Titres et travaux

Titres et diplômes

2005 : Diplôme Inter-Universitaire du CESAM, Université Pierre & Marie Curie (Paris VI)
2002 : Diplôme d’Université « Angiographie et Pathologie Rétinienne », Université Paris VII, Faculté de Médecine Lariboisière Saint-Louis
2002 : Thèse de Doctorat en médecine, Université Paris VII, Faculté de Médecine Lariboisière Saint-Louis
2001 : Diplôme d’Etudes Spécialisées d’ophtalmologie, Université Paris VII, Faculté de Médecine Lariboisière Saint-Louis
1997 : Maîtrise de Sciences Biologiques et Médicales, Université Montpellier I
1997 : Lauréat de la Faculté de Médecine de Montpellier

Fonctions hospitalières

Depuis Mars 2008 : Praticien Hospitalier
2004 – 2008 : Praticien attaché puis contractuel
2002 – 2004 : Assistant spécialiste
1997 – 2002 : Interne des Hôpitaux de Paris, spécialités chirurgicales
1993 – 1997 : Externe des hôpitaux de Montpellier.

Publications (PubMed)

Dexamethasone intravitreal implant in patients with macular edema related to branch or central retinal vein occlusion twelve-month study results.

Dexamethasone intravitreal implant in patients with macular edema related to branch or central retinal vein occlusion twelve-month study results.

Ophthalmology. 2011 Dec;118(12):2453-60

Authors: Haller JA, Bandello F, Belfort R, Blumenkranz MS, Gillies M, Heier J, Loewenstein A, Yoon YH, Jiao J, Li XY, Whitcup SM, , Li J

Abstract OBJECTIVE: To evaluate the safety and efficacy of 1 or 2 treatments with dexamethasone intravitreal implant (DEX implant) over 12 months in eyes with macular edema owing to branch or central retinal vein occlusion (BRVO or CRVO). DESIGN: Two identical, multicenter, prospective studies included a randomized, 6-month, double-masked, sham-controlled phase followed by a 6-month open-label extension. PARTICIPANTS: We included 1256 patients with vision loss owing to macular edema associated with BRVO or CRVO. METHODS: At baseline, patients received DEX implant 0.7 mg (n = 421), DEX implant 0.35 mg (n = 412), or sham (n = 423) in the study eye. At day 180, patients could receive DEX implant 0.7 mg if best-corrected visual acuity (BCVA) was <84 letters or retinal thickness was >250 μm. MAIN OUTCOME MEASURES: The primary outcome for the open-label extension was safety; BCVA was also evaluated. RESULTS: At day 180, 997 patients received open-label DEX implant. Except for cataract, the incidence of ocular adverse events was similar in patients who received their first or second DEX implant. Over 12 months, cataract progression occurred in 90 of 302 phakic eyes (29.8%) that received 2 DEX implant 0.7 mg injections versus 5 of 88 sham-treated phakic eyes (5.7%); cataract surgery was performed in 4 of 302 (1.3%) and 1 of 88 (1.1%) eyes, respectively. In the group receiving two 0.7-mg DEX implants (n = 341), a ≥ 10-mmHg intraocular pressure (IOP) increase from baseline was observed in (12.6% after the first treatment, and 15.4% after the second). The IOP increases were usually transient and controlled with medication or observation; an additional 10.3% of patients initiated IOP-lowering medications after the second treatment. A ≥ 15-letter improvement in BCVA from baseline was achieved by 30% and 32% of patients 60 days after the first and second DEX implant, respectively. CONCLUSIONS: Among patients with macular edema owing to BRVO or CRVO, single and repeated treatment with DEX implant had a favorable safety profile over 12 months. In patients who qualified for and received 2 DEX implant injections, the efficacy and safety of the 2 implants were similar with the exception of cataract progression. FINANCIAL DISCLOSURE(S): Proprietary or commercial disclosure may be found after the references.

PMID: 21764136 [PubMed - indexed for MEDLINE]

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[AMD: Future therapies].

[AMD: Future therapies].

