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Albinism is a group of genetic disorders characterized by general skin and retinal hypopigmentation. It is in most cases an autosomal recessive condition. Foveal hypoplasia (FH) is one of the main criteria for the diagnosis of albinism. The aim of this study was to analyze the macular profile of the parents of patients with albinism.This study included a case series of 27 patients with albinism seen in Rothschild Foundation between April 2017 and February 2020. Spectral-domain optical coherence tomography (SD-OCT) and OCT angiography (OCT-A) were performed in every patient when possible and in every available parents. FH was graded according to Thomas' classification based on OCT. Next generation sequencing-based gene panel testing was performed in parents and children when a FH was detected on OCT in a parent.Twenty-seven patients with albinism were examined. Nine parents had FH based on the OCT B-scan (33%). In parents without FH based on the SD-OCT B-scan (67%), OCT-A showed a reduced avascular zone in the deep vascular plexus in 4 parents. Six parents carried variants that could explain their phenotype, including TYR R402Q hypomorphic alleles.This study showed the presence of FH in parents of patients with albinism, and aimed to genetically explain this phenotype.

Background Fovea plana is defined as an immature macula diagnosed by OCT, showing the unusual shunt of the inner retinal layers into the fovea. The incidence of fovea plana in the adult population remains to be determined. The aim of this study was to determine the incidence of fovea plana in the French population with age-related cataract. Methods Consecutive patients who underwent cataract surgery in Rothschild Foundation Hospital, France, between January and March 2021, with preoperative analyzable OCT scans available, were retrospectively screened in order to determine the incidence of fovea plana in these population. Ophthalmological characteristics of patients were reported, and detailed. Result Fovea plana was encountered in 20 out of 204 patients during the 3 months corresponding to an incidence of 9.8%. One of those patients had stage 2 fovea plana. Conclusion Although fovea plana is defined as an immature macula, it is not rare in preoperative population. This macular aspect was not associated with poor visual acuity in our cohort.

Resume L’optimisation des schemas de traitement des anti-angiogeniques est aujourd’hui un enjeu majeur de la prise en charge des patients atteints de DMLA exsudative. L’evolution des approches a conduit les retinologues a privilegier des regimes d’administration dit proactifs, permettant d’anticiper la recidive et de planifier a l’avance les injections intravitreennes d’anti-angiogenique, tel que le Treat-and-Extend. Neanmoins, un reel besoin d’uniformiser l’application de ce schema a ete identifie. Cet article propose un consensus etabli selon la methodologie de type Delphi qui pourrait constituer un guide pour la prise en charge des patients atteints de DMLA exsudative selon le schema d’administration T&E aux ophtalmologistes. Si certains aspects restent a ce jour non consensuels, cet article apporte des elements guidant la mise en œuvre du regime T&E. Les experts recommandent ainsi de realiser une dose de charge comprenant 3 IVT mensuelles en amont de la mise en place du T&E. Ils recommandent aussi d’ajuster les intervalles de reinjections de ± 2 semaines de maniere standard. Les intervalles sont alors diminues en cas de degradation anatomique et/ou fonctionnelle, ils sont maintenus lorsque l’intervalle de recidive est determine, et ils sont augmentes lorsqu’une amelioration anatomique et/ou fonctionnelle est observee. Un intervalle maximal entre 3 et 4 mois est recommande par les experts avec un maintien de l’intervalle maximal durant 1 an avant d’envisager une eventuelle sortie du T&E. En cas de baisse d’acuite visuelle importante liee a la pathologie et d’aggravation anatomique importante, il est recommande de repartir sur des injections mensuelles. En cas d’atteinte bilaterale, lorsqu’une synchronisation des rythmes d’injection des deux yeux est realisee, les experts recommandent de prendre l’intervalle le plus court.

The goal of this manuscript is to assess data suggesting that intravitreal injection of anti-vascular endothelial growth factors (anti-VEGFs) could result in systemic adverse events (AEs). The class-specific systemic AEs should be similar to those encountered in cancer trials. The most frequent AE observed in oncology, hypertension and proteinuria, should thus be the most common expected in ophthalmology, but their severity should be lower because of the much lower doses of anti-VEGFs administered intravitreally. Such AEs have not been frequently reported in ophthalmology trials. In addition, pharmacokinetic and pharmacodynamic data describing systemic diffusion of anti-VEGFs should be interpreted with caution because of significant inconsistencies reported. Thus, safety data reported in ophthalmology trials and pharmacokinetic/pharmacodynamic data provide robust evidence that systemic events after intravitreal injection are very unlikely. Additional studies are needed to explore this issue further, as much remains to be understood about local and systemic side effects of anti-VEGFs.

