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International audience; PURPOSE: Investigate the genotype-phenotype correlations for five TGFBI (transforming growth factor, beta-induced) mutations including one novel pathogenic variant and one complex allele affecting the fourth FAS1 domain of keratoepithelin, and their potential effects on the protein's structure. METHODS: Three unrelated families were clinically diagnosed with lattice corneal dystrophy (CD) and one with an unclassified CD of Bowman's layer. Mutations in the TGFBI gene were detected by direct sequencing, and the functional impact of each variant was predicted using in silico algorithms. Corneal phenotypes, including histological examinations, were compared with the literature data. Furthermore, molecular modeling studies of these mutations were performed. RESULTS: Two distinct missense mutations affecting the same residue at position 509 of keratoepithelin: p.Leu509Pro (c.1526T>C) and p.Leu509Arg (c.1526T>G) were found to be associated with a lattice-type CD. The novel p.Val613Gly (c.1828T>G) TGFBI mutation was found in a sporadic case of an Algerian individual affected by lattice CD. Finally, the Bowman's layer CD was linked to the association in cis of the p.Met502Val and p.Arg555Gln variants, leading to the reclassification of this CD as atypical Thiel-Behnke CD. Structural modeling of these TGFBI mutations argues in favor of these mutations being responsible for instability and/or incorrect folding of keratoepithelin, predictions that are compatible with the clinical diagnoses. CONCLUSIONS: Description of a novel TGFBI mutation and a complex TGFBI allele further extends the mutational spectrum of TGFBI. Moreover, we show convincing evidence that TGFBI mutations affecting Leu509 are linked to the lattice phenotype in two unrelated French families, contrasting with findings previously reported. The p.Leu509Pro was reported to be associated with both amyloid and non-amyloid aggregates, whereas p.Leu509Arg has been described as being responsible for Epithelial Basement Membrane Dystrophy (EBMD).

National audience; Introduction La connaissance des données épidémiologiques des patients porteurs de lentilles de contact (LC) pourrait permettre une meilleure prévention des kératites infectieuses. Objectifs et Méthodes Dans le cadre de cette étude prospective et multicentrique (2007-2008), tout patient porteur de lentilles de contact et présentant un abcès cornéen a été invité à remplir anonymement un questionnaire standardisé a posteriori de la consultation aux urgences ou del’hospitalisation, renseignant les caractéristiques du port et de l’entretien des lentilles de contact ainsi que certaines habitudes de vie. Résultats Sur une période de 1 an, 86 abcès sous lentilles de contact ont été recensés. Les personnes atteintes étaient principalement des femmes (70,4 %), jeunes (29,7 ans) portant les lentilles pour un motif réfractif (89,3 %) avec une durée de port de 7,8 ans en moyenne au moment de l’épisode infectieux. Les lentilles de contact étaient principalement des lentilles souples hydrophiles à renouvellement fréquent (96 %) portées tous les jours dans 79 % des cas pour une durée quotidienne de 14 h. Le dépassement du délai de renouvellement était présent dans 20 % des cas et la notion de port nocturne dans 20 % des cas. Dans 67 % des cas, les lentilles de contact ont été prescrites par un ophtalmologiste, dont la dernière consultation remontait en moyenne à 14,8 mois. L’éducation des porteurs (maniement et des règles d’hygiène) était réalisée le plus souvent par les opticiens (43 %), devant les ophtalmologistes (40 %). L’hygiène des mains étaient défectueuses dans 40 % des cas. 55 % des patients ne massaient ni ne rinçaient leur lentilles de contact avant la pose ou au retrait. Concernant les facteurs de risque environnementaux potentiels, 65 % des cas déclaraient travailler sur écran pour une durée moyenne quotidienne de 5,5 heures, 40 % fumaient ou subissaient un tabagisme passif et 70 % vivaient en ville. Le risque infectieux ne semblait pas lié au niveau socio-économique. Discussion L’étude de l’épisode infectieux par un questionnaire standardisé permet de mettre en évidence des mésusages dans un grand nombre de cas. Conclusion Un encadrement médical adapté, la délivrance des lentilles en milieu spécialisé, l’identification et la correction de facteurs de risque lié à l’environnement pourraient permettre de réduire le risque d’abcès cornéen.

Date de publication à confirmer par l'auteur.

