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Background: Susac syndrome (SuS) is a rare occlusive microvessel disease of the brain, retina and inner ear. We aimed to determine whether brain lesion load at the acute phase predicts poor outcomes in SuS. Methods: A prospective national cohort study was conducted from December 2012 to December 2019 in 20 centres in France. Patients included at the principal investigator's center with available brain magnetic resonance imaging (MRI) at diagnosis were analyzed. MRI was reviewed by an experienced neuroradiologist blinded to clinical status. The size, topography and number of hyperintense lesions on diffusion‐weighted imaging (DWI‐HL) were analyzed at diagnosis and during follow‐up. Outcomes involved descriptive characteristics of patients at onset and last follow‐up. Results: Twenty‐three patients (38.1 [18.8–56.5] years, 16 females) were prospectively studied. The triad (i.e., brain, eye and ear involvement) was complete at onset in 17 patients. Brain MRI was performed 1.1 (0.1–3.4) months after the first symptom. All patients had DWI‐HL at the acute phase. Patients were separated into two groups according to the number of DWI‐HL on first MRI: a first group of patients (n=15) displaying low brain lesion load (<50 DWI‐HL per patient) and a second group of patients (n=8) displaying high brain lesion load (≥100 DWI‐HL). The median follow‐up was 57.9 (9.7–98) months. Clinical features, treatment, relapse rate, time to disappearance of DWI‐HL, disabilities and professional outcome did not differ according to brain lesion load. Conclusion: Brain lesion load assessed by DWI at the acute phase is not associated with risks of disability in SuS. [ABSTRACT FROM AUTHOR]

Purpose: The objective of this study was to report the evaluation of efficacy and safety of cyclosporine A cationic emulsion (CsA CE) 0.1% for the treatment of severe keratitis in adults with dry eye disease (DED) in a French early-access program. Methods: Patients with DED and severe keratitis (corneal fluorescein staining [CFS] score of 3-5 on the Oxford scale and/or the presence of corneal lesions [filaments or ulcers]) were enrolled in a compassionate use program (Authorization for Temporary Use [ATU]) for oncedaily CsA CE, which was approved by French health authorities prior to its registration. Efficacy and safety at 1, 3, 6, and 12-month follow-up visits were evaluated. Results: The ATU cohort (n=1,212; mean age =60.5 years; 79.5% female; 98.1% with severe keratitis; 74.5% with corneal lesions) consisted of 601 CsA-naïve patients and 611 patients treated previously with other CsA formulations. The primary DED etiology was Sjögren's syndrome (48.7%). Clinical benefit could be discerned among 548 evaluable patients from months 1 to 12: keratitis improvement, 44.8% at month 1 and 42.1% at month 12; keratitis stabilization, 47.2% and 45.7%, respectively; symptom improvement, 47.2% and 48.6%; and symptom stabilization, 44.8% and 45.0%. Corneal clearing (CFS score =0) increased from 4.8% (month 1) to 11.4% (month 12). No unexpected safety concerns were identified; instillation site pain (10.2%) and eye irritation (7.8%) were the most common adverse events. Conclusion: The French ATU cohort provides supportive data on the clinical benefit of CsA CE in improving/stabilizing symptoms and corneal damage in DED patients with severe keratitis in real-world clinical practice. [ABSTRACT FROM AUTHOR]

PURPOSE: To evaluate the evolution of the epidemiology of retinal opportunistic infections in HIV-infected patients from 1994 to 1997 and to assess the effect of HAART initiated in 1996. MATERIALS AND METHODS: Epidemiological prospective study using the data collected during ocular examinations of HIV-infected patients conducted in a single referral center specialized in HIV infection. RESULTS: From 1995 to 1997, the total number of examined HIV-infected patients and the incidence of retinitis related to CMV, VZV, tuberculosis, and toxoplasmosis decreased. The incidence of CMV retinitis, which was by far the most frequent ocular infection, fell from 6.2% to 1.2%. COMMENTS: The dramatic decrease in retinal opportunistic infections since 1996 may be related to the use of HAART. However, a close follow-up is still justified due to the increasing occurrence of resistance to protease inhibitors. [ABSTRACT FROM AUTHOR]