[REFORCE registry]. / Registre REFORCE.

Severe coronary artery calcification, too often underestimated, increases the complexity of percutaneous coronary interventions. Atherectomy is one of preferred approach for the preparation of calcified lesions before stent placement. Orbital atherectomy is a new method that has proven to be safe and effective in the preparation of calcium plaques (ORBIT I and ORBIT II studies). The recent introduction in France allows to perform a prospective registry named REFORCE. Its main objective is to include 300 patients in order to evaluate security and safety of the device in France during routine use.

Cross-cultural adaptation and validation of the Moroccan version of the Glaucoma Quality of Life-15 (GQL-15) questionnaire in patients with glaucoma.

BACKGROUND: Glaucoma is the second leading cause of blindness in the world. In addition, visual impairment and psychological strain have been shown to have a significant impact on quality of life (QoL) in glaucoma patients. Maintaining the quality of life of glaucoma patients has become an important component of treatment. The goal of this study is to develop a Moroccan Arabic dialect version of the Glaucoma Quality of Life-15 questionnaire and to examine its psychometric properties. METHODS: The Glaucoma Quality of Life-15 questionnaire was translated and cross-culturally adapted into Moroccan Arabic dialect and administered to glaucoma patients recruited from the ophthalmology department of the Omar Drissi Hospital, Hassan II University Hospital, Fez. Sociodemographic and other clinical data were collected. Psychometric properties were performed, including internal consistency, which was tested using Cronbach's alpha (α), test-retest reliability using intraclass correlation coefficients (ICC). Construct validity was assessed by examining the convergent and divergent validity of items. RESULTS: The questionnaire was administered to 148 patients with a mean age of 60.91 ± 15.10 years. Over half of the patients were female (58.1%), patients were married (77.7%), illiterate (62.2%) and unemployed (82.3%). The majority of patients had primary open angle glaucoma (68.9%). The mean time to complete the GQL-15 was 3.26±0.51min. The mean summary score for the GQL-15 was 39.50±16.76. Cronbach's alpha for the entire scale was 0.95 (central and near vision 0.58; peripheral vision 0.94; glare and dark adaptation 0.87). CONCLUSION: The Moroccan Arabic dialect version of the GQL-15 demonstrates adequate reliability and validity. Therefore, this version could be used as a reliable and valid tool for quality-of-life assessment in Moroccan glaucoma patients.

[Anatomic variations in the ethmoid sinus in patients undergoing dacryocystorhinostomy at the Hassan II de Fès Medical Center (study of 215 patients)]. / Variations anatomiques du sinus ethmoïdal des patients opérés de dacryocystorhinostomie au centre hospitalier Hassan II de FES (étude de 215 patients).

INTRODUCTION: Although several studies have tried to identify the causes of failure of dacryocystorhinostomy (DCR) surgery, the ethmoid sinus remains an underestimated and little described source of failure. OBJECTIVE: To study anatomical relationship between the ethmoidal sinus, particularly the "Agger nasi" cell, with the lacrimal fossa in the North African population, little described in the literature. This study is based on the results of preoperative analysis of dacryo-computed tomography. PATIENTS AND METHODS: Analysis of preoperative computed tomography images of patients undergoing dacryocystorhinostomy over a 7-year period from January 2011 to December 2017. Anatomical relationships were studied according to the following classification: type I: No ethmoid cells located anteriorly to the posterior lacrimal crest on transverse images; type II: ethmoidal cells extending anteriorly to the posterior lacrimal crest, but not reaching the anterior edge of the lacrimal bone; Type III: ethmoidal cells located anterior to the lacrimal bone suture. RESULTS: Two hundred and fifteen preoperative computed tomography images were analyzed. The morphology of the ethmoid sinus was classified as type 1 in 33.5%, type 2 in 42.32% and type 3 in 24.18%. Computed tomography analysis was symmetrical in 87.5% and asymmetrical in 12.5%. CONCLUSION: During dacryocystorhinostomy, the surgeon must take into consideration type III, which can be present in 25% of cases. In the case of surgical failure, a dacryo-CT must be performed to rule out such anterior positioning of the ethmoid cells.

Malignant transformation of a mature retroperitoneal teratoma into adenocarcinoma.

Retroperitoneal mature teratoma is a rare congenital tumor, far behind ovarian and testicular localizations. Malignant transformation of teratomas is extremely uncommon. We report a case of a 23-year-old female, who presented with chronic pelvic heaviness, abdominopelvic ultrasound revealed a cystic mass in the right iliac fossa, initially considered as a functional ovarian cyst. Given the persistence of the patient's symptoms a pelvic MRI was requested. It showed a right retro-colic cystic unilocular with parietal nodule. The two ovaries showed normal appearance. A retroperitoneal teratoma was suggested given the retroperitoneal topography of the mass, and the presence of a tissular parietal nodule. She underwent surgery and the diagnosis was confirmed after histological study.

Atypical manifestation of a fistula between a hydatid cyst of a liver and a gallbladder: A case report.

The hydatid cyst of the liver is the most common location of hydatid disease. Complications in this form are dominated by superinfection of the cyst and rupture into the bile ducts or the peritoneal cavity. We report the case of a 54-year-old female patient with a hydatid cyst of the liver complicated by a rupture in the gallbladder revealed by urinary symptoms.

Extensive prostatic abscess drained by CT-guided percutaneous approach: Case report.

