Trends in prescriptions for glaucoma and ocular hypertension in France between 2014 and 2019.

PURPOSE: To explore the national trend in prescriptions for glaucoma and ocular hypertension (OHT) in France between 2014 and 2019. METHODS: This is a retrospective descriptive study based on prescription data from the Primary Health Insurance Fund databases. All patients with a social security number who received one or more glaucoma/OHT prescriptions between 2014 and 2019 were identified. Figures for 2020 are not yet available as of the date of submission of this article. Demographic characteristics from Common Classification of Medical Acts information and from National Institute of Statistics and Economic Studies were analyzed. The data analysis was carried out using the R version 3.6.2.software from the available databases of the Information Systems Medicalization Program. RESULTS: Our results suggest an increase in the number of patients treated with glaucoma drugs, which cannot be explained simply by demographic growth. There is also a change in drug prescription habits, both in the class of medication used and in the use of fixed combinations. We also note the increasing use of SLT (Selective Laser Trabeculoplasty), a relatively newer tool in the therapeutic arsenal. Over the same time period, demographic characteristics remained stable; age and sex distribution for each year remained constant. In addition, the phenomenon of poor therapeutic compliance, which we attempted to explore, remained stable. DISCUSSION: This study updates the French epidemiologic data available on prescriptions for glaucoma and ocular hypertension, a true public health concern. CONCLUSION: On the one hand, prescribing practices have evolved over the study period. On the other hand, the number of patients treated has increased faster than the growth of the French population over the same period. These findings are consistent with trends observed in previous studies.

Glaucoma progression analysis by Spectral-Domain Optical Coherence Tomography (SD-OCT).

Spectral domain optical coherence tomography (SD-OCT) provides an objective quantification of the lesions of various target tissue structures in glaucoma, with unprecedented resolution, which has now demonstrated its interest in controlling the progression of glaucomatous neuropathy, from early stages to late stages. A certain number of well-established proofs state that a progressive modification in OCT is a common predictor of functional loss, and that patients with rapid OCT changes have an increased risk of developing glaucomatous scotoma. Follow-up of the progression goes through three stages. It consists first of all in detecting the evolution of damage to the retinal nerve fiber layer (RNFL), then that of the macular ganglion cell complex (GCC), in order to better define this progression of the damage to the target structures and, thirdly, to complete its analysis by integrating it with the analysis of the functional impairment. We note today that there is a greater risk of developing a future functional deficit of the visual field in subjects with a RNFL loss slope greater than -1/year, for all clinical stages of glaucoma. The characteristics of GCC progression are much better specified. Often earlier than that of the progress of the thinning of the RNFL and much faster in the subjects considered as "progressors", its cartography is better defined, with a particular interest for the follow-up of diversion maps and "wide field" acquisitions offering better visibility of deficits and their progression. To date, a certain number of suspicious indicators of short-term progress can be retained, highlighting the essential precaution of having two or more basic measures and a confirmation of the change on at least one new OCT acquisition. Finally, if the interpretation of the progression must always be based on clinical examination data, and the macula in particular, it remains crucial to confront the progression of the RNFL with that of the GCC and with that of the visual field.

[Reliability and reproducibility of introcular pressure (IOP) measurement with the Icare® Home rebound tonometer (model TA022) and comparison with Goldmann applanation tonometer in glaucoma patients]. / Fiabilité et reproductibilité des mesures de la pression intraoculaire par le tonomètre Icare® Home (modèle TA022) et comparaison avec les mesures au tonomètre à aplanation de Goldmann chez des patients glaucomateux.

PURPOSE: The Icare® Home tonometer is a new rebound tonometer, developed for intraocular pressure (IOP) self-monitoring. The main objective of our study was to evaluate the reliability and reproducibility of measurements taken with the Icare® Home tonometer in glaucoma patients compared to the Goldmann applanation tonometer. A secondary objective was to investigate factors that could influence the reproducibility of these measurements. MATERIALS AND METHODS: Fifty-two glaucoma patients were included in this prospective, non-randomized, monocentric study. IOP measurements were performed on the right eye and then on the left eye in the following order (3 measurements of IOP for each method): air tonometer (T-Air), Icare® Home tonometer by the patient (RT-P), Icare® Home tonometer by an ophthalmologist (RT-O), Goldmann applanation tonometer (GAT). RESULTS: Forty-four patients (85%) managed to take their IOP on both eyes with the Icare® Home tonometer. Mean IOPs were 14.35±3.93mmHg (T-Air), 13.43±4.65mmHg (RT-P), 14.13±4.29mmHg (RT-O), 14.74±3.84mmHg (GAT). The intraclass correlation indices (ICC) on the 3 repeated IOP measurements were 0.924, 0.872, 0.947 and 0.957, respectively. Bland-Altman analysis found a mean difference (bias) between GAT and RT-P, between GAT and RT-O, and between RT-O and RT-P, respectively, of 1.31, 0.61 and 0.70mmHg, with a 95% confidence interval of -3.34 to 5.96, -3.91 to 5.14 and -3.44 to 4.84mmHg, respectively. The reproducibility of the measurements taken with the Icare® Home tonometer did not vary according to corneal thickness or age of the patients. CONCLUSION: The Icare® Home tonometer provides reliable and reproducible IOP values in glaucoma patients, although it appears to slightly underestimate the IOP measurements compared to the Goldmann applanation tonometer.