J Fr Ophtalmol. 2011 Sep;34(7):498-501

Authors: Cohen SY, Girmens JF

Abstract Many drugs are presently tested in the different types of age-related macular degeneration (AMD), i.e. geographic atrophy or exudative AMD. In atrophic AMD, drugs attempt to spare the photoreceptors and the retinal pigment epithelium to prevent the oxidative damages or to suppress the inflammation process. In exudative AMD, some drugs try to challenge the available anti-VEGF drugs but others try to improve the visual prognosis in targeting other mechanisms or cells involved in angiogenesis, such as pericytes. The present article aims to summarize the available data, given in scientific meetings or given by the companies.

PMID: 21658792 [PubMed - indexed for MEDLINE]

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Evaluation of retinal function and flicker light-induced retinal vascular response in normotensive patients with diabetes without retinopathy.

Evaluation of retinal function and flicker light-induced retinal vascular response in normotensive patients with diabetes without retinopathy.

Invest Ophthalmol Vis Sci. 2011 May;52(6):2861-7

Authors: Lecleire-Collet A, Audo I, Aout M, Girmens JF, Sofroni R, Erginay A, Le Gargasson JF, Mohand-Saïd S, Meas T, Guillausseau PJ, Vicaut E, Paques M, Massin P

To correlate retinal function with vascular response to flicker light in normotensive patients with diabetes without diabetic retinopathy (DR).

PMID: 21282578 [PubMed - indexed for MEDLINE]

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Randomized, sham-controlled trial of dexamethasone intravitreal implant in patients with macular edema due to retinal vein occlusion.

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Randomized, sham-controlled trial of dexamethasone intravitreal implant in patients with macular edema due to retinal vein occlusion.

Ophthalmology. 2010 Jun;117(6):1134-1146.e3

Authors: Haller JA, Bandello F, Belfort R, Blumenkranz MS, Gillies M, Heier J, Loewenstein A, Yoon YH, Jacques ML, Jiao J, Li XY, Whitcup SM,

OBJECTIVE: To evaluate the safety and efficacy of dexamethasone intravitreal implant (DEX implant; OZURDEX, Allergan, Inc., Irvine, CA) compared with sham in eyes with vision loss due to macular edema (ME) associated with branch retinal vein occlusion (BRVO) or central retinal vein occlusion (CRVO). DESIGN: Two identical, multicenter, masked, randomized, 6-month, sham-controlled clinical trials (each of which included patients with BRVO and patients with CRVO). PARTICIPANTS: A total of 1267 patients with vision loss due to ME associated with BRVO or CRVO. INTERVENTION: A single treatment with DEX implant 0.7 mg (n = 427), DEX implant 0.35 mg (n = 414), or sham (n = 426). MAIN OUTCOME MEASURES: The primary outcome measure for the pooled data from the 2 studies was time to achieve a > or =15-letter improvement in best-corrected visual acuity (BCVA). Secondary end points included BCVA, central retinal thickness, and safety. RESULTS: After a single administration, the time to achieve a > or =15-letter improvement in BCVA was significantly less in both DEX implant groups compared with sham (P<0.001). The percentage of eyes with a > or =15-letter improvement in BCVA was significantly higher in both DEX implant groups compared with sham at days 30 to 90 (P<0.001). The percentage of eyes with a > or =15-letter loss in BCVA was significantly lower in the DEX implant 0.7-mg group compared with sham at all follow-up visits (P< or =0.036). Improvement in mean BCVA was greater in both DEX implant groups compared with sham at all follow-up visits (P< or =0.006). Improvements in BCVA with DEX implant were seen in patients with BRVO and patients with CRVO, although the patterns of response differed. The percentage of DEX implant-treated eyes with intraocular pressure (IOP) of > or =25 mmHg peaked at 16% at day 60 (both doses) and was not different from sham by day 180. There was no significant between-group difference in the occurrence of cataract or cataract surgery. CONCLUSIONS: Dexamethasone intravitreal implant can both reduce the risk of vision loss and improve the speed and incidence of visual improvement in eyes with ME secondary to BRVO or CRVO and may be a useful therapeutic option for eyes with these conditions.

PMID: 20417567 [PubMed - indexed for MEDLINE]

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Imaging of macroaneurysms occurring during retinal vein occlusion and diabetic retinopathy by indocyanine green angiography and high resolution optical coherence tomography.

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Imaging of macroaneurysms occurring during retinal vein occlusion and diabetic retinopathy by indocyanine green angiography and high resolution optical coherence tomography.

