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Rationale: Nd:YAG (neodymium:yttrium-aluminum-garnet) capsulotomy (Nd:YAG-caps) is the gold standard for the treatment of PCO (Posterior Capsule Opacification). There is a lack of real-world data about Nd:YAG-caps use. Purpose: This study's objectives were to estimate Nd:YAG-caps incidence in France, to describe the patient characteristics, and to analyze the time between surgeries and capsulotomies. Setting: The study was based on data extracted from the EGB database, a 1/97th sample representative of the French population. Design: observational, retrospective, cohort study using national claims data. Methods: French adult patients who underwent Nd:YAG-caps between 2014 and 2017 were selected. Main outcomes were the number of patients and procedures performed and the risk factors associated with early Nd:YAG-caps. Results: During the study period, Nd:YAG-caps were performed in 8,425 patients accounting for 10,774 procedures. The extrapolation to the French population led to estimate that 253.103 patients had Nd:YAG-caps, representing 312.103 procedures in 2017. The mean age at Nd:YAG-caps was 75.1 (± 10.2) years. About 36% of patients presented at least one ocular comorbidity. Nd:YAG-caps was performed within 2 years after surgery in 33.0% of patients and within one year in 9.8% of patients. Patients with Nd:YAG-caps within the first year (OR CI95 0.721 [0.673–0.772]) or in the first two years (OR CI95 0.721 [0.673–0.772]) were younger than patients with later Nd:YAG-caps and had a more frequent history of treated ocular diseases (OR 1.516 and 1.178, respectively). Conclusions: This study brought new real-world and large-scale data regarding Nd:YAG-caps use and gave an updated insight into the patients' characteristics. [ABSTRACT FROM AUTHOR]

Introduction: To evaluate real-life efficacy, safety, and treatment patterns with the dexamethasone intravitreal implant (DEX) in posterior segment inflammation due to non-infectious uveitis (treatment-naïve or not) in French clinics. Methods: In this prospective, multicenter, observational, non-comparative, post-reimbursement study, consecutive patients with posterior segment inflammation due to non-infectious uveitis were enrolled and evaluated at baseline (day 0). Those who received DEX on day 0 were re-evaluated at months 2, 6, and 18. Retreatment with DEX and/or alternative therapies was allowed during follow-up. Primary outcome: patients (%) with at least a 15-letter gain in best corrected visual acuity (BCVA) at 2 months. Secondary outcomes included patients (%) with at least 15-letter BCVA gains at 6 and 18 months; mean BCVA change from baseline at 2, 6, and 18 months; and patients (%) retreated, mean central retinal thickness (CRT), and adverse events (AEs) at all post-baseline visits. Results: Ninety-seven of 245 enrolled patients with posterior segment inflammation due to non-infectious uveitis (80% previously treated) and disease duration of 5 years (average) received DEX on day 0 and were included in efficacy analyses. At month 2 (n = 91), 20.5% of patients (95% CI 12.0–28.9) gained at least 15 letters from a baseline mean of 60.9 letters; the mean gain was 6.2 letters (95% CI 3.5–8.9). At month 6, 50.0% (n = 38/76) of patients did not receive alternative treatment or DEX retreatment, mostly because inflammation had sufficiently subsided (n = 27/38, 71.1%). Although early study termination prevented efficacy analysis at 18 months (n = 12), CRT reductions persisted throughout follow-up. From baseline to month 18, 21/245 (8.6%) patients had DEX-related AEs; 17/245 (6.9%) had ocular hypertension (most common AE). Conclusion: LOUVRE 2 confirms DEX efficacy on visual acuity and CRT in predominantly DEX-pretreated patients with relatively old/stabilized uveitis. DEX tolerability was consistent with known/published data, confirming treatment benefits in posterior segment inflammation due to non-infectious uveitis. ClinicalTrials.gov Identifier: NCT02951975. [ABSTRACT FROM AUTHOR]

