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Background/aims: X-linked retinitis pigmentosa (XLRP) is considered one of the most severe forms of retinitis pigmentosa (RP), accounting for 5–15% of all RP cases and primarily affecting males. However, the real-world humanistic impacts of this disease on patients are poorly investigated, especially with respect to burdens faced by patients with varying disease severities. Methods: EXPLORE XLRP-2 was an exploratory, multicentre, non-interventional study. A retrospective chart review was conducted to collect clinical/demographic data, including XLRP clinical stage (mild, moderate or severe). Cross-sectional surveys were used to gather experiences directly from patients by validated and modified patient-reported outcomes. Results: 176 patients with XLRP caused by retinitis pigmentosa GTPase regulator (RPGR) gene mutation were enrolled, of whom 169 were included in analyses. 81% of patients were male, mean (SD) age was 39.3 (17.61) years, and 20 adolescents were included. Mean age (SD) at genetic confirmation was 33.4 years (17.98), and the mean duration (SD) from initial symptoms to genetic diagnosis was 16.4 (15.66) years. Compared with patients with mild disease, patients with severe XLRP are more likely to experience difficulties with functioning in low luminance, depression, unemployment, productivity issues, mobility and daily activities. Conclusion: This is the first real-world study to collect data directly from patients on the burden of XLRP and to correlate that burden with disease stage. As a result, several areas of significant burden, especially for patients with severe disease, have been identified that should provide focus for future public policies and therapeutic prospects.

Previous animation techniques mainly focus on leveraging explicit structure representations (e.g., meshes or keypoints) for transferring motion from driving videos to source images. However, such methods are challenged with large appearance variations between source and driving data, as well as require complex additional modules to respectively model appearance and motion. Towards addressing these issues, we introduce the Latent Image Animator (LIA), streamlined to animate high-resolution images. LIA is designed as a simple autoencoder that does not rely on explicit representations. Motion transfer in the pixel space is modeled as linear navigation of motion codes in the latent space. Specifically such navigation is represented as an orthogonal motion dictionary learned in a self-supervised manner based on proposed Linear Motion Decomposition (LMD). Extensive experimental results demonstrate that LIA outperforms state-of-the-art on VoxCeleb, TaichiHD, and TED-talk datasets with respect to video quality and spatio-temporal consistency. In addition LIA is well equipped for zero-shot high-resolution image animation. Code, models, and demo video are available at https://github.com/wyhsirius/LIA.

Regular unsupervised domain adaptive person re-identification (ReID) focuses on adapting a model from a source domain to a fixed target domain. However, an adapted ReID model can hardly retain previously-acquired knowledge and generalize to unseen data. In this paper, we propose a Dual-level Joint Adaptation and Anti-forgetting (DJAA) framework, which incrementally adapts a model to new domains without forgetting source domain and each adapted target domain. We explore the possibility of using prototype and instance-level consistency to mitigate the forgetting during the adaptation. Specifically, we store a small number of representative image samples and corresponding cluster prototypes in a memory buffer, which is updated at each adaptation step. With the buffered images and prototypes, we regularize the image-to-image similarity and image-to-prototype similarity to rehearse old knowledge. After the multi-step adaptation, the model is tested on all seen domains and several unseen domains to validate the generalization ability of our method. Extensive experiments demonstrate that our proposed method significantly improves the anti-forgetting, generalization and backward-compatible ability of an unsupervised person ReID model.

PAX6is a key regulator of eye development and epithelial homeostasis in the cornea. When deficient, chronic corneal inflammation, neovascularization and limbal stem cell deficiency can occur. Here we investigated the potential of duloxetine, a generic serotonin reuptake inhibitor that can upregulate PAX6 in vitro, for its in vivoactivity in the context of corneal inflammation.

