Non-immediate drug hypersensitivity reactions secondary to intravitreal anti-vascular endothelial growth factors.

PURPOSE: To describe a series of non-immediate drug hypersensitivity reactions after intravitreal anti-vascular endothelial growth factors (anti-VEGFs). PATIENTS AND METHODS: Retrospective report of 6 patients with cutaneous non-immediate drug hypersensitivity reactions following intravitreal anti-VEGF injections, 4 after ranibizumab, 1 after bevacizumab and 1 after aflibercept. RESULTS: Clinical manifestations ranged from mild maculopapular rash, purpura to severe generalized erythroderma, with or without systemic involvement such as microscopic hematuria and proteinuria or fever. In two out of the six patients, reintroduction of either the same or an alternative anti-VEGF drug did induce a recurrence of the drug hypersensitivity reaction, while 4 patients showed no recurrence. CONCLUSION: Cutaneous non-immediate drug hypersensitivity reactions secondary to intravitreal anti-VEGF may occur. Continuation of the same drug or switch to another anti-VEGF may either induce recurrence or be well supported by the patient. The decision of drug discontinuation should be guided by the severity of the disease.

Descemet's membrane endothelial keratoplasty rejection after SARS-COV2 infection or vaccination: 2-year retrospective study.

PURPOSE: To assess the incidence of Descemet's membrane endothelial keratoplasty (DMEK) rejection potentially associated with coronavirus disease 2019 (COVID-19) infection or vaccination, and its association with known rejection risk factors during the first two years of the pandemic. METHODS: This retrospective study included patients with DMEK rejection between January 2020 and December 2021. Diagnostic criteria were based on symptoms, visual acuity, and other clinical assessments. Risk factors for graft rejection were considered, and a telephone survey was conducted to identify possible preceding COVID-19 infection or vaccination. RESULTS: Of 58 patients, 44 were included. Six patients (14%) reported COVID-19 infection, with one immediate endothelial graft rejection (EGR) post-infection. After vaccine availability, 13 of 36 patients had EGR at an average of 2.7 months post-vaccination. Five (38%) had immediate EGR following vaccination, four of which had concomitant risk factors for rejection. CONCLUSION: Although the risk of endothelial graft rejection (EGR) associated with COVID-19 infection or vaccination appears to be extremely low, there may be a causative relationship, especially in patients with pre-existing risk factors for EGR. A temporary increase in anti-rejection treatment following COVID-19 infection or vaccination is recommended, especially in patients with pre-existing risk factors, along with closer monitoring during the subsequent 4 to 8 weeks.

[Choroidal metastasis from a lung adenocarcinoma treated by intravitreal injection of anti-VEGF and external beam radiotherapy: A case report]. / Métastases choroïdiennes d'un adénocarcinome pulmonaire traité par injections intravitréennes d'anti-VEGF et irradiation externe : à propos d'un cas.

Choroidal metastases of lung cancer are very uncommon. This localization should be suspected on blurred vision and confirmed with an ophthalmological examination. Its treatment is not entirely codified. We report a case of blurred vision secondary to bilateral choroidal metastasis in a patient with choroidal metastases from a lung adenocarcinoma, treated by intravitreal anti-vascular endothelial growth factor (VEGF) injection and external beam radiotherapy. According to a literature review, we analyzed the place of the targeted treatments used alone or combined with the radiotherapy.

[Study of the internal canthus with magnetic resonance imaging]. / Etude du canthus interne par imagerie par résonance magnétique.

In oculoplastic surgery, the internal canthus is a particular feature of great importance. An analysis has been carried out with 10 MRI tests of the internal canthi and the authors will outline the major difficulties, before detailing a protocol which would enable further studies of pathological canthi.

[Diagnosis of ocular toxoplasmosis by the ELISA method applied to the determination of immunoglobulins of the aqueous humor]. / Diagnostic de la toxoplasmose occulaire par la méthode ELISA appliquée au dosage des immunoglobulines de l'humeur aqueuse.

The toxoplasmosic origin of focal chorioretinitis can be detected on the basis of certain clinical signs in the fundus. However, this must be biologically confirmed by studying the local production of specific antibodies. For that purpose, the rate of intraocular specific Immunoglobulins is compared to the serum rate. The ELISA method is well adapted to quantitative determination of microamounts in aqueous humors. The authors report a study of 103 patients of whom, 28 were suffering from uveitis, and have studied the correlation between clinical lesions and results of the ELISA test. There was no false positive in the first group reference series, and in the positive cases there was a very high correlation with the clinical indicators.