[Selective laser trabeculoplasty: Effect of number of preoperative topical glaucoma medications on pressure lowering and success rate]. / Trabéculoplastie sélective au laser : effet du nombre de traitements antiglaucomateux topiques préopératoires sur la baisse pressionnelle et le taux de succès.

PURPOSE: To evaluate the lowering of intraocular pressure (IOP) one year after SLT and to assess if differences are related to number of pre-SLT topical treatments in ocular hypertension (OHT) and primary open angle glaucoma (POAG) patients. METHODS: Retrospective review of 106 eyes of 13 OHT and 93 POAG patients treated by SLT for insufficient IOP control, allergy, discomfort or non-compliance to glaucoma medications, excluding patients with less than 1 year of follow-up after SLT. IOP was measured by applanation before and at 1, 6 and 12 months after SLT. RESULTS: Hundred and six eyes untreated (n=13), or treated with one (n=25), two (n=40) or three or more (n=28) glaucoma medications were included. Mean IOP decreased from 19.4±3.6mmHg preoperatively to 15.7±3.1mmHg at 12 months, which corresponds to an average decrease of 18.8%. At 1 year, 62.2% (n=66) were responders (IOP reduction≥3mmHg): 92.3% without medications (n=12), 68% with one (n=17), 57.5% with two (n=23) and 50% with three or more medications (n=14). Their average IOP decreased from 20.7±3.4 to 15.2±2.9mmHg (26.6%), respectively from 20.8±2.6 to 15.8±3.2 (25%) without medications, 20.6±3.2 to 14.9±3.7 (27.3%) with one, 20.8±4.1 to 15.5±3.3 (25.1%) with two and 20.7±3.2 to 14.4±2.4mmHg (29.7%) with three medications. CONCLUSIONS: The number of responders seems to be greater in OHT and POAG patients without or with few glaucoma medications, but the IOP reduction seems to be similar regardless of the number of glaucoma medications.

Differences during the first lactation between cows cloned by somatic cell nuclear transfer and noncloned cows.

Lactation performance is dependent on both the genetic characteristics and the environmental conditions surrounding lactating cows. However, individual variations can still be observed within a given breed under similar environmental conditions. The role of the environment between birth and lactation could be better appreciated in cloned cows, which are presumed to be genetically identical, but differences in lactation performance between cloned and noncloned cows first need to be clearly evaluated. Conflicting results have been described in the literature, so our aim was to clarify this situation. Nine cloned Prim' Holstein cows were produced by the transfer of nuclei from a single fibroblast cell line after cell fusion with enucleated oocytes. The cloned cows and 9 noncloned counterparts were raised under similar conditions. Milk production and composition were recorded monthly from calving until 200d in milk. At 67d in milk, biopsies were sampled from the rear quarter of the udder, their mammary epithelial cell content was evaluated, and mammary cell renewal, RNA, and DNA were then analyzed in relevant samples. The results showed that milk production did not differ significantly between cloned and noncloned cows, but milk protein and fat contents were less variable in cloned cows. Furthermore, milk fat yield and contents were lower in cloned cows during early lactation. At around 67 DIM, milk fat and protein yields, as well as milk fat, protein, and lactose contents, were also lower in cloned cows. These lower yields could be linked to the higher apoptotic rate observed in cloned cows. Apoptosis is triggered by insulin-like factor growth binding protein 5 (IGFBP5) and plasminogen activator inhibitor (PAI), which both interact with CSN1S2. During our experiments, CSN1S2 transcript levels were lower in the mammary gland of cloned cows. The mammary cell apoptotic rate observed in cloned cows may have been related to the higher levels of DNA (cytosine-5-)-methyltransferase 1 (DNMT1) transcripts, coding for products that maintain the epigenetic status of cells. We conclude, therefore, that milk production in cloned cows differs slightly from that of noncloned cows. These differences may be due, in part, to a higher incidence of subclinical mastitis. They were associated with differences in cell apoptosis and linked to variations in DNMT1 mRNA. However, milk protein and fat contents were more similar among cloned cows than among noncloned cows.