The pathophysiology of optic disc drusen (ODD) has long been discussed. According to one leading theory, they develop from calcified mitochondria extruded from axons compressed by an unusually small scleral canal. To examine this hypothesis, we conducted a systematic review and meta-analysis evaluating the scleral canal size in patients with ODD (PO) in comparison to healthy subjects (HS). We searched MEDLINE, Cochrane Central, EMBASE and gray literature to identify relevant articles. A subgroup analysis compared patients with buried ODD (POb) and patients with visible ODD (POv). The study was registered with the International Prospective Register of Systematic Reviews on December 9th, 2022 (Registration: CRD42022375110). We included fifteen articles in the review and fourteen in the meta-analysis. The mean diameter of the scleral canal computed using both fundus photography (DF) and spectral-domain with enhanced depth imaging optical coherence tomography (DO-EDI) was significantly smaller in PO compared to HS (standardized mean difference −1.21 [−1.85 to −0.56] and −0.66 [−0.94 to −0.37] respectively). DO-EDI, but not DF, was higher in POvas compared to POb. When including all-generation OCT in the analysis, the difference between POvand POb, but not between PO and HS, remained. Several intertwined hypotheses can explain these subgroup and sensitivity results: an enlargement of the canal as the ODD grow, an enlargement with time, or a measurement bias (artefactual enlargement of the canal due to a posterior shadow on OCT). In conclusion, this review and meta-analysis further supports the role of a small scleral canal in the development of ODD.

Deep neural networks have become prevalent in human analysis, boosting the performance of applications, such as biometric recognition, action recognition, as well as person re-identification. However, the performance of such networks scales with the available training data. In human analysis, the demand for large-scale datasets poses a severe challenge, as data collection is tedious, time-expensive, costly and must comply with data protection laws. Current research investigates the generation of synthetic data as an efficient and privacy-ensuring alternative to collecting real data in the field. This survey introduces the basic definitions and methodologies, essential when generating and employing synthetic data for human analysis. We summarise current state-of-the-art methods and the main benefits of using synthetic data. We also provide an overview of publicly available synthetic datasets and generation models. Finally, we discuss limitations, as well as open research problems in this field. This survey is intended for researchers and practitioners in the field of human analysis.

La reconstruction du ligament fémoro-patellaire médial est une des options thérapeutiques du traitement de l’instabilité fémoro-patellaire. Classiquement, un traitement « à la carte » des anomalies osseuses et ligamentaires est décrit. Cette option est difficile à réaliser chez l’enfant car les gestes osseux peuvent endommager les cartilages de croissance tibiaux ou fémoraux. L’objectif est d’évaluer, dans une grande cohorte, une stratégie de reconstruction isolée du MPFL chez les enfants ayant une instabilité patellaire objectivée. Le retour au sport, la fonction du genou, la douleur ou l’inconfort seront étudiés en critères de jugements secondaires.

Congenital aniridia is caused by heterozygous mutations on the PAX6gene leading to reduced amount of PAX6 protein (haploinsufficiency), abnormal eye development, and aniridia-associated keratopathy (AAK). This progressive corneal opacification resembles late-onset limbal stem cell (LSC) deficiency, leading to disrupted corneal epithelial renewal. The factors leading to AAK are not known and defects in native LSC differentiation and/or features leading to ocular surface dysfunction like inflammation and loss of innervation could contribute to development of AAK. Here, we produced induced pluripotent stem cells (hiPSC) from 3 AAK patients and examined whether PAX6 haploinsufficiency affects LSC lineage commitment. During LSC differentiation, characterization of the AAK lines showed lowered PAX6 expression as compared to wild type (WT) controls and expression peak of PAX6 during early phase of differentiation was detected only in the WT hiPSC lines. Whether it reflects developmental regulation remains to be studied further. Nevertheless, the AAK-hiPSCs successfully differentiated toward LSC lineage, in line with the presence of LSCs in young patients before cell loss later in life. In addition, patient-specific LSCs showed similar wound healing capacity as WT cells. However, extensive batch-related variation in the LSC marker expression and wound healing efficacy was detected without clear correlation to AAK. As development and maintenance of corneal epithelium involves an interplay between LSCs and their environment, the AAK-hiPSCs generated here can be further used to study the crosstalk between LSCs and limbal niche including, eg, corneal immune cells, stroma cells, and neurons.Graphical Abstract

ABSTRACTIntroductionRetinal artery occlusion (RAO), often caused by a microembolus and resulting in inner retinal ischemia, could be considered as the retinal analog to cerebral stroke. Although several therapeutic targets have been suggested in animal models of retinal ischemia and several potential treatments have been evaluated on small series of patients, central retinal artery occlusion (CRAO) is still rarely treatable in clinical practice.Areas coveredHere, we review several animal models of RAO, including increased intraocular pressure, laser, vasoconstriction, embolization and clamp. We also review the pathogenic mechanisms that contribute to cell death cascades during ischemia, and the therapeutic strategies targeting these events. These strategies aim to restore blood flow by fibrinolysis, increase the oxygen or glucose supply, decrease the energy demands, restrict ionic leak fluxes or reduce the detrimental effects of glutamate, calcium and free radicals. The current literature suggests that tPA treatment could be effective for CRAO.Expert opinionEye care professionals must make a rapid and accurate diagnosis and immediately refer patients with acute retinal stroke to specialized centers. CRAO management should also be facilitated by developing local networks to encourage collaboration among ophthalmologists, retina specialists and stroke neurologists.