Resume Introduction La retinopathie diabetique (RD) est l’une des premieres causes mondiales de cecite. La connaissance de cette pathologie progresse grâce a l’utilisation de modeles animaux de RD. Or le modele murin de RD, qui est un modele seduisant par les modifications genetiques realisables, reste moins utilise. Afin d’expliquer ce paradoxe, nous avons realise une revue de la litterature des differents modeles murins de RD afin d’en detailler les avantages et les inconvenients. Materiel et methodes Nous avons realise la revue de la litterature a partir du moteur de recherche Pubmed. Nous avons retenu les articles qui decrivaient un modele de RD et qui detaillaient la verification de l’hyperglycemie, des anomalies des capillaires retiniens et une perte des pericytes. Tout article ne comprenant pas ces trois criteres etait exclu. Resultats Nous avons retrouve sept modeles de RD. Pour chacun de ces modeles, nous rapportons le mecanisme d’induction ainsi que les caracteristiques histopathologiques et electrophysiologiques de la RD. Conclusion Les modeles obtenus par manipulations genetiques semblent les plus interessants car le diabete ainsi que ses complications apparaissent plus precocement et sans modifications physiologiques supplementaires. Cependant, les modeles de diabetes different souvent en fonction du sexe, il s’agit donc d’un parametre important a prendre en compte.

To evaluate the role of a fast track for management of patients with neovascular age- related macular degeneration (nARMD) treated by intravitreal injection of anti-VEGF.The records of 100 patients in the chronic maintenance phase of intravitreal anti-VEGF followed in the fast track and 63 patients followed in the standard protocol for at least 12 months were retrospectively analyzed.Patients in the fast track underwent visual acuity (VA) testing by ETDRS, optical coherence tomography (OCT) and a physician assessment. The injection was performed the same day whenever possible. The primary endpoint to evaluate patient adherence was the time between the ideal date of visit or injection prescribed by the physician and the actual date of administration.The mean time between the ideal date of visit or injection prescribed by the physician and the actual date of administration was 4.1±7.5 days for the patients followed in the fast track and 5.6±18.7 days for the patients followed in the standard protocol. Mean VA remained stable for the patients followed in the fast track: 20/50 (20/800 to 20/20) at baseline vs. 20/50 (20/800 to 20/16) at the conclusion of follow-up. It dropped from 40/50 at baseline to 20/63 at the conclusion of follow-up for the patients followed in the standard protocol.In the context of a fast track, it was possible to improve the adherence of nARMD patients and maintain their VA gain or stabilization achieved after the induction phase.

National audience; Purpose To describe the course of functional and anatomical damage after successful repair of macula‐off rhegmatogenous retinal detachment (RRD). Methods This was a prospective multicenter study including patients with successful surgery for macula‐off RRD between October 2011 and April 2014. Patients with pre‐existing macular diseases or with surgery failures were excluded. Each patient underwent a complete ophthalmologic exam at baseline and at one, three and six months after the surgery (M1, M3, M6), with an assessment of the best‐corrected visual acuity (BCVA) at 4 m using the standard Early Treatment Diabetic Retinopathy Study chart, and with Spectral‐Domain Optical Coherence Tomography (SD‐OCT) macular imaging. Results One hundred and three eyes of 103 patients from ten French centers, with a 63‐years median age (IQR: [58; 69]), were included. The median BCVA increased significantly from 63 [46; 73] letters at M1 to 73 [62; 80]) at M6, p < 0.01). SD‐OCT morphologic lesions in the outer retina significantly improved between M1 and M6: irregular hyporeflectivity of the photoreceptor outer segments (76.7% vs 61.5%, p < 0.01) and disruption of the inner/outer segment junction line (51.5% vs 26.2%, p < 0.01). The rate of epiretinal membrane did not significantly increase between M1 and M6 (9.7% vs 20.4%, p < 0.67). Conclusions These preliminary results of the study “DécOllement de REtine: Fonction et Anatomie (DOREFA)” show a slow recovery of the external retinal layers after a successful RRD surgery. These observations seem to be parallel to the progressive recovery of the visual function after the intervention. A better knowledge of functional and anatomical kinetics after macula‐off RRD constitutes a preliminary step to the study of factors influencing the visual prognosis.

