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Objective: To determine the prevalence of vernal keratoconjuntivitis (VKC) in Europe. Methods: A cross-sectional survey was mailed to 3003 ophthalmologists from six countries (Finland, France, Italy, The Netherlands, Norway and Sweden) representing 151.9 million inhabitants. Results were analysed per country, and VKC prevalence for the 15 European member states in 2002 was extrapolated. Six hypotheses were used: disease duration (4 or 8 years) combined with three prevalence hypotheses for non-responding ophthalmologists. Results: The response rate to the survey was 29.5%. The estimates of VKC prevalence in Western Europe (per 10 000 inhabitants) ranged from 1.16 to 10.55. The prevalence of VKC with corneal complications ranged from 0.30 to 2.26. The VKC prevalences per country were in the following ranges: Italy 2.4-27.8, Finland, 0.7-8.4, Sweden 1.2-8.7, The Netherlands 0.6-4.6, France 0.7- 3.3 and Norway 0.3-1.9. VKC with corneal complications were: Italy 0.4-4.8, Sweden 0.3-2.4, Finland 0.2-2.8, The Netherlands 0.2-1.6, France 0.3-1.4 and Norway 0.1-1.0. Conclusions: Based on the most likely hypotheses concerning disease duration and non-responding ophthalmologists' VKC case rate, the best estimate of VKC prevalence in Western Europe is 3.2/10 000 inhabitants. The prevalence of VKC with corneal complications is 0.8/10 000 inhabitants. [ABSTRACT FROM AUTHOR]

Aims: This comparative and randomised pilot study assessed the clinical and biological efficacy of Noaxia Sine® eye-drops versus levoccibastine eye-drops in the treatment of vernal keratoconlunctivitis (VKC). Methods: Twenty-three VKC patients were randomised and treated bilaterally for 28 days with N-acetyl-asparlyl-glutamate (NAAGA) or levocabastine (LEVO) eye-drops. The primary efficacy variable, overall evolution of eosinophil cationic protein (ECP) tear concentrations, was assessed in a masked fashion on D0, D7 and D28. Clinical symptoms and signs were reported at the same time points. Biological parameters were analysed with a non-parametric rank-based approach. Global tolerance was assessed by the investigator and patient. Results: At all time points, ECP tear levels were significantly reduced in the NAAGA compared with the LEVO group (p=0.023). Reduction of eosinophil leucocytes and tear lymphocytes was higher not significant in the NAAGA group. The same trend was observed for the evolution of total ocular symptom score. There were no significant differences between treatment groups in the occurrence of adverse effects, except for burning which was more frequent in the LEVO group (p=0.002). Conclusion: The anti-eosinophiiic actions of NAAGA were shown by a significant reduction of ECP tear concentrations. A decreased lymphocyte count and an overall improvement of the symptomatology were also noted. Moreover, the tolerability of NAAGA appeared to be better. [ABSTRACT FROM AUTHOR]

Our study aimed to define the organization of the orbital adipose tissue, which is constituted from white adipose tissue. Six orbital samples were taken by dissection from fresh cadavers. After fixation and paraffin-embedding, the blocks were sectioned in the three spatial planes (two in the frontal, two in the sagittal, two in the horizontal). Semi-serial sections of 7 μm were then stained with hematein, eosin, safran or Masson trichrome green. We noticed strong areas of adhesion with orbital bones located at the lacrimal gland, the orbital trochlea and the inferior orbital fissure. Our mesoscopic and histological results allowed the description of two types of orbital adipose tissue corresponding to morpho-functional topographic variations. One was constituted of thick conjunctival septa with small adipocytes near muscles and the lacrimal gland. This was a supporting tissue that gave the points of rotation. The other was constituted of thin conjunctival septa with larger adipocytes near the optic nerve, allowing its movements in the orbit. These morphological differences appeared to be correlated with the mechanical role of these two areas. The dense appearance could correspond to the functional trochlea of rectus muscles described. In contrast we did not observe the systematic radial and concentric conjunctival meshwork classically described. This study underlines the specificity of orbital adipose tissue, which could be useful for a better understanding of its normal and pathological partition and its involvement in ocular motility. [ABSTRACT FROM AUTHOR]