Designing activity detection systems that can be successfully deployed in daily-living environments requires datasets that pose the challenges typical of real-world scenarios. In this paper, we introduce a new untrimmed daily-living dataset that features several real-world challenges: Toyota Smarthome Untrimmed (TSU). TSU contains a wide variety of activities performed in a spontaneous manner. The dataset contains dense annotations including elementary, composite activities and activities involving interactions with objects. We provide an analysis of the real-world challenges featured by our dataset, highlighting the open issues for detection algorithms. We show that current state-of-the-art methods fail to achieve satisfactory performance on the TSU dataset. Therefore, we propose a new baseline method for activity detection to tackle the novel challenges provided by our dataset. This method leverages one modality (i.e. optic flow) to generate the attention weights to guide another modality (i.e RGB) to better detect the activity boundaries. This is particularly beneficial to detect activities characterized by high temporal variance. We show that the method we propose outperforms state-of-the-art methods on TSU and on another popular challenging dataset, Charades.

La rétinopathie du prématuré (ROP, ORPHA : 90050), responsable de la majorité des séquelles visuelles des anciens prématurés, est la principale cause évitable de cécité infantile dans les pays à revenu élevé et intermédiaire. Elle reste cependant une maladie rare dans ses formes sévères. Bien que les recommandations relatives au dépistage de la maladie soient bien établies en France, la prise en charge en cas de ROP nécessitant un traitement est moins codifiée, d’autant plus que l’arsenal thérapeutique inclut l’utilisation des médicaments ayant récemment obtenu une autorisation de mise sur le marché (AMM). Cette prise en charge complexe requiert le concours multidisciplinaire d’ophtalmo-pédiatres, de chirurgiens vitréo-rétiniens, des néonatologistes, d’anesthésistes pédiatriques, d’infirmières et d’orthoptistes, au sein d’une structure adaptée au nouveau-né prématuré. Il existe un réel besoin d’unifier les pratiques nationales autour de cette pathologie, avec une demande forte des différents acteurs de cette prise en charge. L’objectif de ce Protocole national de diagnostic et de soins (PNDS) est de présenter aux professionnels concernés la prise en charge diagnostique et thérapeutique optimale actuelle et le parcours de soins des prématurés nécessitant un traitement pour une ROP. Il a pour but d’optimiser et d’harmoniser la prise en charge de cette maladie sur l’ensemble du territoire. Les principales indications au traitement, les différentes modalités de traitement incluant la photocoagulation laser, les injections d’anti-VEGF et la chirurgie vitréo-rétinienne, sont revues afin d’établir des recommandations de bonne pratique pour leur réalisation et pour le suivi post-traitement.

To describe pediatric ophthalmology surgery activity in private or public practice in metropolitan France in 2016 and to anticipate training needs in surgical pediatric ophthalmology.

This work focuses on unsupervised representation learning in person re-identification (ReID). Recent self-supervised contrastive learning methods learn invariance by maximizing the representation similarity between two augmented views of a same image. However, traditional data augmentation may bring to the fore undesirable distortions on identity features, which is not always favorable in id-sensitive ReID tasks. In this article, we propose to replace traditional data augmentation with a generative adversarial network (GAN) that is targeted to generate augmented views for contrastive learning. A 3D mesh guided person image generator is proposed to disentangle a person image into id-related and id-unrelated features. Deviating from previous GAN-based ReID methods that only work in id-unrelated space (pose and camera style), we conduct GAN-based augmentation on both id-unrelated and id-related features. We further propose specific contrastive losses to help our network learn invariance from id-unrelated and id-related augmentations. By jointly training the generative and the contrastive modules, our method achieves new state-of-the-art unsupervised person ReID performance on mainstream large-scale benchmarks.

L’e-learning ; apprentissage électronique ou en ligne, est une approche de l’enseignement qui repose sur l’utilisation de supports et de dispositifs électroniques comme outils pour améliorer l’accès à la formation, à la communication et à l’interaction et qui facilite l’adoption de nouvelles connaissances, compétences et/ou comportements. Les jeux sérieux proposent un environnement d’apprentissage et d’entraînement utilisant des éléments ludiques, issus du jeu vidéo avec une mise en situation reproduisant un contexte réel. L’objectif de ce travail est la mise en place d’un jeu sérieux pour la formation des étudiants d’orthoptie.