[Disc-fovea angle adjustment for peripallary retinal nerve fiber layer analysis by a spectral domain optical coherence tomography. Preliminary study]. / Analyse des fibres nerveuses rétiniennes péripapillaires ajustée selon l'angle papillo-maculaire en tomographie par cohérence optique en domaine spectral. Étude préliminaire.

INTRODUCTION: Circumpapillary retinal nerve fiber layer (cpRNFL) analysis by spectral domain optical coherence tomography (SD-OCT) has become essential for the assessment of glaucoma patients. The foveal projection is conventionally below the disc plane, creating an angle with the horizontal meridian, the disc-fovea angle. The purpose of this study is to evaluate the role of adjustment of cpRNFL analysis based on this angle. MATERIALS AND METHODS: This study concerns 40 control eyes and 55 eyes affected with and followed for primary open angle glaucoma (POAG). After precise localization of the optic disc center and the axis connecting it to the center of the fovea, a circular peripapillary scan is performed with Spectralis OCT (Heidelberg Engineering, Germany). The mean thickness in each of six papillary sectors and the global mean thickness of the cpRNFL were evaluated. The ROC (receiver operating characteristic) analysis evaluated the diagnostic capabilities of the various sectors before and after adjustment of the analysis for the disc-fovea angle. RESULTS: The disc-fovea angle was not different between the two groups (-7.0 ± 1.2° for controls vs. -6.6 ± 1.2° for POAG, P=0.70). There is a significant variance of this angle in both groups (the angle varies in the control group between -22.5° to +1.8° and in the POAG group between -18° to +2.4°). The global mean and inferior temporal (IT) thickness of the cpRNFL show the best diagnostic performance. Adjustment for disc-fovea angle does not increase the diagnostic accuracy of the various sectors analyzed. Although there is an increase in the area under the curve for the IT sector after adjustment, it is not statistically significant (0.910 ± 0.056 vs. 0.936 ± 0.045, P=0.06). CONCLUSIONS: There is a significant variation in disc-fovea angle. In this study, accounting for it does not significantly improve the diagnostic capabilities of cpRNFL in patients with POAG.

[Post-traumatic endophthalmitis]. / Les endophtalmies post-traumatiques.

Post-traumatic endophthalmitis is a rare but serious complication of open globe injury, representing a major turning point for the patient's visual prognosis. Risk factors for this complication are lens capsule rupture, an intraocular foreign body, type of eye trauma and especially a delay in initial management of the trauma. Although Staphylococcus epidermidis is the most common organism, as in postoperative acute endophthalmitis, other microorganisms are more frequently represented and the multi-microbial involvement is common. The diagnosis can be difficult in the presence of inflammatory signs of trauma. Aside from rapid globe repair, neither preventive nor curative treatment have been well delineated. The class of antibiotics, the dosage, route of administration, as well as surgical treatment by vitrectomy remain topics of discussion.

[Evaluation of the new Canon HS-100 SD-OCT: Reproducibility of macular ganglion cell complex (GCC) thickness measurement in normal, hypertensive and glaucomatous eyes]. / Évaluation du nouvel OCT SD Canon HS-100: reproductibilité de la mesure de l'épaisseur du complexe cellulaire ganglionnaire maculaire pour des yeux normaux, hypertones et glaucomateux.