Background: Sociological and economic risk factors of visual impairment have never been described in France at a national level as the association between the number of ophthalmologists per inhabitant and visual impairment prevalence. Methods: Two national surveys were pooled. First, 2075 institutions were selected at random from the French Health Ministry files. Second, a random, stratified sample of 356,208 citizens living in the community was selected. Blindness and low vision (LV) prevalence rates were estimated by age and gender. Geographical equities were estimated by logistic regression adjusted on age and occupational category. The association between ophthalmologist density and visual impairment prevalence rate was estimated per region. Interviews were completed with 14,603 (94.9%) of 15,403 randomly selected subjects in institutions, and 16,945 (77.8%) of 21,760 randomly selected subjects in the community. Three groups were defined from the interviews: low vision, blind, and control. Results: Prevalence rates were LV 2.08% and blindness 0.12%. Both rates increased exponentially with age. No major difference was found with gender. Injury was the declared reason for both LV (12%) and blindness (12%). Large regional differences in prevalence persisted for LV after adjustment on age and occupation (ORs: 0.35 to 2.10), but not for blindness. Regions with ophthalmologists below the national per capita average were usually those with higher LV prevalence. Conclusion: An inverse correlation was found between ophthalmologist number and LV prevalence rates for subjects of similar age and socio-professional category. This denoted possible inequity in the provision of healthcare. [ABSTRACT FROM AUTHOR]

Purpose: To compare postoperative inflammation in patients receiving 1 of 3 AcrySof intraocular lenses (IOLs): MA60AC (Group 1), SA60AT (Group 2), or SN60AT (Group 3). Setting: Service d''Ophtalmologie, Université Paris Descartes Hôpital Cochin, Paris, France. Methods: This prospective randomized 3-month study included eyes that received 1 of the 3 IOL models with standard surgery and postoperative care. Anterior chamber cells were assessed at the slitlamp and anterior chamber flare values, with a Kowa 500 flare meter. Results: Fifty-nine patients (59 eyes) with a mean age of 72.7 years were evaluated. Group 1 and Group 2 comprised 20 eyes each and Group 3, 19 eyes. No eye had anterior chamber cells at baseline. In all 3 groups, the presence of anterior chamber cells was highest 1 week postoperatively and generally decreased at subsequent visits, with no statistically significant differences between IOL groups at 1 week (P = .2655), 1 month (P = .073), or 3 months (P = .5766). A similar proportion of eyes in each IOL group had residual cells in the anterior chamber at 3 months; the cells were not clinically significant. In all groups, the mean flare values were low (<11 photons/ms) at baseline (P = .4522) and statistically similar between groups at each subsequent visit (P≥.2801). There were no adverse events. Conclusion: The 3 IOLs models, including the blue light–filtering model, had similar anterior chamber cells and flare values over a 3-month period, showing the lack of difference in inflammation induced by cataract surgery with implantation of the 3 similar IOL models. [Copyright &y& Elsevier]

Purpose: To analyze the roles of acquired or congenital infections in cases of ocular toxoplasmosis, and to compare their clinical manifestations. Design: Retrospective, observational case series. Methods: We analyzed the charts of consecutive patients with a diagnosis of ocular toxoplasmosis. Data from the French program for the prevention of congenital toxoplasmosis were used to assess the origin of infection. The data included patients'' serologic status prior to their ocular manifestations and patients'' mothers'' serologic status before, during, and/or after pregnancy. Infections were categorized as congenital, acquired, or unknown. Results: Of 425 cases of ocular toxoplasmosis, 100 (23.5%) were acquired, 62 (14.6%) were congenital, and 263 (61.9%) were of unknown origin. At the time of the study, the mean age of the patients with congenital ocular toxoplasmosis was 9.1 ± 8.8 years, and was 21.7 ± 12.6 years in the patients with acquired ocular toxoplasmosis (P < .0001). Bilateral chorioretinitis was observed in 4% of acquired cases and in 43.5% of congenital cases (P < .0001). In acquired infections, mean decimal visual acuity (VA) was 1.0 (logarithm of the minimum angle of resolution [logMAR] 0.0 ± 1 line) in the best eye and 0.4 (logMAR 0.4 ± 5 lines) in the worst eye. In congenital cases, mean decimal VA was 0.8 (logMAR 0.1 ± 4 lines) in the best eye and 0.25 (logMAR 0.6 ± 7 lines) in the worst eye (P < .05). Conclusion: In cases where the origin of the infection could be determined, acquired infections were a more frequent cause of ocular toxoplasmosis than congenital infections. Cases of congenital ocular toxoplasmosis were more severe than acquired cases. [Copyright &y& Elsevier]

