[Real life retrospective study of 98 eyes treated with intravitreal dexamethasone or anti-VEGF injections for macular edema due to diabetes or retinal vein occlusion]. / Étude rétrospective de vraie vie de patients traités par injections intra-vitréennes de dexaméthasone ou d'anti-VEGF pour œdèmes maculaires diabétiques ou secondaires à une occlusion veineuse rétinienne : à propos de 98 yeux.

PURPOSE: To evaluate long term outcomes of patients presenting with diabetic macular edema (DME) or edema secondary to a retinal vein occlusion (RVO). METHODS: This is a real world, retrospective, single-center study of 65 eyes of 47 patients treated for DME and 33 eyes of 33 patients with macular edema secondary to RVO between July 2012 and October 2018. The patients treated were treatment-naive and were followed for at least one year. We collected data such as visual acuity, central macular thickness, intravitreal injections (number/year, injection schedule, number of switches), number of visits and cases of vision loss. RESULTS: DME: the mean age at inclusion was 65.9years with 60.4% women, and the mean follow-up was 28.5months. The mean gain in visual acuity after 1year of follow-up was 6.4 ETDRS letters for patients treated with anti-VEGF and 2.6 letters for patients treated with dexamethasone. The average number of intravitreal injections of anti-VEGF was 5.6/year, compared to 2.9/year for dexamethasone. Fourteen patients initially treated with anti-VEGF were switched to dexamethasone. RVO: the mean age at inclusion was 68.8years with 54.5% women and a mean follow-up of 31.1months. The mean gain in visual acuity after 1year of follow-up was 26.7 ETDRS letters for patients treated with anti-VEGF and 7.0 letters for patients treated with dexamethasone. The average number of intravitreal injections of anti-VEGF was 5.8/year, compared to 2.4/year for dexamethasone. Five patients initially treated with anti-VEGF were switched to dexamethasone in the first year of follow-up. CONCLUSION: In this real-life retrospective study, we found good anatomical and functional results similar to those reported in other studies, remaining stable over time, for patients with DME or macular edema secondary to RVO.

Safety of intravitreal injection of ranibizumab in early pregnancy: a series of three cases.

PurposeRanibizumab is used in the treatment of choroidal neovascularization (CNV). Although systemic exposure to ranibizumab is low after ocular administration, its mechanism of action must be regarded as potentially teratogenic and embryo-fetotoxic. Women are advised to wait 3 months after the last dose of treatment with ranibizumab before conceiving. Little is known about the fetal side-effects of this drug.MethodsThree pregnant women were treated with ranibizumab. One patient had idiopathic CNV.ResultsAfter receiving injections at 10 and 21 weeks after her last menstrual period (LMP), she gave birth to a healthy child. The second patient had myopic choroidal neovascularization (mCNV) and was treated by a single injection at 17 weeks post LMP. She gave birth to a healthy child after an uneventful pregnancy. The third patient had CNV secondary to a punctuate inner choroiditis. The injection was performed at 8 weeks post LMP. This patient presented a cholestasis of pregnancy at 36 weeks post LMP and gave birth at 38 weeks post LMP to a child that did not present any malformations.ConclusionsThis case series describes three women who underwent intravitreal ranibizumab treatment during pregnancy without showing any obstetric, embryofetal or neonatal complications.

[Validation of the French version of the health-related quality of life questionnaire for adult strabismus (AS-20)]. / Validation de la version française d'un questionnaire de qualité de vie de l'adulte strabique (AS-20).

INTRODUCTION: A growing number of articles have shown the negative impact of strabismus on self image, relationships with others and professional life. The AS-20 is a standardized questionnaire in English measuring the psychosocial impact of strabismus in adults. The goal of this study is to validate the AS-20 in the French language. PARTICIPANTS: Three hundred and ninety one patients took part in the study: 131 had strabismus (group 1), 128 other ocular diseases (group 2) and 132 "normal" patients (group 3). RESULTS: The AS-20 scale showed good psychometrical properties in 2 or 4 dimensions: internal consistency was very good (Cronbach's alpha coefficient>0.9 in all dimensions and overall) and the reproducibility was satisfactory (intra class coefficient>0.7). The comparison of the scores in the 2 dimension scale showed significant differences between the groups (P<0.001): lower score in strabismus (63.9±18.3) than in other ocular diseases (73.5±17.8) and normal group (89.4±12.0) (divergent validity). The 4 dimension psychometric analysis was performed by removing 2 items and grouping the 18 others in 4 groups. It confirmed the divergent and convergent validity, internal consistency and reproducibility of the scale. The results of the confirmatory factor analysis were better with the 4 dimension scale than the 2 dimension scale (adjustment coefficients>0.9). CONCLUSION: We now have access to a health related questionnaire in French to quantify the impact of strabismus on quality of life and measure the results of treatment.