Albinism is a worldwide genetic disorder caused by mutations in at least 20 genes, identified to date, that affect melanin production or transport in the skin, hair and eyes. Patients present with variable degrees of diffuse muco‐cutaneous and adnexal hypopigmentation, as well as ocular features including nystagmus, misrouting of optic nerves and foveal hypoplasia. Less often, albinism is associated with blood, immunological, pulmonary, digestive and/or neurological anomalies. Clinical and molecular characterizations are essential in preventing potential complications. Disease‐causing mutations remain unknown for about 25% of patients with albinism. These guidelines have been developed for the diagnosis and management of syndromic and non‐syndromic forms of albinism, based on a systematic review of the scientific literature. These guidelines comprise clinical and molecular characterization, diagnosis, therapeutic approach and management. [ABSTRACT FROM AUTHOR]

Purpose To study efficacy and tolerance of ophthalmic insert Mydriasert® versus standard treatment phenylephrine and tropicamide eye drops for fundus examination in neonates. Methods Prospective, randomised, single-blinded non-inferiority study of 80 premature and full-term babies and infants treated for fundus examination. Mydriasis was obtained with two groups randomly assigned. The eye drop group received three instillations of 2.5% phenylephrine and 0.5% tropicamide and the insert group received Mydriasert® containing phenylephrine and tropicamide. the mydriasis was evaluated 75 minutes after the introduction of the mydriatic agents. Results The mydriasis was successfully achieved in both eyes in 97.5% of infants in the insert group and 90% in the eye drop group at 75 minutes after dispensation. The efficacy of the insert was non-inferior compared to the eye drops. To reach effective mydriasis, the insert group required fewer nursing interventions for one patient comparing to the eye drop group. Good general and local tolerance was observed in the two groups. However two patients reported an adverse event as bradycardia and gastro-oesophageal reflux that could be related to neonate pathology. Conclusions Mydriasis obtained with the ophthalmic insert Mydriasert® was not inferior compared to standard eye drop treatment. Insert reduced the number of nursing interventions to obtain mydriasis for a fundus examination. [ABSTRACT FROM AUTHOR]

Purpose To study efficacy and tolerance of ophthalmic insert Mydriasert® versus standard treatment phenylephrine and tropicamide eye drops for fundus examination in neonates. Methods Prospective, randomised, single-blinded non-inferiority study of 80 premature and full-term babies and infants treated for fundus examination. Mydriasis was obtained with two groups randomly assigned. The eye drop group received three instillations of 2.5% phenylephrine and 0.5% tropicamide and the insert group received Mydriasert® containing phenylephrine and tropicamide. The mydriasis was evaluated 75 minutes after the introduction of the mydriatic agents. Results The mydriasis was successfully achieved in both eyes in 97.5% of infants in the insert group and 90% in the eye drop group at 75 minutes after dispensation. The efficacy of the insert was non-inferior compared to the eye drops. To reach effective mydriasis, the insert group required fewer nursing interventions for one patient comparing to the eye drop group. Good general and local tolerance was observed in the two groups. However two patients reported an adverse event as bradycardia and gastro-oesophageal reflux that could be related to neonate pathology. Conclusions Mydriasis obtained with the ophthalmic insert Mydriasert® was not inferior compared to standard eye drop treatment. Insert reduced the number of nursing interventions to obtain mydriasis for a fundus examination. [ABSTRACT FROM AUTHOR]

