Increased choroidal thickness in primary angle closure measured by swept-source optical coherence tomography in Caucasian population.

PURPOSE: A role of the choroid has been suggested in the pathophysiology of angle closure. We assessed the choroidal thickness (CT) in Caucasian patients with primary angle closure (PAC) and in a subgroup of patients with plateau iris using swept-source optical coherence tomography (SS-OCT) compared to normal eyes. METHODS: This prospective cohort study in a hospital-based population in a tertiary center compared consecutive patients with PAC to healthy controls. A subgroup analysis of patients with plateau iris was also performed. Choroidal thickness was measured by SS-OCT in the subfoveal area (SFCT) and at 1- and 3-mm eccentricity superiorly, inferiorly, nasally and temporally from the fovea. RESULTS: Compared to the 25 eyes of 13 control patients [7 women, mean (SD) age, 56.6 (15.7) years], the 45 eyes of 25 patients with PAC [15 women, mean (SD) age, 55.7 (10.7) years] had a significantly increased SFCT. SFCT was 355.36 µm (SD 85.97) in PAC eyes versus 286.08 µm (SD 98.09) in control eyes (p = 0.009). The CT was also significantly increased compared to control eyes in other macular areas (p < 0.05), except at 3 mm temporal to the fovea. In the plateau iris subgroup, a not significant (except 3 mm nasal to the fovea) trend toward an increased CT was observed in all studied macular areas compared to control eyes. CONCLUSION: In eyes of Caucasian patients with PAC, the CT is increased compared to controls. Increased CT could contribute to the pathophysiology of PAC with a possible choroidal expansion and dysfunction of choroidal ganglion cells.

Endothelial cell loss 5 years after Preserflo MicroShunt implantation: About two cases.

PURPOSE: Preserflo MicroShunt is a minimally-invasive glaucoma drainage micro-tube used to shunt aqueous humor from the anterior chamber to the subtenon space. The safety of the procedure was considered satisfactory with a majority of minor side effects. OBSERVATION: We describe the 5 year endothelial cell loss after Preserflo implantation in 2 primary open angle glaucoma patients. The case 1 presented a device-cornea touch after a backward migration of the device. The case 2 presented a modified aspect of the device compatible with an inflammatory reaction. Both cases were explanted. CONCLUSION: As described in Ahmed glaucoma valve, Xen gel stent and Cypass, Preserflo MicroShunt can lead to endothelial cell loss in some cases. A long-term prospective study with pre and postoperative endothelial cell count and AS-OCT or UBM evaluation of the device positioning would be of great interest to assess the real impact of Preserflo MicroShunt and risk factors for endothelial cell loss.

[Myopia boom: how to slow the progress ?] / Enfant myope : que faire pour ralentir l'évolution ?

Myopia boom: how to slow the progress? Myopia is an optical defect linked to an excessive elongation of the eyeball resulting in a blurred vision from afar. The last few years have seen an emergence of this phenomenon, which although partly genetic, mainly presents environmental risk factors such as low exposure to sunlight or prolonged near reading. Current generations are more myopic than prior generations and are so at a younger age. Detected early, myopia control management can help slow its progression in children and ensure a better quality of life. Why is myopia soaring? How to slow its progression in our children? Several optical methods are now possible and it is essential to properly inform parents about these too little known possibilities.

Enfant myope : que faire pour ralentir l'évolution ? La myopie est un défaut optique lié à une élongation trop importante du globe oculaire entraînant une vision floue de loin. Les dernières années ont connu une émergence dans la compréhension de l'apparition de ce phénomène qui, bien qu'en partie génétique, a majoritairement des facteurs de risque environnementaux tels qu'une faible exposition à la lumière extérieure ou la lecture de près prolongée. Les générations actuelles sont plus myopes que les générations précédentes et le sont à un âge plus jeune. Des solutions de contrôle de la myopie, si elle est détectée précocement, peuvent aider à ralentir sa progression chez les enfants et assurer une meilleure qualité de vie. Pourquoi la myopie flambe-t-elle ? Que faire pour ralentir l'évolution de la myopie chez nos enfants ? Différentes méthodes optiques sont désormais possibles, et il est essentiel de bien informer les parents sur ces possibilités encore peu connues.

Effects of Resistance Exercise with or without Whey Protein Supplementation on Ocular Changes after a 21-Day Head-Down Bed Rest.

Neuro-ophthalmological changes have been reported after prolonged exposure to microgravity; however, the pathophysiology remains unclear. The objectives of the present study were twofold: (1) to assess the neuro-ophthalmological impact of 21 days of head-down bed rest (HDBR) and (2) to determine the effects of resistance vibration exercise (RVE) alone or combined with nutritional supplementation (NeX). In this case, 12 healthy male subjects completed three interventions of a 21-day HDBR: a control condition without countermeasure (CON), a condition with resistance vibration exercise (RVE) comprising of squats, single leg heel and bilateral heel raises and a condition using also RVE associated with nutritional supplementation (NeX). Intraocular pressure (IOP) was assessed by applanation tonometry. Retinal nerve fiber layer thickness (RNFLT) was assessed with spectral-domain optical coherence tomography, before HDBR and between Day 2 and Day 4 after each session of HDBR. In CON condition, IOP was preserved; while in RVE and NeX conditions, IOP was increased. In CON condition, RNFLT was preserved after HDBR. RVE and NeX conditions did not have significant effects on RNFLT. This study showed that a 3-week HDBR did not induce significant ophthalmological changes. However, RVE induced an elevation in IOP after HDBR. Nutritional supplementation did not reduce or exacerbate the side effects of RVE.