevier]

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