Purpose MGD in children is a common pathology. Many clinical forms need to be recognized, from mild to severe, with classical features of chalazia and blepharitis or more unusual the sight‐threatening ocular rosacea. Methods Ocular rosacea in children, secondary to severe MGD, is probably underdiagnosed meanwhile it induces major ocular discomfort. The treatment aims to eyelid hygiene, anti‐inflammatory treatment and topical steroid sparing. Results Place of heat therapy with innovative steamed goggles, topical azithromycin and topical cyclosporine with analyze of literature and clinical cases, is discussed. The French prospective clinical study performed was useful to evaluate the interest of each treatment. Conclusion Further studies with more patients are needed to a better understanding of the severe MGD. Ocular rosacea in children should be recognized early and to avoid steroid dependence and complications. Eyelid hygiene, topical anti‐inflammatory and topical cyclosporin are essential in MGD treatment for a better quality of life of the children and their parents. Commercial interest [ABSTRACT FROM AUTHOR]

Purpose to evaluate in a retrospective study ocular surface impairment and tear osmolarity in children presenting ongoing ocular allergy. Tears are necessary for continued health of ocular surface and tear osmolarity is considered a key point for tear film impairment and ocular surface damage. Methods Our retrospective study included 20 children (mean age 11 yo, range 6 to 17 yo) of two groups that presented at ocular consultation of our hospital. Group a, 10 children with ongoing ocular allergy, group b 10 control children who had been tested but finally did not present any sign of allergy or dry eye. All the children underwent a tear osmolarity measure prior to complete ocular consultation to be aware of influencing results by the examination. The tear osmolarity measure was obtained with the Tear Lab Osmolarity System (OcuSense). A complete ocular examination was also performed. So the type of ocular allergy was diagnosed. Results In group a, all the children presented clinical signs of on going ocular allergy with conjunctival redness, follicles and/or papillae. In two cases severe keratitis was present. In group b no ocular signs of conjunctiva anomalies were found. Mean tear osmolarity in group b, was 305mOsm/l and in group a, was 316mOsm/l. Tear osmolarity appeared higher in the ocular allergy group than in the non symptomatic children. Younger children had a higher measure of tear osmolarity. Conclusion In adults 305mOsm/l is a cut‐off value for dry eye. In our study this measure appears similar to adults but could be higher in youngest children. In children with ocular allergy, higher measure of tear osmolarity indicates an ocular surface damage that is underestimated. Tear osmolarity can be useful to manage ocular surface disease in children. [ABSTRACT FROM AUTHOR]

Purpose Resolution of papillae is a desirable objective in the management of tarsal VKC. The effect of Vekacia®, an unpreserved cyclosporine cationic emulsion, was evaluated in children with active VKC presenting with giant papillae and keratitis at enrollment. Methods 118 VKC patients were randomized to Vekacia® 0.05%, 0.1%, or vehicle QID. The primary criterion was subjective symptom improvement. Objective signs (giant papillae, conjunctival hyperemia, discharge, chemosis, limbal infiltrates and corneal epithelial disease) were assessed as secondary endpoint. Results At Day 28, patient subjective symptoms improved in all groups without statistically significant difference between groups. Among the objective signs, except for papillae, clinically significant improvements were observed: absence of the sign ranged from 20.5% to 72% in both active groups and from 16.7% to 41.2% for vehicle group, depending of the sign. For papillae, only 4 patients experienced total clearing (2.8%, 2.6% and 6.6% in vehicle, 0.05% and 0.1% CsA groups respectively). Clinically and statistically significant differences in keratitis (CFS mean change) over vehicle were observed at Day 28 in Vekacia® treated patients (0.05%, p=0.003; 0.1% p=0.014). Conclusion Corneal involvement in VKC is a sight‐threatening complication. Improvement in keratitis, a key element in the management of the active VKC was not associated with complete resolution of the papillae. Therefore, among the signs of the disease, papillae appear to be the least helpful sign to follow VKC improvement. Commercial interest [ABSTRACT FROM AUTHOR]