PURPOSE: To evaluate intra- and interobserver reproducibility of macular GCC thickness measurement by automated segmentation on the Canon HS-100 SD-OCT (Tokyo, Japan) in normal (N), hypertensive (OHT) and glaucomatous eyes. METHODS: A total of 179 eyes of 93 patients were included: 90 N, 28 OHT and 36 early glaucoma and 25 advanced glaucoma. All patients underwent a complete ophthalmologic exam, central corneal thickness and 24-2 standard automated perimetry (HFA SITA standard). Each of two observers performed three macular acquisitions with the Canon OCT HS-100. Acquisitions were analyzed with the Glaucoma 3D mode, which estimated the macular GCC thickness in global, superior and inferior hemisectors, and in eight separate macular areas. Reproducibility was assessed by intraclass correlation coefficient (ICC), coefficient of variation (CV) and test-retest variability (TRTV) calculated as 1.96 times the standard deviation. RESULTS: Mean GCC thickness was respectively 92.4 µm, 89.0 µm, 80.7 µm and 71.2 µm in N, OHT, early and advanced glaucomatous eyes. In all groups, intra- and interobserver reproducibility ranged respectively for ICC from 89.8 to 99.8% and from 90.2 to 99.4%, for CV from 0.43 to 1.95% and from 0.58 to 2.16% and for TRTV from 0.8 to 3.22 µm and from 1.04 to 3.53 µm. GCC thickness measurements using the new HS-100 SD-OCT were highly reproducible. However, in the advanced glaucoma group, while the reproducibility of GCC thickness measurement is good in the average, superior and inferior hemisectors of the macula, it was slightly less for the paracentral sectors, especially inferior. These sectors correspond generally to the areas most affected by glaucoma. CONCLUSION: The reproducibility of GCC thickness measurements using the new Canon HS-100 SD-OCT is high for normal, OHT, and glaucomatous eyes. It is thus a reliable and reproducible ancillary test available to the clinician for the examination of glaucomatous optic neuropathies.

[New neuroretinal rim analysis with spectral domain optical coherence tomography, Spectralis (Heidelberg Engineering, Germany). Preliminary study]. / Une nouvelle analyse de l'anneau neuro-rétinien en tomographie par cohérence optique en domaine spectral, Spectralis (Heidelberg Engineering, Germany). Étude préliminaire.

INTRODUCTION: Clinical determination of the outer limits of the optic disk (OD) doesn't always correspond to the true anatomic limits of the optic nerve head (ONH) defined by the Bruch's membrane opening (BMO). A new index analyzing the OD with optical coherence tomography (OCT), "minimal rim width" (BMO-MRW), evaluates the smallest thickness of the neuroretinal rim between the BMO and the internal limiting membrane. The purpose of this study was to evaluate new software for automatic measurement of the BMO-MRW. MATERIALS AND METHODS: This study investigated 95 eyes: 40 control eyes and 55 eyes followed and treated for primary open angle glaucoma (42 early glaucoma, 7 moderate glaucoma and 6 advanced glaucoma). After a precise localization of the OD center, 24 radial scans of the ONH are taken with the Spectralis OCT (Heidelberg Engineering, Germany). From the 48 measurements of BMO-MRW, the mean thickness as well as that in each of the 6 papillary sectors of this new index are calculated. ROC curves analysis (receiver operating characteristic) was used to assess the diagnostic capabilities of the various parameters. RESULTS: Thicknesses of all parameters were statistically lower in glaucoma than in controls. The mean value and inferotemporal sector (IT) had the best diagnostic capabilities without significant difference between them (BMO-MRW-average = 0.890 ± 0.062, BMO-MRW-IT = 0.881 ± 0.066, P = 0.59). The area under the curve was lowest in the temporal sector (0.820 ± 086 statistically lower than the average value, P = 0.04). CONCLUSIONS: This preliminary study of a new automated analysis of the neuroretinal rim highlights the diagnostic value of the BMO-MRW index. This evaluation appears to be best correlated with the anatomy of the ONH with good diagnostic sensitivity.

[Glaucoma medications, preservatives and the ocular surface.] / Traitement du glaucome, conservateurs et surface oculaire.

Several clinical and experimental studies have demonstrated that ocular surface disease is common in glaucoma patients receiving chronic glaucoma drops, and that the preservatives in these drops play a major role in the occurrence of ocular surface disease. These ocular surface changes may induce both symptoms reported by the patients and anterior segment clinical signs, and should be systematically assessed by history and exam in all glaucoma patients. In these patients with ocular surface disease, reducing the amount of preservatives administered to the eye should be strived for, rather than adding additional eye drops to alleviate or mask the side effects of the glaucoma drops.

Spatial and temporal changes of decorin, type I collagen and fibronectin expression in normal and clone bovine placenta.