Introduction While paramacular retinal atrophy (PRA) is known to be found in 48% of eyes of adults and 42% of eyes of children with homozygous SCD (SS-SCD), the aim of this study is to assess the association between PRA and red blood cell (RBC) deformability, hematological markers and brain imaging abnormalities in SS-SCD.Methods This study is a subset of DREAM2, a prospective observational study performed between August 2015 and August 2016. Children (5–17 years) with SS-SCD and no history of large vessel vasculopathy, were included. Ophthalmological characteristics including visual acuity, fundus examination, OCT of central and temporal retina (with several retinal thickness measurements) were explored in relation with RBC deformability (ektacytometry), hematological and biochemical (hemolysis parameters), and neurological (cerebral oxygenation estimated by Near Infrared Spectroscopy, brain magnetic resonance imaging) investigations.Results 17 children (5 boys; mean age: 13 years) with complete ophthalmological investigations were included in the analysis; 8 exhibited PRA. RBC deformability was found to be significantly lower in children with PRA for measurements made at 1.69 Pa (0.16 a.u ± 0.02 vs 0.21 a.u ± 0.03, p= 0.02) and above, as well as cerebral oxygenation (59.25% ± 9.9 vs 71.53% ± 4.9, p= 0.02). A significant positive correlation was found between temporal retinal thickness and hemoglobin level (ρ = 0.65, p= 0.007), hematocrit (ρ = 0.53, p= 0.04) and RBC deformability at 3 Pa (ρ = 0.75, p= 0.005) and above.Conclusions These results suggest that PRA could be an early marker of systemic severity and cerebral oxygenation in SCD. Whether it could help predicting cerebral vasculopathy requires further investigations.

Introduction Among non-syndromic, single-suture craniosynostoses, unicoronal craniosynostosis (UCS) presents the highest rate of ophthalmic manifestations requiring a visual follow-up, due to the high risk of amblyopia. After birth or during childhood, children with UCS have a high risk to present an aniso-astigmatism and a strabismus. The aim of this study was to characterize clinical ophthalmologic findings associated with UCS in a paediatric cohort.Methods This retrospective study included children admitted in our unit between 2015 and 2021, with isolated UCS treated in our institution and complete ophthalmological assessment comprising visual assessment, refractive status and oculomotor examination. Children with associated craniofacial disorders were excluded.Results A total of 28 children met the inclusion criteria. Median age was 62 [13-192] months with a large proportion of girls (86%) and 71% of right-sided UCS. The mean best corrected visual acuity was 0.07 (±0.13) LogMAR, including 10 (36%) children with an amblyopia or history of amblyopia. Astigmatism was significantly higher on the contralateral side of the UCS than on the ipsilateral side, with a refractive cylinder error of 0.97 (±1.06) vs 0.56 (±0.68) diopters, respectively (p = 0.03). Strabismus was observed in 20 patients (71%) with a main pattern of esotropia with a vertical component. A pseudo-superior oblique palsy was found in 13 children (65%) with a median cyclodeviation of 8.7° [-5,4°-20.6°].Conclusion Children with UCS experience a high rate of various visual manifestations. This study highlights their need for a strict ophthalmological follow-up, in order to early diagnose and prevent visual complications.

Cette étude vise à évaluer la formation chirurgicale en ophtalmologie via un retour d’expérience des internes.

La myasthénie est une maladie rare chez l’enfant avec une incidence estimée de 1 à 5 par million d’enfants. Néanmoins, la gravité potentielle de ses conséquences et l’existence de traitements spécifiques exigent une connaissance de ses modalités de diagnostic.

ABSTRACTAngle lambda assessment is essential in pediatric and strabismus practice. An abnormal angle lambda will modify the visual appearance of a strabismus or mimic one. Currently, angle lambda can be assessed by corneal topographs. Unfortunately, the use of these devices remains limited in the context of a strabismus clinic. Herein, we propose an easy, low cost, and reproducible method for angle lambda quantification, based on monocular photographs. Monocular pictures were taken by using a camera with a ring flash, centered by a fixation point. A digital evaluation analyzed the position of the corneal reflex on the pupil diameter. Using a trigonometric formula, the resulting ratio was converted into the value of angle lambda. This method was tested on 20 healthy eyes, on two successive couples of pictures, to evaluate its repeatability. Assessment using Pentacam was performed for comparison. The mean value of angle lambda was +2.61° ± 2.92° and 2.63° ± 2.85° in both picture series, respectively, and Lin’s repeatability coefficient was 0.99 – with a systematic deviation of −0.071° compared to Pentacam assessment. Angle lambda distribution was in range with values from the literature. This new method allows for angle lambda assessment without requiring a specific device and can be used in strabismus and pediatric clinics.