Purpose To evaluate a new quality of life questionnaire in children presenting a strabismus with abnormal retinal correspondence and amblyopia before and after reeducation. Methods Twenty children of a mean age of 4,2 yo (range 2‐7yo) were included with a strabismus with 3 type deviations. They presented amblyopia of at least 2 lines VA. They underwent a complete ocular and orthoptic examination with binocular quantification. At the consultation, parents and child completed a self‐administered questionnaire of quality of life. The questionnaire has three major items including a total of 10 criterions. Criterions were quoted by 4 colors corresponding to a score (from 0 to 30) reflecting the daily activity. Children were treated with optical correction, eye‐patching and orthoptic reeducation as needed. Six months after, examination and questionnaire was completed again to appreciate the progression of the children capacities. Results Of the twenty children, 16 presented an esotropia, 4 an exotropia and 10 an isolated or associated vertical hypertropia. The mean rate of the questionnaire at baseline was 18. The twenty patients who presented an amblyopia had an improvement of VA after treatment. After 6 months, rate of all questionnaires was improved with a mean score of 25. Conclusion Very few QOL questionnaires had been developed and even more in ophthalmology. This questionnaire appears simple to complete for parents and children, it can also be a basis to evaluate the progress of amblyopia reeducation. [ABSTRACT FROM AUTHOR]

Purpose To report and to classify the ocular motility disorders in congenital central hypoventilation syndrome. This rare syndrome, 1 of 200,000 livebirths, is characterized by a lack of ventilation due to defects of autonomic control especially of hypercapnia. Methods We examine in a study 34 children (range 9 days‐old to 15 yo) with congenital central hypoventilation syndrome. They underwent a complete ocular and orthoptic consultation. An informed consent was signed to perform a DNA analysis to precise PHOX‐2B gene mutations. Results Anisocoria, stabismus, eso and exotropia or phoria, ptosis, craniofacial palsy were found and we evaluated disorders considering intrinsic ocular motility and extrinsic ocular motility. We classified ocular anomalies in minor and major types with a score. The phenotype score was established in correlation with genotype. The score is higher in patients with genotype of equal or more 7 ALA mutations and a precise table correlation was established. Conclusion The high incidence of ocular motility disorders may result of neurologic defects of the oculomotor nerves and muscles involving neural crest development. A precise phenotype contributes to an evaluation of the severity of the disease and can also lead to a better reeducation of oculomotor anomalies. [ABSTRACT FROM AUTHOR]

This study aimed to determine the relationship between the presence of visual problems and academic success, in a population of students aged 15–22 years. This was a prospective, nonrandomized study involving clinical testing and structured interviews. At recruitment (September 2012 to April 2013), participants were asked to answer a questionnaire consisting of 28 questions aiming to identify symptoms commonly related to visual disorders. Each question was graded from 0 (no symptoms) to 2 (frequent). This questionnaire was followed by a visual screening including binocular function. If a problem was identified, participants were referred to an ophthalmologist for a comprehensive examination and an orthoptic work-up (September 2012 to June 2013). Participants returned in September 2013 for a follow-up. The findings were analyzed regarding academic grades and the scores obtained during national examinations in June 2014. Many participants in this study had visual disorders and the presence of these disorders was not associated with the expression of visual discomfort: 24.3% of participants expressed visual discomfort while 86.5% had visual disorders. More than half of the participants had hyperopia often associated with binocular vision problems, which they were not aware of because both their distance and near visual acuity were good. Although the results of this study cannot be extrapolated to all young people aged 15–22 years, the study confirms the link between visual problems and academic achievement while emphasizing the high prevalence of such problems in the population studied. [ABSTRACT FROM AUTHOR]