Graefes Arch Clin Exp Ophthalmol. 2010 Feb;248(2):161-6

Authors: Bourhis A, Girmens JF, Boni S, Pecha F, Favard C, Sahel JA, Paques M

BACKGROUND: Macular edema occurring after retinal vein occlusion (RVO) or diabetic retinopathy (DR) may be due to the development of capillary and/or venous macroaneurysms (MAs). Here, we investigated the respective contribution of fluorescein angiography (FA), of indocyanine green angiography (ICGA) and of high-resolution optical coherence tomography (HR-OCT) to their detection. METHODS: Review of the charts of six consecutive patients with MAs secondary to RVO (n = 4) or DR (n = 2). For each patient, FA, ICGA and HR-OCT data were analyzed and compared. RESULTS: All detectable MAs were detected by ICGA, while in three eyes FA failed to show them. Overall, ICGA provided a better delineation of MAs than FA. In all cases, HR-OCT identified MAs under the form of a vascular structure with a reflective wall surrounding a lumen containing variably reflective material. CONCLUSIONS: MAs can develop during the course of RVO and DR. ICGA and HR-OCT improves the identification of capillary and venous MAs, and may thus be of interest to better identify sites of blood-retinal barrier rupture during chronic macular edema due to RVO or DR.

PMID: 19701812 [PubMed - indexed for MEDLINE]

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[Optical coherence tomography: a reliable tool for localisation of macular hemorrhage. Two case reports]

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[Optical coherence tomography: a reliable tool for localisation of macular hemorrhage. Two case reports]

J Fr Ophtalmol. 2008 Nov;31(9):e20

Authors: Errera MH, Barale PO, Danan-Husson A, Scheer S, Girmens JF, de Monchy I, Sahel JA

Recent observations have found that premacular hemorrhage in Valsalva retinopathy is located under the internal limiting membrane. We confirm these findings in two case reports of Valsalva retinopathy. Visual acuity rehabilitation was obtained in the first case by conservative treatment and by draining the hemorrhage into the vitreous with Neodymium (Nd):Yag laser in the second case. We report the current therapeutic guidelines for Valsalva retinopathy, including the systematic search of autosomal dominant syndrome of retinal arterial tortuosity, a rare condition, often discovered after this type of benign macular hemorrhage.

PMID: 19107054 [PubMed - in process]

[Link]
[Optical coherence tomography: a reliable tool for localisation of macular hemorrhage. Two case reports]

Related Articles

[Optical coherence tomography: a reliable tool for localisation of macular hemorrhage. Two case reports]

J Fr Ophtalmol. 2008 Nov;31(9):e20

Authors: Errera MH, Barale PO, Danan-Husson A, Scheer S, Girmens JF, de Monchy I, Sahel JA

Recent observations have found that premacular hemorrhage in Valsalva retinopathy is located under the internal limiting membrane. We confirm these findings in two case reports of Valsalva retinopathy. Visual acuity rehabilitation was obtained in the first case by conservative treatment and by draining the hemorrhage into the vitreous with Neodymium (Nd):Yag laser in the second case. We report the current therapeutic guidelines for Valsalva retinopathy, including the systematic search of autosomal dominant syndrome of retinal arterial tortuosity, a rare condition, often discovered after this type of benign macular hemorrhage.

PMID: 19107054 [PubMed - indexed for MEDLINE]

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Malformation of junctional microdomains in cataract lens membranes from a type II diabetes patient.

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Malformation of junctional microdomains in cataract lens membranes from a type II diabetes patient.

Pflugers Arch. 2009 Apr;457(6):1265-74

Authors: Mangenot S, Buzhynskyy N, Girmens JF, Scheuring S

In eye core lens membranes, aquaporin-0 (AQP0) and connexins (Cx) form together well-structured supramolecular assemblies, the junctional microdomains, in which they assure water, ion, metabolite, and waste transport. Additionally, they mediate cell-cell adhesion-forming thin junctions (AQP0) and gap junctions (Cx). We have used atomic force microscopy and biochemical methods to analyze and compare the structure of junctional microdomains in human cataract lens membranes from a type II diabetes patient and healthy lens membranes from calf. A healthy intercellular junctional microdomain consists in average of approximately 150 tetragonally arranged (a = b = 65.5 A, gamma = 90 degrees) AQP0 tetramers surrounded by densely packed non-ordered connexon channels. Gap-junction connexons act as lineactants inside the membrane and confine AQP0 in the junctional microdomains. In the diabetic cataract lens, connexons were degraded, and AQP0 arrays are malformed. We conceptualize that absence of connexons lead to breakdown of cell nutrition.