Prostatic abscess is a rare entity that occurs most frequently after the age of 50. The main risk factors are immunosuppressive conditions such as diabetes, HIV infection and chronic renal failure. It is clinically manifested by signs of bladder irritation. The management of the disease involves antibiotic therapy and drainage of the abscess, which can be performed by various invasive methods. We report the case of a 60-year-old patient with a large prostatic abscess drained by CT-guided percutaneous approach.

[Impact of the SARS-CoV-2 pandemic on diabetic macular edema and prognostic factors]. / Impact de la pandémie du SARS-CoV-2 sur l'œdème maculaire diabétique et facteurs pronostiques.

PURPOSE: To assess functional and anatomical consequences of the delay in intravitreal injections for diabetic macular edema (DME) patients during the corona virus pandemic lockdown in Morocco as well as to evaluate factors associated with disease progression. PATIENTS AND METHODS: This cross-sectional study included DME patients who did not complete their scheduled intravitreal bevacizumab injections during the Lockdown period (March 20, 2020 to May 20, 2020). Data recorded included age, duration of diabetes, number of previous intravitreal injections, best-corrected visual acuity, and central macular thickness before and after the lockdown. RESULTS: One hundred and fifty four eyes of 104 patients were analyzed. 57.8% were male. The mean age was 59.4±9.04 years. The mean duration of delay of intravitreal injections was 57.3±6.7 days. The mean number of intravitreal bevacizumab injections received before the lockdown was 2.29±2.1. Worsening of visual acuity was noted in 44.8% of patients and was associated with a lower number of intravitreal injections performed prior to the lockdown (P=0.001) and with glycemic imbalance (P=0.04). An increase in central macular thickness was noted in 26.6% of patients and was associated with a lower number of intravitreal injections (P=0.038). CONCLUSION: The delay in intravitreal injections during the lockdown had negative effects on visual acuity and central macular thickness in eyes with DME. Prolonged delay in intravitreal anti-VEGF injections in diabetic patients should be avoided.

Scleral contact lenses: Visual outcomes and tolerance. A prospective study about 98 eyes.

PURPOSE: To assess the improvement in visual acuity (VA), tolerance and quality of life of patients after scleral contact lens (SCL) fitting. MATERIAL AND METHODS: We carried out a prospective observational study conducted from April 2016 to August 2017. Patients fitted with SCL were included. For the purpose of this study, we analyzed VA and quality of life score (NEI-VFQ25) after 6 months of use. RESULTS: We identified 98 eyes of 56 patients; the major indication for SCL fitting was keratoconus in 64.3%; the other indications were post-penetrating keratoplasty, other irregular astigmatism, severe ametropia and ocular surface disease. The mean follow-up was 10.71 months. The mean daily wearing time was 9.89±1.63 hours. Best corrected Visual acuity "BCVA" (baseline 1.11±0.37 in the right eye and 1.13±0.42 LogMar in the left eye) improved to 0.19±0.20 and 0.23±0.38 LogMar respectively in the right and left eyes after SCL wear (P=0.000). The scores on the various subscales of the NEI-VFQ 25 questionnaire were significantly higher 6 months after SCL fitting, with a mean score of 87.28±9.87 with SCL versus 39.94±11.33 without these lenses (P=0.000). In our group, no complications related to the SCL wear occurred, except for the occurrence of "loose conjunctival tissue" at the inferior limbus in one patient. DISCUSSION: Our results complement those of several large series published on this subject. The best visual acuities were reported after correction of irregular astigmatism, in particular keratoconus. Therefore, SCL fitting has become an alternative or a precursor to penetrating keratoplasty in patients with advanced keratoconus. In the case of ocular surface disease, in addition to the improvement in VA, the comfort and recovery of the homeostasis of the ocular surface is greater, with fewer wearing complications. Hence, their inclusion in the therapeutic arsenal for severe ocular surface disease alongside the conventional treatment options. CONCLUSION: SCL have proven their efficacy and safety in the optical correction of irregular corneas and in the management of ocular surface problems. Additional studies are needed to compare the many lenses currently available and assess optimal fitting strategies for each type of scleral lens for easier fitting procedures and better wearing comfort.

[Hemifacial spasm. Etiology and management]. / Spasmes hémifaciaux. Étiologies et conduite à tenir.

INTRODUCTION: Hemifacial spasm (HFS) is an involuntary contracture of the facial muscles innervated by the ipsilateral facial nerve. We studied the etiology of these HFS. MATERIALS AND METHODS: This retrospective study included 233 patients with HFS who came to the ophthalmologist for quarterly botulinum neurotoxin A injection. Of these, we analyzed the 198 patients for whom MRI scans were performed. We recorded patient clinical data and clarified the etiology of their HFS. RESULTS: The 198 patients (62.6% women) had a mean age of 55.7±14years. An etiology was found in 52.5% of cases. In 34.5% of HFS, MRI revealed vascular compression where the facial nerve emerged from the brainstem. We specify the arteries involved. Brain tumors accounted for 1.5% of cases. MRI was normal in 64.5% of cases. In these secondary cases of HFS, we found 8.5% peripheral facial palsy, 4% post-traumatic HFS and 4% secondary to an eye injury. Stress was found in 17% of patients. DISCUSSION AND CONCLUSION: This study illustrates the need for MRI with attention to the posterior fossa in the work-up of HFS in order to identify primary HFS associated with vascular compression of the facial nerve and to rule out a rare but serious posterior fossa tumor. The treatment of HFS is based on quarterly injections of botulinum neurotoxin/A (NTBo/A), the three brands of which have market approval. The injection pattern and frequency is customized according to the results. In cases of insufficient response to injections of NTBo/A, neurosurgical microvascular decompression may be considered for cases of primary HFS.