Introduction Nos recherches préalables ont permis d’établir chez le sujet sain des régularités posturales, liées à la qualité des mouvements oculaires de vergence : meilleure performance posturale avec yeux ouverts que fermés, en fixation proche que lointaine. Or, les troubles de vergence sont fréquents. L’étude présente menée à l’hôpital, examine la présence des régularités posturales chez des jeunes présentant des troubles des vergences, avant et après 12 séances de rééducation orthoptique. Matériel et méthode Les troubles de vergence de 9 sujets (6 à 27 ans) ont été évalués puis rééduqués par les orthoptistes libéraux. La posture a été mesurée en position orthostatique avant et après rééducation orthoptique avec l’accéléromètre triaxial Dynaport dans des conditions suivantes : yeux ouverts/yeux fermés, vision proche/vision lointaine. Résultats La rééducation orthoptique a renforcé significativement l’ampleur des vergences oculaires : de 3,7 à 5 dioptries prismatiques pour la divergence et de 19 à 30 dioptries prismatiques pour la convergence. Avant la rééducation, ces sujets ne présentaient aucune des régularités posturales connues. Après la rééducation, certaines régularités apparaissent : l’oscillation médiolatérale est significativement plus basse en yeux ouverts que yeux fermés ; l’oscillation antéro-postérieure est significativement plus basse en vision proche qu’en vision lointaine. Discussion–conclusion L’émergence des régularités posturales est sans doute médiatisée par le renforcement des signaux efférents et afférents des vergences, jouant un rôle pivot au contrôle postural. L’étude valide le concept de la présence des régularités comme indicateur clinique de normalité. Des études futures combinant l’enregistrement oculomoteur et postural ainsi que des méthodes issues du laboratoire renforçant la dynamique des vergences sont en cours. [ABSTRACT FROM AUTHOR]

Purpose To evaluate the anatomic and visual outcomes of one treatment with dexamethasone intravitreal implant (Ozurdex®) in eyes with macular edema secondary to branch or central vein occlusion (BRVO or CRVO) during the first six months. Methods The safety and efficacy of the dexamethasone intravitreal implant (Dex. implant) were evaluated retrospectively from January 2011 to May 2012 in a tertiary referral hospital. CRVO or BRVO diagnosis was confirmed with fluorescein angiography. At baseline, patients received a 0.7 mg dex. implant. They were evaluated at one, three and six months. Best corrected visual acuity (BCVA), optical coherence tomography (OCT) and intraocular pressure (IOP) were collected. Results We included twenty one eyes: 28.5% had a CRVO and 71.5% a BRVO. At baseline, the mean BCVA was 47 letters (ETDRS) (52 in the BRVO group, 22 in the CRVO group). All patients had a macular edema involving the fovea. The mean central retinal thickness (CRT) was 513 micrometer [255‐780]. At one month, 47.5% of eyes had more than three line gains and the mean CRT was 286 µm. Only two eyes had an IOP increase (>25 mmHg). However, at six months, only 17% of eyes had more than three line gains and the mean CRT was 380 µm. IOP remained uncontrolled with medication in one eye. Conclusion The dexamethasone intravitreal implant reduces macular edema and improves visual acuity in patients with either branch retinal vein occlusions or central retinal vein occlusions. However, this efficacy remains transient. A retreament with a dex. implant is necessary for most of the patients. [ABSTRACT FROM AUTHOR]

Purpose To evaluate tear break‐up time (BUT) with repeated higher order wavefront aberrations (HOA) measurements in children with Meibomian Gland Dysfunction(MGD). Methods Wavefront aberrations up to the sixth order for a 4‐mm pupil were measured in 10 normal children (Group 1) and 10 children with severe MGD (Group 2) with corneal involvement, using the IRX3 (Imagine Eyes, Orsay, France) Hartmann‐Shack (H‐S) aberrometer. The aberrometry was performed once every second for up to 20 seconds. HOA measurements were performed 3 times in a row. HOA variations were compared with the BUT by the conventional fluorescein method (CFM°. Results There was an excellent correlation between the HOA variation and the BUT recorded by the CFM in both groups. There was also an excellent reproducibility of the HOA measurements in all patients. BUT was significantly decreased (P<0.005) in all children in Group 2 compared to the normal tests subjects (Group 1). Conclusion HS aberrometry is a non ivasive method, that has been used for the last decade for the assessment of the quality of vision in patients undergoing refractive surgery and cataract or clear lensextration. Studying the HOA variation is a valuable method for evaluating both the quality visionand the BUT in children with MGD. [ABSTRACT FROM AUTHOR]