Numerous techniques for mammalian cell culture have been developed to mimic the complex in vivo three-dimensional structure of tissues and organs. Among them, the sole use of proteins to create a matrix where cells are embedded already gives rise to self-organized multicellular assemblies. Loading cells in a controlled extracellular matrix along with cell culture and monitoring through a strategy that is compatible with pipetting tools would be beneficial for high throughput screening applications or simply for a standardized method. Here, we design submillimeter compartments having a thin alginate hydrogel shell and a core made of a collagen matrix where cells are embedded. The process, using a microfluidic device, is based on a high speed co-extrusion in air, leading to a compound jet whose fragmentation is controlled. The resulting core–shell liquid drops are then collected in a gelling bath that triggers a fast hardening of the shell and is followed by a slower self-assembly of collagen molecules into fibers. We show how to formulate the core solution in order to maintain cell viability at physiological conditions that otherwise induce tropocollagen molecules to self-assemble, while being able to prevent flow disturbances that are detrimental for this jetting method. Encapsulated Caco-2 cells, mainly used to model the intestinal barrier, proliferate and form a closed polarized epithelial cell monolayer where the apical membrane faces the continuous medium.

Uranium is a naturally occurring radionuclide. Its redistribution, primarily due to human activities, can have adverse effects on human and non-human biota, which poses environmental concerns. The molecular mechanisms of uranium tolerance and the cellular response induced by uranium exposure in bacteria are not yet fully understood. Here, we carried out a comparative analysis of four actinobacterial strains isolated from metal and radionuclide-rich soils that display contrasted uranium tolerance phenotypes. Comparative proteogenomics showed that uranyl exposure affects 39–47% of the total proteins, with an impact on phosphate and iron metabolisms and membrane proteins. This approach highlighted a protein of unknown function, named UipA, that is specific to the uranium-tolerant strains and that had the highest positive fold-change upon uranium exposure. UipA is a single-pass transmembrane protein and its large C-terminal soluble domain displayed a specific, nanomolar binding affinity for UO22+and Fe3+. ATR-FTIR and XAS-spectroscopy showed that mono and bidentate carboxylate groups of the protein coordinated both metals. The crystal structure of UipA, solved in its apo state and bound to uranium, revealed a tandem of PepSY domains in a swapped dimer, with a negatively charged face where uranium is bound through a set of conserved residues. This work reveals the importance of UipA and its PepSY domains in metal binding and radionuclide tolerance.

La myopie est une anomalie de la réfraction, trouble visuel le plus répandu dans le monde, en forte augmentation. Elle se développe chez l’enfant par un allongement de la longueur de l’œil provocant ainsi une vision floue de loin. Elle peut être évolutive chez l’enfant. Les patients atteints de myopie peuvent présenter des complications, dont certaines cécitantes. La prévention de la myopie est donc un véritable enjeu de santé publique. Sa progression est définie comme une augmentation supérieure à -0,5 dioptrie par an. Le dépistage précoce de la myopie est essentiel. Un examen ophtalmologique et orthoptique complet est effectué pour le bilan initial. L’enfant présentant une forte myopie doit bénéficier d’un bilan pour détecter un glaucome ou une myopie syndromique. Plusieurs techniques permettent d’en freiner la progression dont certaines récentes et très innovantes. Elles regroupent les mesures environnementales, les verres défocalisants, les lentilles de contact défocalisantes, l’orthokératologie et les traitements pharmacologiques par atropine faiblement dosée.