INTRODUCTION: Alteration of expression of various genes including extracellular matrix components, have been suggested to play major role in the placental pathologies after somatic cloning in mammals. The objectives of the present study were to analyze pattern of expression (mRNA and protein) of the small leucine-rich proteoglycan, Decorin in association with Type I Collagen and Fibronectin in bovine placental tissues from normal and clone pregnancies. METHODS: Genotyping and allelic expression of Decorin were determined by Sanger sequencing. The expression patterns of Decorin, Type I collagen and Fibronectin 1 were analyzed by quantitative RT-qPCR and combined in situ hybydization (ISH) and immunohistochemistry (IHC) in endometrial and placental tissues from D18 to term from artificially inseminated and somatic cloning pregnancies. RESULTS: The expression levels of DCN increased in the AI endometrial stroma and chorionic mesenchyme during implantation and declined during placentome growth until term. Combined ISH and IHC revealed an unexpected discrepancy mRNA and protein tissue distribution. Moreover, Decorin was maintained in the placentome tissues from SCNT pregnancies while both mRNA and protein were absent in AI derived placenta. DISCUSSION: In bovine, the pattern of expression of Decorin exhibits significant changes during placental formation. Downregulation of Decorin is associated with proliferation, remodeling and vascularization of placental tissues. These observations reinforces the putative role of Decorin in these processes. CONCLUSIONS: These observations suggest that Decorin is involved in placental growth and that dysregulation of its expression is associated with placental abnormalities in SCNT derived pregnancy.

[Acute blindness secondary to quinine toxicity: role of hyperbaric oxygen treatment]. / Amaurose bilatérale aiguë par surdosage accidentel en quinine: intérêt de l'oxygénothérapie hyperbare.

We report a rare case of quinine toxicity causing acute bilateral blindness, followed by documented partial recovery within 24 hours. The patient was treated with hyperbaric oxygenotherapy and intravenous nitrates. Visual defects persist after 6 months.

Interface effects and the evolution of ferromagnetism in La2/3Sr1/3MnO3 ultrathin films.

Pulse laser deposited La2/3Sr1/3MnO3 ultrathin films on SrTiO3 substrates were characterized by polar and longitudinal Kerr magneto-optical spectroscopy. Experimental data were confronted with theoretical simulations based on the transfer matrix formalism. An excellent agreement was achieved for a 10.7 nm thick film, while a distinction in the Kerr effect amplitudes was obtained for a 5 nm thick film. This demonstrated the suppression of ferromagnetism due to the layer/substrate interface effects. A revised, depth-sensitive theoretical model with monolayer resolution described the experimental data well, and provided clear cross-section information about the evolution of ferromagnetism inside the film. It was found that the full restoration of the double-exchange mechanism, responsible for the ferromagnetic ordering in La2/3Sr1/3MnO3, occurs within the first nine monolayers of the film. Moreover, all the studied films exhibited magneto-optical properties similar to bulk crystals and thick films. This confirmed a fully developed perovskite structure down to 5 nm.

[Diagnostic use of macular layer analysis by SD-OCT in primary open angle glaucoma]. / Capacités diagnostiques de l'analyse des différentes couches maculaires par SD-OCT dans le glaucome primitif à angle ouvert.

PURPOSE: The purpose of this study is to evaluate the diagnostic ability of segmentation of the various internal macular layers by spectral domain optical coherence tomography (Cirrus HD-OCT, Carl Zeiss Meditec (CZM), Dublin, CA, USA) and to compare it to that of the peripapillary retinal nerve fiber layer (cpRNFL) in primary open angle glaucoma (POAG). MATERIALS AND METHODS: This study included 252 eyes diagnosed with primary open angle glaucoma (POAG) (164 early POAG, 44 moderate POAG and 44 advanced POAG) and 223 eyes of control subjects. All patients underwent visual field testing (Humphrey Field Analyser, SITA-Standard 24-2, CZM), and SD-OCT imaging (Cirrus HD-OCT) of the macular and optic nerve head regions (ganglion cell analysis (GCA), macular cube 200×200; optic disc cube 200×200). OCT macular scans were segmented into macular nerve fiber layer (mNFL), ganglion cell layer with inner plexiform layer (GCIPL), outer retinal layers, and ganglion cell complex (GCC) (mNFL+GCIPL). Glaucoma discriminating ability was assessed using the area under the receiver operator characteristic curve (AUC) for all macular parameters and mean circumpapillary retinal nerve fibre layer (cpRNFL). RESULTS: For the entire POAG population of this study, the minimum GCIPL index provided greater diagnostic ability than the other parameters studied, with a statistically significant difference in their AUC (minimum GCIPL [0.887], mean GCIPL [0.865], GCC [0.863], cpRNFL [0.823], mean mNFL [0.786] and minimum mNFL [0.742]). The results were similar in the early POAG group but without any statistically significant difference with the cpRNFL parameter. In the moderate POAG group, the diagnostic ability was similar for all indices, whereas in the advanced POAG group, minimum GCIPL and GCC gave the largest AUC indices. DISCUSSION AND CONCLUSION: The minimum macular GCIPL is a new index obtained with the GCA algorithm of the Cirrus HD-OCT. It appears to have an excellent ability to detect glaucoma at every stage and demonstrates performance comparable to that of the cpRNFL parameter, in combination with which it may provide important complementary information for clinical practice.