Purpose Interest of imaging of an unusual optic neuropathy case report and to perform a conservative treatment. Methods A 17 year‐old girl was referred for a 3 months progressive visual loss. No personal or family history was noticed. At ocular examination right VA was 3/10 P14 OR and 10/10 P2 OS. At fundus optic disc was discolored with optic neuropathy. At examination she showed a large unilateral visual field loss possibly mimicking ocular manifestation of multiple sclerosis. OCT was performed. MR Imaging revealed a high signal and a right optic nerve sheath meningioma, with unilateral optic disc mild atrophy. Stereotactic fractionated radiotherapy treatment was decided and applied twice at one month interval. After 3 years follow‐up tumor was non active with a visual improvement at 4/10 P5 OR. Results This clinical presentation of an optic neuropathy can mimic ocular defect in multiple sclerosis but the imaging allow the diagnosis of the meningioma. Saeed study underlines the interest of stereotactic treatment in optic nerve sheath meningioma. A conservative treatment is of interest and visual improvement of our case was obtained with stable tumor. Conclusion Unusual presentation of optic neuropathy systematically must benefit of an imaging with accurate definition. Primary radiotherapy for patients with optic nerve sheath meningioma is associated with long‐term improvement of visual acuity and few adverse effects. [ABSTRACT FROM AUTHOR]

CHARGE syndrome (OMIM #214800) is a multiple malformation syndrome with distinctive diagnostic criteria, usually because of CHD7 (chromodomain helicase DNA binding 7) haploinsufficiency. Familial occurrence of CHARGE syndrome is rare. We report six patients from two Caucasian families (both with one parent and two children) affected by mild to severe CHARGE syndrome. Direct sequencing of the CHD7 gene was performed in these two unrelated families. A mutation in exon 8 (c.2501C>T – p.S834F) in first chromodomain was found in family A and a nonsense mutation in exon 2 (c.469C>T – p.R157X) in family B. Both mutations are de novo in the parents. In family A, the elder son had bilateral cleft lip and palate, esophageal atresia with fistula, complex heart defect and vertebral abnormalities, while the younger had a posterior coloboma. Their mother had asymptomatic vestibular dysfunction and retinal coloboma, identified after the molecular diagnosis of her children. In family B, both affected children had severe expression of CHARGE syndrome. The father carrying the mutation only had asymmetric anomaly of the pinnae. These familial reports describe the intrafamilial variability of CHARGE syndrome, and underline the presence of CHD7 mutations in patients who do not fit the ‘classical clinical criteria’ for CHARGE syndrome. [ABSTRACT FROM AUTHOR]

Stevens-Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN) can lead to severe ophthalmologic sequelae. The main risk factor is the severity of the initial ocular involvement. There are no recommendations for ocular management during acute phase.We conducted a national audit of current practice in the 11 sites of the French reference center for toxic bullous dermatoses and a review of the literature to establish therapeutic consensus guidelines. We sent a questionnaire on ocular management practices in SJS/ TEN during acute phase to ophthalmologists and dermatologists. The survey focused on ophthalmologist opinion, pseudomembrane removal, topical ocular treatment (i.e. corticosteroids, antibiotics, antiseptics, artificial tear eye drops, vitamin A ointment application), amniotic membrane transplantation, symblepharon ring use, and systemic corticosteroid therapy for ophthalmologic indication. Nine of 11 centers responded. All requested prompt ophthalmologist consultation. The majority performed pseudomembrane removal, used artificial tears, and vitamin A ointment (8/9, 90%). Combined antibiotic-corticosteroid or corticosteroid eye drops were used in 6 centers (67%), antibiotics alone and antiseptics in 3 centers (33%). Symblepharon ring was used in 5 centers (55%) if necessary. Amniotic membrane transplantation was never performed systematically and only according to the clinical course. Systemic corticosteroid therapy was occasionally used (3/9, 33%) and discussed on a case-by-case basis.The literature about ocular management practice in SJS/ TEN during acute phase is relatively poor. The role of specific treatments such as local or systemic corticosteroid therapy is not consensual. The use of preservatives, often present in eye drops and deleterious to the ocular surface, is to be restricted. Early amniotic membrane transplantation seems to be promising. [ABSTRACT FROM AUTHOR]