Purpose: To detail the highly variable ocular phenotypes of a French family affected with an autosomal dominantly inherited vitreoretinopathy and to identify the disease gene., Methods: Sixteen family members with ten affected individuals underwent detailed ophthalmic evaluation. Genetic linkage analysis and gene screening were undertaken for genes known to be involved in degenerative and exudative vitreoretinopathies. Qualitative reverse transcriptase-PCR analysis of the versiscan (VCAN) transcripts was performed after mutation detection in the VCAN gene., Results: The first index patient of this French family was referred to us because of a chronic uveitis since infancy; this uveitis was associated with exudative retinal detachment in the context of a severe uncharacterized familial vitreoretinopathy. Genetic linkage was obtained to the VCAN locus, and we further identified a new pathogenic mutation at the highly conserved splice acceptor site in intron 7 of the VCAN gene (c.4004-2A>T), which produced aberrantly spliced VCAN transcripts., Conclusions: Extensive molecular investigation allowed us to classify this familial vitreoretinopathy as Wagner syndrome. This study illustrates the need to confirm clinical diagnosis by molecular genetic testing and adds new ocular phenotypes to the Wagner syndrome, such as vascular and inflammatory features.

Introduction: Published studies on birdshot chorioretinopathy (BCR) did not provide definitive information on possibly associated extraocular manifestations., Methods: Single-center cross-sectional analysis of extraocular manifestations in a cohort of patients with BCR., Results: Since 2002, 118 patients (45 men, 73 women) were enrolled. Their mean age was 51.5 years at diagnosis. The most common features of their medical histories were: hypertension (32 patients), drug allergy (19), sinusitis (17), thyroid disease (12), otitis media (11), asthma (11); diabetes (10); cancer (8); psoriasis (5); monoclonal gammopathies (3). At the time of disease onset, arthralgias were noted in 23, ENT manifestations in 26, Raynaud's phenomenon in 6, headaches in 10, psoriasis in 3 others. Between diagnosis and cross-sectional evaluation visits, only the frequency of hypertension has increased significantly (11 additional patients)., Discussion and Conclusions: No predominant extraocular manifestation of BCR was identified in our patients. Their ongoing follow-up may yet discern whether BCR is definitively eye-restricted., (Copyright 2010 Elsevier Masson SAS. All rights reserved.)

Purpose: To investigate a role of common polymorphisms of the CYP1B1 gene in French patients with primary open-angle glaucoma (POAG)., Methods: Six common CYP1B1 variants, 5 coding and one in promoter, were compared in 224 unrelated French Caucasian POAG patients, excluding those with a CYP1B1 mutation, and in 47 population-matched controls with a normal ophthalmic examination. Allelic associations were assessed with the D' and r2 parameters. An effect of the representative variants on subphenotypes, including the age and the intraocular pressure at diagnosis, the cup to disk ratio, and the visual field alteration, was tested by multivariate analyses., Results: Allele and haplotype frequencies were similar in patients and in controls. Five variants formed two groups with tightly correlated alleles while the sixth one, N453S, was independent. The age and the intraocular pressure at diagnosis were not influenced by any of the variants. In contrast, the 453*Serine allele was associated with decreased cupping of the optic disk (Odds ratio=0.32, 95% CI: 0.15-0.70; p=0.0036) and with a milder alteration of the visual field (p=0.025)., Conclusions: The common N453S coding variant of CYP1B1 is potentially a factor of severity in POAG patients.