The most common cause of vision impairment in children is amblyopia. It is defined as impaired visual acuity in one or both eyes that is present with no demonstrable abnormality of the visual pathway and is not immediately resolved by wearing glasses. After the World Health Organization (WHO) recognized COVID-19 as a global pandemic on March 11, 2020, widespread changes and restrictions to social and sanitary practices have presented significant issues in access to eye care during the COVID-19 pandemic. A reduction of more than 80% in pediatric eye care volume up to its total cessation has been observed in different departments. In this scenario, reduced or absent eyesight, due to delay in timely treatment of amblyopic conditions, could create major, long-lasting effects on all aspects of life, including daily personal activities, interacting with the community, school and work opportunities and the ability to access public services. Processes coming out of lockdown should be gradually easing restrictions giving priority to ophthalmology and eye care facilities so that amblyopia does not remain unattended and irreversible as in adults due to lack of timely treatments. If not reversible, this process could lead to a dramatic increase in disability and unsustainable social costs for many governments.

Background/Objectives: Cyclosporine A cationic ophthalmic emulsion (CsA CE) was evaluated in paediatric and adolescent patients with vernal keratoconjunctivitis (VKC) in the NOVATIVE (NCT00328653) and VEKTIS (NCT01751126) trials. The similarity of these studies permitted pooled assessment of the effect of CsA CE on corneal damage as well as safety and tolerability. Subjects/Methods: Pooled outcomes were assessed for the first 28 days of treatment. In NOVATIVE, 118 patients were randomised to 4 times daily (QID) CsA CE 0.05%, 0.1%, or vehicle eye drops. In VEKTIS, 169 patients were randomised to CsA CE 0.1% QID or twice daily (BID) or vehicle. For these analyses, treatment groups comprised: (1) pooled CsA CE 0.1% QID arms (high-dose; n= 96); (2) pooled CsA CE 0.05% QID arm from NOVATIVE and CsA CE 0.1% BID data from VEKTIS (low-dose; n= 93); and (3) pooled vehicle QID arms (vehicle; n= 98). Results: Changes from baseline to day 28 (mean ± standard deviation) in corneal fluorescein staining (CFS) scores for CsA CE high-dose, low-dose, and vehicle groups were −1.6 ± 1.47 (95% CI: −0.9, −0.1; p= 0.0124 vs vehicle), −1.7 ± 1.39 (95% CI: −1.1, −0.3; p= 0.0015 vs vehicle), and −1.0 ± 1.55, respectively. Adverse events (AEs) of any type were reported in 37.5%, 34.4%, and 37.8% of the high-dose, low-dose, and vehicle groups, respectively. Most were mild or moderate in severity. Conclusions: CsA CE significantly decreased corneal damage and was safe and well tolerated in patients with VKC. These data support CSA CE as a treatment option for the management of VKC.

This study reports a comprehensive description of retinal vascular abnormalities observed in a large series of children with neurofibromatosis Type 1 and demonstrates a frequent occurrence (37%) of these vascular malformations, involving mainly small veins.

Long-term and ongoing support in accordance with the changing needs of patients and their families is one of the main components of patient care, including therapeutic patient education (TPE).

Between the heat of the power train and the jolting of highway travel, automobile parts undergo significant stress. To validate automotive and component designs under these conditions, automobile manufacturers and […]

Le voretigene neparvovec (VN) est la première thérapie génique en ophtalmologie indiquée chez des patients présentant une dystrophie rétinienne héréditaire liée à une mutation bi-allélique du gène RPE65. Sa récente autorisation européenne de mise sur le marché impose un cadre réglementaire et organisationnel strict pour son utilisation. Nous analysons ici les principales études ayant permis cette autorisation de mise sur le marché et décrivons les étapes nécessaires à déployer au niveau hospitalier pour une administration optimale chez le patient dans le cadre de la réglementation actuelle.

Le chiasma optique est une structure anatomique essentielle en neuro-ophtalmologie. De la disposition des fibres ganglionnaires rétiniennes découle la systématisation des voies visuelles. De l’organisation des fibres ganglionnaires au sein du chiasma optique résulte la pathologie chiasmatique. Ainsi, une bonne maîtrise de l’anatomie permet de corréler les anomalies du champ visuel avec l’imagerie. Les connaissances acquises au fil des années ont permis de schématiser la disposition des fibres ganglionnaires au sein du chiasma. Leur hémi-décussation permet la vision stéréoscopique chez l’homme. Les causes du syndrome chiasmatique sont multiples, mais les causes tumorales et compressives dominent. La proximité entre la région hypophysaire et le chiasma rend compte de la fréquence du syndrome chiasmatique, qui implique l’ophtalmologiste tant par l’atteinte des voies visuelles pouvant être inaugurale, que par les complications possibles au cours du suivi. Dans cette revue, nous abordons l’embryologie, l’anatomie, les principes d’exploration du syndrome chiasmatique ainsi que ses nombreuses causes.