Idiopathic epiretinal membranes represent a common condition, and are present in approximately 10% of people over the age of 70 years. They are idiopathic in 80% of cases, or may be secondary to various conditions such as a prior retinal detachment, or vascular or inflammatory retinal diseases. The main symptoms are visual loss and metamorphopsia. The diagnosis of epiretinal membrane is currently facilitated by OCT, which provides prognostic and therapeutic decision-making assistance. Surgery for epiretinal membranes is currently well codified through sutureless vitrectomy and dyes. Dissection of the membrane (with or without associated peeling of the internal limiting membrane) ensures good anatomical and functional results, while being relatively minimally invasive.

Le decollement de retine rhegmatogene est cause par des ouvertures retiniennes, le plus souvent dechirures par traction vitreenne. Le traitement, chirurgical, repose sur l’obturation de ces ouvertures, par indentation, vitrectomie ou retinopexie pneumatique. On peut ainsi obtenir la reapplication dans plus de 90 % des cas avec une seule ou plusieurs operations. Les deux grandes causes d’echec initial sont les ouvertures non fermees et la proliferation vitreoretinienne. La proliferation vitreoretinienne est responsable de la quasi-totalite des echecs anatomiques definitifs et elle est un facteur important, avec le decollement maculaire, d’echec fonctionnel ; en outre, elle n’a pas a l’heure actuelle de traitement pharmacologique veritablement efficace. Cette gravite potentielle du decollement de retine rhegmatogene incite fortement, malgre sa rarete, a proposer des traitements preventifs. Le plus important a cet egard, et aussi a l’egard du pronostic anatomique et fonctionnel, est d’examiner les patients le plus vite possible apres le debut des signes visuels.

Resume Les membranes epiretiniennes maculaires sont des proliferations cellulaires non vasculaires, benignes, d'evolution autolimitee avec un epicentre contractile maculaire ou paramaculaire et s'etendant habituellement peu au-dela du pole posterieur. En se contractant elles provoquent un plissement plus ou moins severe de la macula et peuvent entrainer une gene fonctionnelle. Elles sont idiopathiques dans 80 % des cas, ou peuvent etre secondaires a diverses affections telles qu'un decollement de retine opere, ou des retinopathies vasculaires ou inflammatoires. Leur physiopathologie est incompletement connue, mais elles sont chronologiquement liees a la survenue d'un decollement posterieur du vitre et leur incidence augmente avec l'âge. Les membranes epimaculaires peuvent etre enlevees chirurgicalement par voie de vitrectomie avec un bon resultat fonctionnel.

In recent years, intravitreal injections have added to the treatment modalities available for macular edema (ME) secondary to retinal vein occlusion (RVO). This article aims to provide an update regarding the management of ME secondary to RVO.A work group met in order to analyze the literature available on Embase/PubMed, regarding treatments for venous occlusion that have received market approval and are reimbursed in France. In total, 33 articles were selected. Consensus within the group for recommendations was based on this data from the literature review and clinical experience and was reported in this article.The management of ME secondary to branch retinal vein occlusion (BRVO) or central vein occlusion of the retina (CRVO) differs on a number of points. Methods of best practice were discussed separately for BRVO and CRVO, taking into account various ocular and associated parameters.Ranibizumab and dexamethasone implant are the first-line treatments for visual impairment due to ME secondary to RVO. The choice of either of these drugs may take into account various ocular and extraocular parameters. A change of treatment to one or the other or to laser may also be considered during follow-up.

Optical coherence tomography has significantly changed the approach to vitreomacular diseases, including macular holes (MH). OCT provides information on differential diagnoses (lamellar hole, pseudo-hole), the MH size, the status of the vitreous, and the status of the various retinal layers. The evolution of diagnostic tools and treatment justifies the need for an update of the current classification of vitreomacular diseases.A group of retina specialists met several times to discuss the international classification, recently published by The International Vitreomacular Traction Study Group, focusing on vitreomacular adhesion (VMA), vitreomacular traction (VMT) and MH. It was compared to the classification currently used in France, based on the ophthalmoscopic system of Gass, then further delineated by Gaudric's OCT studies, in order to suggest a French adaptation to the international classification.An adapted classification for clinical use in France and in connection with the international classification is proposed. VMA are classified as an "associated" or "isolated" VMA respectively with or without macular disease. MH are distinguished as "primary" or "secondary" MH depending on whether the etiology is known or not, and classified as "small", "medium" and "large" depending on the size of the hole, and according to the presence or absence of VMT. Finally, VMT are described according to presence or absence of an epimacular membrane and according to the width of the adhesion.