National audience; 27 consecutive cases of non freeze myopic keratomileusis (using Barraquer Krumeich Swinger Set) were performed by one surgeon on 22 patients in a retrospective study. 4 per operative complications were noticed. Visual acuity with and without correction, astigmatism before and after surgery were reviewed preoperatively, at 1 week, 1 month, 3 months, 6 months and 1 year postoperative. The preoperative myopia (mean +/- standard deviation) was -15.55 +/- 5.46 D, the average postoperative residual myopia was: at 1 week -0.43 +/- 3.58 D, at 1 month -1.18 +/- 4.15 D, at 3 month -4.44 +/- 4.80 D, at 6 month -5.43 +/- 5.51, at 1 year -6.95 +/- 4.81 D. Visual acuity without correction was always better postoperatively. The best visual acuity (with correction) was preoperatively 0.38 +/- -0.22 at 1 week postoperative 0.21 +/- 0.09, at 1 month 0.35 +/- 0.16, at 3 month 0.31 +/- 0.15, at 6 month 0.32 +/- 0.15, at 1 year 0.34 +/- 0.17. Further investigation is monitoring to assess the predictability and stability of non freeze keratomileusis.

National audience

Currently, the systemic antibiotics intraocular penetration's rate is low and we have to perform intraocular antibiotics injections to reach levels above the minimal inhibitory concentration of the bacterial agents found commonly in endophthalmitis. Authors try to specify a rational strategy based on pharmacokinetics and bacteriological aspects of a new class of antibiotics, the fluoroquinolones, using their own studies and those from other teams about the intraocular distribution of these antibiotics. Further investigation is mandatory to assess the safety and efficacy of our first clinical results.

National audience; Authors have studied the penetration of ciprofloxacin in the aqueous humor of 30 patients (30 eyes). The concentration in the anterior chamber was on average 0.73 mg/l (33% of serum level), from 1.30 hours after a single oral dose (1000 mg) till the 5th hour after this dose. The samples were assessed by a microbiological method. These results are over the minimal inhibitory concentration for many bacterial agents found in endophthalmitis. So this antibiotic may be proposed in the treatment of endophthalmitis, with further investigations assessing the safety of this procedure.

Currently, the systemic antibiotics intraocular penetration's rate is low and we have to perform intraocular antibiotics injections to reach levels above the minimal inhibitory concentration of the bacterial agents found commonly in endophthalmitis. Authors try to specify a rational strategy based on pharmacokinetics and bacteriological aspects of a new class of antibiotics, the fluoroquinolones, using their own studies and those from other teams about the intraocular distribution of these antibiotics. Further investigation is mandatory to assess the safety and efficacy of our first clinical results.

Journal succeeded by: Journal of zoology. Series B.

International audience

National audience; Authors have studied the intraocular penetration of a new antibiotic, pefloxacin in 35 patients (35 eyes). This study emphasizes the three main qualities of this recent quinolone in ophthalmology: wide spectrum adequate for the most pathogens commonly found in endophthalmitis. Very large penetration in the aqueous humour flow with an average level of 0.95 mu/ml, which is over the minimal inhibitory concentration for many bacterial infections and is equal to 25% of average serum level.

Purpose To report the incidence and characteristics of endophthalmitis after intravitreal injections of anti–vascular endothelial growth factor agents or corticosteroids and to describe the clinical and bacteriologic characteristics, management, and outcome of these eyes with acute endophthalmitis in France. Design Retrospective, nationwide multicenter case series. Methods From January 2, 2008 to June 30, 2013, a total of 316 576 intravitreal injections from 25 French ophthalmic centers were included. For each center, the number of intravitreal injections was determined using billing codes and the injection protocol was recorded. A registry and hospital records were reviewed to identify patients treated for endophthalmitis after injection during the same time period. The main outcome measures were the incidence of clinical endophthalmitis and visual acuity of endophthalmitis cases. Results During the study period, 65 cases of presumed endophthalmitis were found, giving an overall incidence of 0.021% (2.1 in 10 000 injections) (95% confidence interval [CI], 0.016%–0.026%). The median number of days from injection to presentation was 4 [1–26] days. The most common symptom was vision loss. Bacterial identification was achieved in 43.4%. The most frequent pathogens were gram-positive bacteria (91.3%), including coagulase-negative Staphylococcus in 78.3%. Neither the interval between injection and presentation for endophthalmitis nor the clinical signs differentiated culture-positive from culture-negative cases. In multivariate analysis, the use of a disposable conjunctival mould assist device and the use of prophylaxis with an antibiotic or antiseptic were significantly associated with an increased incidence of endophthalmitis ( P = .001). The majority of patients had worse visual acuity after 3 months of follow-up when compared with acuity before endophthalmitis. Conclusions The incidence of presumed endophthalmitis after intravitreal injections of anti–vascular endothelial growth factors or corticosteroids was low and the prognosis poor. Prevention and management remain challenging. It remains to be determined whether the findings of this study are relevant for other countries using different techniques for intravitreal injections.