Congenital orbital masses are rare disorders. A wide variety of lesions, including malignant and benign tumors, may develop around the orbit; hemangioma, lymphangioma, and optic nerve meningioma are the most common. Counseling for the prognosis and postnatal treatment depends on antenatal suspicion. Glial heterotopia should also be considered for the differential diagnosis. Integration of antenatal ultrasound and magnetic resonance imaging characteristics could help in the differential diagnosis. For the first time to our knowledge, a literature review on fetal orbital tumors was performed, along with a systematic description of imaging characteristics, treatment, and the prognosis.

•The present paper aimed at collecting recommendations on nonpharmacological treatment (NPT) for apathy and on the role of new Information and Communication Technologies (ICT) in this domain.•Based on the experts’ opinion, NPT should be tailored to deficits, clinical objectives, and preferences of each patient. ICT may help to improve treatment personalization, increase motivation, and aid remote treatment delivery.•Further structured research is needed to determine NPT efficacy.

In published series, a large proportion of patients with craniosynostosis show impaired vision.

ABSTRACTIntroduction: Corneal ulcers normally resolve spontaneously because of the proliferative ability of the corneal epithelium; however, sometimes, epithelial healing is diminished, even when standard treatments are administered. Hence, the treatment of refractory corneal ulcers is challenging and is the subject of ongoing efforts in preclinical and clinical development. Emerging treatment approaches include thymosine β4, CODA001, and topical insulin. Cenegermin eye drops, containing recombinant human nerve growth factor and ReGenerating Agent, a matrix therapy agent, have recently been commercialized for the treatment of moderate to severe neurotrophic keratitis in adults.Areas covered: We describe emerging therapeutic approaches for the management of refractory corneal ulcers and treatments recently introduced to the market. Pubmed and Clinicaltrial.gov databases were first searched including the terms: “corneal ulcer” or “neurotrophic keratopathy” and “treatment.” Each treatment was searched in the same databases separately.Expert opinion: Affections of the sensory corneal nerves are the main factor contributing to the pathophysiology of neurotrophic keratopathy; this explains the healing difficulties of this form of ulcer. Cenegermin is a promising therapy acting as a neurotrophic agent for corneal healing. ReGenerating Agent has led to rapid pain relief and corneal healing, but randomized clinical trials are still necessary for further assessment.

L’objectif de cette étude était de décrire et d’analyser les principales manifestations ophtalmologiques retrouvées dans une cohorte de 21 patients suivis pour maladie d’Ehlers–Danlos dans notre service.

Uranium speciation and bioaccumulation were investigated in the sea urchin Paracentrotus lividus. Through accumulation experiments in a well-controlled aquarium followed by ICP-OES analysis, the quantification of uranium in the different compartments of the sea urchin was performed. Uranium is mainly distributed in the test (skeletal components), as it is the major constituent of the sea urchin, but in terms of quantity of uranium per gram of compartment, the following rating: intestinal tract > gonads ≫ test, was obtained. Combining both extended X-ray Absorption Spectroscopy and time-resolved laser-induced fluorescence spectroscopic analysis, it was possible to identify two different forms of uranium in the sea urchin, one in the test, as a carbonato-calcium complex, and the second one in the gonads and intestinal tract, as a protein complex. Toposome is a major calcium-binding transferrin-like protein contained within the sea urchin. EXAFS data fitting of both contaminated organs in vivo and the uranium-toposome complex from protein purified out of the gonads revealed that it is suspected to complex uranium in gonads and intestinal tract. This hypothesis is also supported by the results from two imaging techniques, i.e., Transmission Electron Microscopy and Scanning Transmission X-ray Microscopy. This thorough investigation of uranium uptake in sea urchin is one of the few attempts to assess the speciation in a living marine organism in vivo.

The objective of this study was to confirm that the standardized endonasal dacryocystorhinostomy (DCR) technique routinely performed in adults can be used in children.

La formation en santé connaît depuis de nombreuses années des modifications importantes quant aux méthodologies employées. Parmi ces dernières, les jeux sérieux et les simulateurs font maintenant partie intégrante de l’arsenal éducatif au service des étudiants. Au département d’orthoptie de l’université Paris Cité, nous avons développé le premier jeu sérieux dédié à la formation des étudiants en orthoptie. Nous présentons ici les différentes modalités du jeu. Composé de trois chapitres, il permettra de couvrir les principaux outils rencontrés lors du bilan orthoptique.