Age related macular degeneration (AMD) is a pathological aging of the macula, brought about by the interaction of genetic and environmental factors. It induces geographic atrophy of the retina and/or choroidal neovascularization. In the latter, abnormal vessels develop from the choriocapillaris, with the involvement of VEGF (vascular endothelial growth factor). The VEGF family includes several factors, including VEGF-A, B, C, D, F and PlGF (placental growth factor). Their biological properties and their affinities to the VEGFR1, VEGFR2 and VEGFR3 receptors found on endothelial cells differ. Exudative AMD involves mainly VEGF-A and VEGF-R2. Anti-VEGF agents used in ophthalmology (ranibizumab, bevacizumab and aflibercept) are designed to primarily target this pathway. In vitro, all have sufficient affinity to their ligands. Their therapeutic efficacy must therefore be judged based on clinical criteria. In clinical practice, the minimum number of injections required for a satisfactory result appears to be comparable with all the three. The few available studies on therapeutic substitutions of anti-VEGF compounds suggest that some patients may benefit from substituting the anti-VEGF in cases of an unsatisfactory response to an initial molecule. Although local side effects, including increased risk of geographic atrophy, and systemic effects, including vascular accidents, have been suggested, these risks remain low, specially compared to the benefits of the treatment. Differences in safety between anti-VEGF are theoretically possible but unproven.

Purpose Discussing data on side effects of ILM peeling. Conclusion ILM peeling induces anatomical and functional alteration of the retina that should be weigh up against its benefits.

Purpose Discussing techniques of combining cataract surgery with vitrectomy. Conclusion To achieve a sustainable gain of vision in selected cases, combined surgery is performed by an increasing number of vitreoretinal surgeons. This combination needs adaptation of both cataract surgery and vitrectomy techniques.

The role of the vascular endothelial growth factors in neovascular AMD and the features of the VEGF Trap-Eye molecule are presented including binding mechanism, affinity, and predicted biologic activities that support the rationale for every-other-month dosing.

Purpose With monthly ranibizumab treatment for wet AMD (wAMD), optimal functional outcomes are achieved. To reduce management burdens, as-needed dosing regimens have been explored. AURA study examines real-world utilization of ranibizumab. Methods Retrospective, international (Canada, France, Germany, Ireland, Italy, Netherlands, UK, Venezuela), non-interventional, observational study. Target enrollment is 444 patients per country and will be completed by September 2012. Consecutive AMD patients prescribed ranibizumab by their physicians will be included, with a follow-up period of up to 2.5 years. Primary outcomes are (1) change in visual acuity and (2) resource utilization (number of treatment and monitoring visits, treatment use). Descriptive statistics will be used. Results Results for Germany are already available: 916 patients from 28 sites were screened. Of these, 462 (50.4%) were not enrolled. The reasons (not mutually exclusive) included no written informed consent (n=349), consent obtained after target patient number reached (n=68), use of non-conventional interventions (n=21), ranibizumab use did not start between January-August 2009 (n=23), and no wAMD diagnosis (n=6). Of the 454 enrolled, 437 (96.3%) received ≥1 ranibizumab dose. Of the 437, most were women (n=260, 59.5%), Caucasian (n=368, 84.2%), and initiated treatment at ≥75 years of age (n=304, 69.6%). Mean age was 79.2±8.1 years. Conclusion These data will provide valuable insight into resource utilization patterns and their effects on visual outcome in various ranibizumab-treated wAMD patient populations. Commercial interest

Diabetic retinopathy (DR) is a leading cause of vision loss worldwide. A variety of species of animals have been used to investigate the pathogenesis of DR. However, the mouse model of diabetic retinopathy, which is an attractive model due to the genetic modifications which can be carried out, remains underutilized. In order to explain this discrepancy, we performed a review of the literature concerning various mouse models of diabetic retinopathy so as to define their advantages and disadvantages.We carried out a literature review using PubMed. We selected articles describing models of DR with pericyte loss, retinal capillary abnormalities and hyperglycemia. Articles not meeting these three criteria were excluded.Out of 25 articles, we found seven models of DR. For each of these models, we report the method of induction of DR and the electrophysiological and histopathological features.Models obtained through genetic manipulation appear the most interesting, since the diabetes and its complications present early without additional physiologic modifications. However, since these models differ frequently by sex, this is an important parameter that must be taken into account.