[Analysis of macular ganglion cell complex (GCC) with spectral-domain optical coherence tomography (SD-OCT) in glaucoma]. / Analyse du complexe cellulaire ganglionnaire maculaire (GCC) en tomographie par cohérence optique (SD-OCT) dans le glaucome.

Early detection of ganglion cell loss is possible with new algorithms for the assessment of the Macular Ganglion Cell Complex (GCC) by SD-OCT. The various data acquisition protocols used by the various versions of software, as well as their accuracy and reproducibility, must be taken into account. Current results show similar ability to detect glaucoma as compared to Retinal Nerve Fiber Layer thickness (RNFL), with some limitations, possible artifacts, and interpretation pitfalls which must be taken into account. The role of the significance map and of various indices (Focal Loss Volume, Global Loss Volume, GCIPL minimum...); data obtained in the setting of various clinical entities (tilted disc, peripapillary atrophy, large and small optic discs, high myopia...); and detection of progression, especially in advanced glaucoma, underline the role of macular GCC analysis as a complementary method to peripapillary RNFL thickness. The diagnostic precision and better reproducibility of these new software protocols offer new perspectives in the detection and management of progression in various stages of the management of glaucomatous optic neuropathy.

A euglycaemic/non-diabetic perinatal environment does not alleviate early beta cell maldevelopment and type 2 diabetes risk in the GK/Par rat model.

AIMS/HYPOTHESIS: We used the GK/Par rat, a spontaneous model of type 2 diabetes with early defective beta cell neogenesis, to determine whether the development of GK/Par offspring in a non-diabetic intrauterine/postnatal environment would prevent the alteration of fetal beta cell mass (BCM) and ultimately decrease the risk of diabetes later in adult life. METHODS: We used an embryo-transfer approach, with fertilised GK/Par ovocytes (oGK) being transferred into pregnant Wistar (W) or GK/Par females (pW and pGK). Offspring were phenotyped at fetal age E18.5 and at 10 weeks of age, for BCM, expression of genes of pancreatic progenitor cell regulators (Igf2, Igf1r, Sox9, Pdx1 and Ngn3), glucose tolerance and insulin secretion. RESULTS: (1) Alterations in neogenesis markers/regulators and BCM were as severe in the oGK/pW E18.5 fetuses as in the oGK/pGK group. (2) Adult offspring from oGK transfers into GK (oGK/pGK/sGK) had the expected diabetic phenotype compared with unmanipulated GK rats. (3) Adult offspring from oGK reared in pW mothers and milked by GK foster mothers had reduced BCM, basal hyperglycaemia, glucose intolerance and low insulin, to an extent similar to that of oGK/pGK/sGK offspring. (4) In adult offspring from oGK transferred into pW mothers and milked by their W mothers (oGK/pW/sW), the phenotype was similar to that in oGK/pGK/sGK or oGK/pW/sGK offspring. CONCLUSIONS/INTERPRETATION: These data support the conclusion that early BCM alteration and subsequent diabetes risk in the GK/Par model are not removed despite normalisation of the prenatal and postnatal environments, either isolated or combined.

[A rare trauma-associated cause of central retinal vein occlusion in a young subject]. / Une cause rare d'occlusion de la veine centrale de la rétine chez le sujet jeune dans un contexte traumatique.

INTRODUCTION: Retinal vein occlusions are the second leading cause of retinal vascular disease, after diabetic retinopathy. In the case of young subjects, a thorough etiological investigation must be conducted in order to diagnose rare etiologies, such as this heterozygous mutation of the factor II gene associated with a central retinal vein occlusion (CRVO), occurring in a young subject within the context of trauma. OBSERVATION: The case deals with a 35-year-old soldier on a mission in a conflict zone. He was the victim of blast injury as a result of the explosion of an improvised explosive device (IED) or homemade bomb, and presented a sudden decline in visual acuity in his left eye associated with the clinical picture of a CRVO. Analysis showed a heterozygous factor II G20210A gene mutation. CONCLUSION: Retinal vein occlusions are always serious visual events. In the case of young subjects, a thorough etiological investigation must be conducted in search of rare abnormalities likely to lead to retinal vein occlusion.