A primigravida was referred to our centre for a fetal peri-orbital tumour diagnosed at third trimester scan. Antenatal magnetic resonance imaging (MRI) at 33 GW showed iso- to hyper-intense areas inside the lesion with no anomalies of T1 and T2 signal and no optic nerve involvement. A wide variety of lesions may develop around the orbit including benign or malign tumours, vascular and inflammatory lesions. [Extracted from the article]

Objectifs Les hématomes sous-duraux (HSD) sont fréquents dans la population pédiatrique et sont une cause de morbi-mortalité importante. L’objectif est de décrire la présentation clinique, les caractéristiques TDM et IRM, les examens complémentaires, la prise en charge thérapeutique, le devenir médical et socio-judiciaire chez les enfants souffrant d’HSD. Matériels et méthodes Dans le cadre de cette revue rétrospective, les 88 dossiers d’HSD survenus dans la population pédiatrique, entre 1998 et 2012, ont été étudiés. Résultats 72% des enfants avaient moins de 12 mois. Les motifs de consultation et les signes cliniques à l’entrée étaient multiples et non spécifiques. Il n’y avait pas de caractéristique radiologique significative permettant d’affirmer avec certitude l’étiologie de l’HSD. Dans 51% des cas il était également retrouvé des hémorragies rétiniennes. 49% des HSD étaient dus à un traumatisme crânien accidentel, 36% à un syndrome du bébé secoué et 15% à une pathologie identifiée ou non. 37,5% des dossiers ont fait l’objet d’un signalement. 46% souffraient à posteriori de séquelles cliniques de gravité variable. Conclusions Chaque acteur de santé a un rôle primordial face à un enfant consultant pour HSD et notamment afin de ne pas méconnaître une situation de maltraitance. [ABSTRACT FROM AUTHOR]

Purpose To quantify angle and anterior chamber changes after corneal transplantation using Visante OCT® Methods In this retrospective study, Visante OCT® examinations were performed in patients, awaiting keratoplasty, preoperatively(J‐1) and one month postoperatively(M+1). The anterior chamber depth(ACD), the angle‐opening distance at 500µm(AOD), the trabecular‐iris space area at 500µm(TISA) and the scleral spur angle(SPA) in the temporal and nasal quadrants were measured. Patients were classified based on their surgery: the surgery was penetrating keratoplasty(PK group), it was descemet's stripping automated endothelial keratoplasty(DSAEK group). Preoperative and postoperative measurements were compared using signed rank test of Wilcoxon. Results Twenty patients were evaluated: fifteen(75%) in the DSAEK group, five(25%) in the PK. Mean anterior chamber depth width increased from 3,31mm(SD 0,69) to 3,35mm(SD 0,341) after PK(p=1) , and from 3,32mm(SD 0,666) to 3,44mm(SD 0,591)after DSAEK(p=0,719). In the temporal quadrant, after DSAEK, mean anterior chamber angle width increased from 0,281mm(SD 0,126) to 0,334mm(SD 0,100)(p=0,03) in the TISA and after PK ,mean anterior chamber angle width decreased from 0,273mm(SD 0,054)to 0,248mm(SD 0,118) (p=0,812). In the nasal quadrant, after DSAEK, mean anterior chamber angle width increased from 0,253mm(SD 0,089) to 0,285mm(SD 0,085)(p=0,207) in the TISA and after PK, from 0,269mm(SD 0,114)to 0,321mm (SD 0,069) (p=0,437). Conclusion The angle change significantly in the temporal quadrant after corneal transplantation. Larger study need to be perform to confirm the angle changes. [ABSTRACT FROM AUTHOR]