The European Society for Cataract and Refractive Surgery (ESCRS) endophthalmitis study demonstrated a significant decrease in the rates of postoperative endophthalmitis with the use of intracameral cefuroxime during cataract surgery. We report the organization of the implementation of this procedure in our departments and our results after 2 years.All patients operated on for cataract between January 2007 and December 2008 in the ophthalmology departments of the Pellegrin University Hospital in Bordeaux and Lariboisiere University Hospital in Paris received an intracameral injection of cefuroxime at the end of the surgery. The cefuroxime was prepared in ready-for-use syringes by the hospital's central pharmacy.A convenient method of preparation and conditioning cefuroxime with stable preservation lasting longer than 1 week was set up in our hospitals. Between January 2007 and December 2008, out of 3316 patients who had a cataract surgery, two presented an endophthalmitis (0.06%).The intracameral cefuroxime injection at the end of the cataract surgery is a means to consider to prevent endophthalmitis. It can be implemented as a part of regular practice with appropriate preparation rules. The major barrier to its further use appears to be the lack of a commercially available preformulated preparation.

The technique of intravitreous injections has been well documented for several years. Recently, a descriptive article on the intravitreous injections procedure was published in the Journal Français d'Ophtalmologie, and the AFSSAPS (French agency for drug safety) released recommendations concerning this matter on the occasion of commercial launch of pegaptanib. Since that time, the number of intravitreal injections has considerably increased, because anti-VEGF drugs had been made available to ophthalmologists, and several teams have performed a large number of procedures, allowing them to better comprehend intravitreous injections. The present paper describes our current practice of intravitreous injections. Several specialists have exchanged their experiences and issued a common synthesis. Detailed modifications of the initial recommendations have been suggested, with such basic changes such as abandoning preoperative pupil dilatation and easing postsurgical monitoring. Follow-up examinations should be adapted to each patient rather than being systematic. The suggested modifications do not change the procedure of intravitreous injections substantially, but they simplify many steps and detail the various procedures when consensus is lacking.

Purpose To discuss data on the potential or real toxicity of intraocular visualization drugs, based on animal and human studies. Methods The course will be based on last experimental and clinical data available in the literature or from our studies. Results There is a larger choice of visualizations drugs with a clear benefit of helping the surgeon. Each of them has its own advantages and risks. The decision to use or not these drugs should also take into account the goal for which they may be used and the expected benefit from it. Conclusion Visualizations drugs, as most drugs, may represent risks that have to be weighed up against awaited benefits.

The primary objective of this study was to compare eye drops and inserts in terms of the quality of preoperative mydriasis. The secondary objective was to evaluate the safety and ease of use of each modality.Prospective randomized and simple blinded study. Patients were randomized into two groups: the insert protocol (atropine 1%, diclofenac 0.1% collyrium and Mydriasert) or the eye drop protocol (atropine 1%, diclofenac 0.1%, tropicamide 0.5%, and phenylephrine 10% collyrium). Fifty-one patients were included: 25 in the insert protocol and 26 in the drop protocol. Mydriasis quality was evaluated by nurses and surgeons. The ease of use was estimated by the number of gestures required to obtain mydriasis and the difficulties encountered. Safety was evaluated at the patient's bedside.Mydriasis of at least 6 mm was obtained in 92% of the patients in the insert protocol (23/25) and 85% of the patients in the drop protocol (22/26) (NS). Four patients lost their insert during the study. Of the patients in the insert group, 16% (4/25) experienced stinging in their eyes, as did 23% (6/26) of patients in the group using drops (NS). To reach effective mydriasis, the insert protocol required fewer nurse gestures per patient than the drop protocol (3.0 versus 8.3; p0.001).With the protocol using an insert, preoperative mydriasis is not inferior to that obtained with drops only and is more efficient in terms of nurse time and number of gestures. Nurses should be trained in appropriate handling of the insert and avoiding the loss of the device.