L’aniridie congénitale (AC), souvent liée à une perte de fonction du gène PAX6, est une maladie génétique pan-oculaire caractérisée par une absence partielle ou totale d’iris et une hypoplasie fovéolaire. Les mécanismes de l’apparition d’une hypertonie oculaire et d’un glaucome chez les patients atteints d’AC demeurent encore relativement méconnus. De nombreuses hypothèses ont été formulées et le développement de nouvelles techniques d’imagerie de segment antérieur ont permis d’identifier différents mécanismes potentiels : dysfonctionnement trabéculaire congénital, fermeture progressive de l’angle irido-cornéen, rôle aggravant des chirurgies intra-oculaires. Le diagnostic doit tenir compte des nombreux obstacles à l’examen clinique (opacité cornéenne, cataracte obturante, aplasie fovéolaire, nystagmus important) et est souvent porté par défaut, sur la seule présence d’une hypertonie oculaire. Le glaucome demeure avec l’insuffisance limbique, une des causes majeures de cécité dans l’AC. Le traitement du glaucome de l’AC est avant tout médical. Le rapport bénéfices/risques d’une intervention chirurgicale doit toujours être évalué soigneusement pour ne pas sous-estimer les potentielles complications postopératoires associées à l’AC.

We report here the case of a 27-year-old man who consulted by telemedicine during the Coronavirus disease 2019 (COVID-19) pandemic, due to foreign body sensation and left eye redness. Examination revealed unilateral eyelid edema and moderate conjunctival hyperemia. A few hours later, the patient experienced intense headache and developed fever, cough and severe dyspnea. A nasopharyngeal swab proved positive for SARS-CoV-2. This case demonstrates that conjunctivitis can be the inaugural manifestation of the COVID-19 infection. It illustrates the interest of telemedicine in ophthalmology during the COVID-19 pandemic, since moderate conjunctival hyperemia can be the first sign of a severe respiratory distress.

Background/aimsInitially reported in a few patients with homozygous sickle cell disease (SCD), atrophic areas of the retina temporal from the macula are now known to be present in about 48% of eyes of adult patients with SS-SCD and in 35% of eyes of adult patients with SC-SCD. The aim of this study is to describe this paramacular atrophy in children affected with SCD.MethodsIn this retrospective series, spectral-domain optical coherence tomography images of 81 children with SCD, acquired with specific patterns including one evaluating the retina temporal to the macula, were reviewed, in order to look for retinal atrophy. Fundus examination status for SCD peripheral retinopathy was also reviewed.ResultsMean age was 12.0 years (SD: 3.56). The genotype distribution was: 64 HbSS (79%), 10 HbSC (12%) and 7 HbS/β0thalassaemia (9%). Using a usual fovea-centred programme, retinal atrophy was found in 38% of eyes (52% of children). Using a specific temporal pattern, retinal atrophy was found in 53% of eyes (64% of children), with no significant difference in the prevalence between HbSS and HbSC genotype (p=0.92), and no effect of age (mean 12.3 years (SD=3.61) vs11.9 (3.56), p=0.65). Peripheral retinopathy was found in 11% of children, with a significant relation between the HbSC genotype and the severity of the retinopathy (p=0.003).ConclusionParamacular temporal atrophy occurs early in the course of SCD, which suggests distinct mechanisms from those of peripheral retinopathy.

ABSTRACTIntroduction: Ocular surface diseases with limbal insufficiency represent a therapeutic challenge for restoring vision. This corneal deficiency includes both classical ocular diseases (as chemical burns) and rare ocular diseases (as congenital aniridia and ocular cicatricial pemphigoid).Areas covered: Our understanding of limbal epithelial stem cells (LESCs) has increased the potential for treatment options. Pharmacological treatment strategies (as regenerating agent ophthalmic solutions) and especially surgical treatment strategies are available. Isolated LESCs can be produced by limbal primary cultures obtained from explants or cell suspensions. We review the latest cornea surgery techniques.Expert opinion: The adjunction of human limbal mesenchymal cells as a support for limbal stem cell primary cultures appears to be of great interest. Recently, human-induced pluripotent stem cells have allowed the generation of minicorneal organoids. This potential means of creating a three-dimensional cornea with in vitromaturation opens up important research areas for corneal regeneration therapy.

Les neuropathies optiques héréditaires (NOH) débutent souvent à l’âge adulte. Cependant, il existe des formes à début précoce. Celles-ci présenteraient des particularités cliniques et évolutives.