Purpose To evaluate tear break‐up time (BUT) with repeated higher order wavefront aberrations (HOA) measurements in adult patients with Meibomian Gland Dysfunction(MGD). Methods Wavefront aberrations up to the sixth order for a 4‐mm pupil were measured in 10 normal subjects (Group 1) and 10 patients with severe MGD (Group 2) with corneal involvement, using the IRX3 (Imagine Eyes, Orsay, France) Hartmann‐Shack (H‐S) aberrometer. The aberrometry was performed once every second for up to 20 seconds. HOA measurements were performed 3 times in a row. HOA variations were compared with the BUT by the conventional fluorescein method(CFM). Results There was an excellent correlation between the HOA variation and the BUT recorded by the CFM in both groups. There was also an excellent reproducibility of the HOA measurements in all patients. BUT was significantly decreased (P<0.005) in all patients in Group 2 compared to the normal tests subjects (Group 1). Conclusion Studying the HOA variation is a valuable method for evaluatingboth the quality visionand the BUT in patients with MGD and evaporative Dry Eye.The IRX3 H‐S aberrometer can be used for an objective and reproducible assessment of the BUT in the follow‐up of patients with severe MGD. [ABSTRACT FROM AUTHOR]

Purpose To evaluate tear break‐up time (BUT) with real‐time (RT) higher order wavefront aberrations (HOA) measurements in myopic patients after Laser‐Assisted In Situ Keratomileusis (LASIK) surgery. Methods HOA up to the sixth order for a 4‐mm pupil were measured in 20 normal subjects (Group 1) and in 20 myopic patients, with no history of dry eye (DE), before and after LASIK surgery (Group 2), using the IRX3 (Imagine Eyes, Orsay, France) Hartmann‐Shack (H‐S) aberrometer. The HOA measurements were performed (in triplicate) with a new dedicated software, once every second for up to 20 seconds. HOA variations were compared with the BUT by the conventional fluorescein method (CFM). Results Twenty percent of the patients from Group 2 were complaining from DE symptoms. There was an excellent correlation between the HOA variation and the BUT recorded by the CFM in both groups. Reproducibility of the HOA measurements in all subjects and patients was excellent. BUT was significantly decreased (P<0.005) in 30% of the patients in Group 2 when compared to the normal tests subjects (Group 1). Conclusion HS aberrometry is a non invasive method that has been used for the last decade for the assessment of the quality of vision, in patients undergoing refractive surgery and cataract or clear lens extraction. Studying the HOA variation is a new interesting method for evaluating both the quality vision and the BUT in patients after LASIK surgery. [ABSTRACT FROM AUTHOR]

Purpose Optic pathway gliomas are rare tumors accounting for 3‐5% of brain tumors in children. Our case aims to understand surgical options. Methods We report the case of a 4‐year‐old child with a single optic pathway glioma revealed by a non esthetical proptosis and blindness. Association with NF1 was not found. The MRI showed a tortuous enlargement of the left optic nerve, the glioma extended into the optic canal with a scleral invasion. Considering those results, a treatment consisting of a double team surgery, ophthalmologists and neurosurgeons was performed with enucleation and complete section of the nerve at its optic chiasm root. Results Histology confirmed the diagnosis of glioma, as a pilocytic astrocytoma, with safety margins. Cytogenetic analysis showed an unspecific chromosome 8 deletion. Chemotherapy was avoided because of systemic toxicity and tumor localization. Conclusion Association with NF1 is classical and the incidence of optic nerve glioma is estimated at 15%. In young children the glioma can be the first manifestation of NF1 and the disease should be kept in mind. Cytogenetic mutation must be searched with surgical sample in culture. In children, surgical treatment can be preferred to chemotherapy when excision of the total tumor removal can be performed. [ABSTRACT FROM AUTHOR]