To analyze the effectiveness of acetazolamide associated with topical nonsteroidal anti-inflammatory drugs (NSAIDs) and/or steroids in the treatment of postsurgical macular edema (ME).Sixteen eyes of 15 consecutive patients presenting with clinical ME 1-120 months after ophthalmologic surgery were studied retrospectively. The mean duration of ME before treatment was 5 months. All patients were treated with 250-500 mg of acetazolamide per day, associated with topical NSAIDs and/or steroids for an average of 6.9 months. The main outcome measures were the best-corrected visual acuity expressed in Log MAR, and the retinal thickness evaluated with OCT.The mean initial visual acuity was 20/100 (0.7 +/- 0.28 Log MAR), with a macular thickness of 599.67 +/-174.17 microm (average +/- standard deviation). The mean final visual acuity was 20/40 (+0.3 +/- 0.2 Log MAR) with a macular thickness of 264.69 +/- 106.59 microm. Treatment was effective in 87.5% of overall cases. The effectiveness was 100% in the subgroup treated with acetazolamide, NSAIDs, and steroids.This study suggests that medical treatment with a combination of acetazolamide, topical NSAIDs and/or steroids may be beneficial for reducing retinal thickness and improving vision in postsurgical ME.

The screening of diabetic retinopathy is still largely insufficient and consequently, its management is often delayed. The various recommendations indicate a fundus examination at diabetes diagnosis and yearly thereafter. In France, this is far to be reached, and this situation is at risk of aggravation with the increasing number of diabetic patients and the decreasing number of ophthalmologists. New efficient tools, as the non-mydriatic cameras and digital photography, may allow a new network organisation for screening of diabetic retinopathy, with local screening sites linked to a centralised ophthalmological reading center where digital images could be transmitted. The various aspects of this screening and possibilities to improve the screening and early management of diabetic retinopathy are discussed in this paper.

Introduction Les Chorioretinites Sereuses Centrales (CRSC) post-greffes d’organes sont exceptionnelles. Leur presentation est semblable a celle des CRSC idiopathiques. Dans un contexte de retinopathie diabetique, le diagnostic peut etre tres difficile. Objectifs et Methodes Patient âge de 51 ans, diabetique insulino dependant depuis l’âge de 27 ans, avec retinopathie diabetique proliferante bilaterale, traitee par PPR, et maculopathie exsudative a gauche, traitee chirurgicalement. Du fait de l’impossibilite d’equilibrer son diabete et d’une insuffisance renale terminale, il a beneficie en 2001 d’une greffe rein-pancreas. Le traitement immunosuppresseur associe ciclosporine, mycophenolate mofetil et prednisone. En mars 2005, le patient consulte pour une baisse d’acuite visuelle (BAV) de l’œil droit, evaluee a 2/10 P5, avec scotome central. L’angiographie retrouve une diffusion maculaire, et l’OCT met en evidence des logettes d’œdeme retinien. Du fait de la suspicion de maculopathie diabetique oedemateuse, une injection latero bulbaire de corticoides est realisee en juillet 2005. Dans les suites, apparition d’un Decollement Sereux Retinien (DSR) bulleux, avec aggravation de la BAV (1/20 P14). Le diagnostic de CRSC est envisage. Resultats L’arret des corticoides est deconseille par les nephrologues, du fait d’un risque de rejet evalue a 20 %. Une vitrectomie avec injection de gaz C3F8 est realisee en septembre 2005. On observe alors a l’OCT une disparition du DSR, et une amelioration de l’acuite visuelle (1/10 P10). Cet acte est suivi par l’apparition d’une cataracte, operee en juillet 2007. Un mois apres, nouvelle BAV (1/20 P28) en rapport avec la recidive de cette CRSC avec DSR bulleux. La poursuite de l’aggravation du DSR conduit a realiser une PDT en demi-fluence en octobre 2007. Elle est suivie d’une nette diminution du DSR, et d’une amelioration de l’acuite visuelle (1/10). Discussion La CRSC post-greffe d’organe est rare, et de physiopathologie mal connue. Les immunosuppresseurs, en particulier les corticoides, semblent a l’origine de son developpement. La vitrectomie et la PDT ont montre chez ce patient une efficacite. Conclusion La CRSC avec DSR bulleux est de pronostic defavorable. La modification du traitement immunosuppresseur semble souhaitable, mais difficile, du fait du risque de rejet.

New configurations of erbium-doped fibre amplifiers have been investigated for the 0.98 μm and 1.48 μm pump wave-lengths. A doubling of the gain coefficient has been predicted for reflective type amplifiers at the cost of a noise figure increase of 1.5 dB.

Reaction of iodosylbenzene with CuI complexes (2a,b) occurs with hydroxylation in the ortho position of one pyridine nucleus; CuIIIO species are postulated.

Reaction of iodosylbenzene with CuI complexes (2a,b) occurs with hydroxylation in the ortho position of one pyridine nucleus; CuIIIO species are postulated.