PMID: 19034495 [PubMed - indexed for MEDLINE]

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The National Eye Institute Visual Function Questionnaire in the Macular Telangiectasia (MacTel) Project.

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The National Eye Institute Visual Function Questionnaire in the Macular Telangiectasia (MacTel) Project.

Invest Ophthalmol Vis Sci. 2008 Oct;49(10):4340-6

Authors: Clemons TE, Gillies MC, Chew EY, Bird AC, Peto T, Figueroa M, Harrington MW,

PURPOSE: To describe vision-targeted health-related quality of life (HR-QOL), measured with the National Eye Institute Visual Functioning Questionnaire (NEI-VFQ-25) in a cohort of patients with macular telangiectasia (MacTel) type 2 and to evaluate the relationship between visual acuity and NEI-VFQ-25 scores. METHODS: This was an analysis of cross-sectional baseline data from a longitudinal natural history study. Patients with MacTel type 2 were enrolled in the Natural History Study of The Macular Telangiectasia Project (The MacTel Project). NEI-VFQ-25 were completed at enrollment. Linear correlation and regression analyses were used to relate baseline NEI-VFQ-25 overall and subscale scores to visual acuity. RESULTS: Participants reported lower vision-related functioning measured by the NEI-VFQ-25 in most of the domains measured by the NEI VFQ compared with that of a normal reference group (P < 0.001 for all domains except color vision). Visual acuity was found to be associated with the NEI-VFQ-25 in many of the domains measuring degree of difficulty with common visual activities. CONCLUSIONS: This is the first cross-sectional cohort study to assess vision targeted HR-QOL in patients with MacTel type 2. Patients with MacTel type 2 reported markedly reduced visual functioning compared to reports of a normal reference group. These findings provide support to the use of the NEI-VFQ-25 in patients with MacTel type 2 to measure the effect of disease and potential therapies on vision-targeted HR-QOL.

PMID: 18586874 [PubMed - indexed for MEDLINE]

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[Center of Clinical Investigation dedicated to ophthalmology, National Center of Ophthalmology of 80 years]

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[Center of Clinical Investigation dedicated to ophthalmology, National Center of Ophthalmology of 80 years]

J Fr Ophtalmol. 2008 Jan;31(1):128-9

Authors: Girmens JF, Mohand-Said S, Sahel JA

PMID: 18401311 [PubMed - indexed for MEDLINE]

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Endogenous erythroid colony formation in patients with retinal vein occlusion.

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Endogenous erythroid colony formation in patients with retinal vein occlusion.

Ophthalmology. 2007 Dec;114(12):2155-61

Authors: Héron E, Marzac C, Feldman-Billard S, Girmens JF, Paques M, Delarue R, Piette JC, Casadevall N, Hermine O

PURPOSE: The pathophysiology and causes of retinal vein occlusion (RVO) remain largely unknown. Latent forms of myeloproliferative disorders, which are diagnosed by the presence of in vitro endogenous erythroid colony (EEC) formation, are a well-known cause of intraabdominal vein thrombosis. The suspected diagnosis of a latent myeloproliferative disorder in a patient with RVO, based on the presence of EEC formation, led us to evaluate the association between latent myeloproliferative disorders and RVO. DESIGN: Observational case series in a national eye center. PARTICIPANTS: Forty-four patients, with a mean age of 46 years (range, 21-62) and central (n = 38) or peripheral (n = 6) RVO responsible for visual acuity decreased to 6/12 or less. METHODS: In vitro bone marrow culture. MAIN OUTCOME MEASURE: Endogenous erythroid colony formation in cytokine-free culture medium. Conventional diagnostic criteria for myeloproliferative disorders and the JAK2 V617F mutation (which is strongly associated with myeloproliferative disorders) were assessed in RVO patients showing EECs. RESULTS: Endogenous erythroid colony formation was observed in 12 of 44 (27%) patients with RVO, 13 of 35 (37%) patients with Budd-Chiari syndrome, and 52 of 53 (98%) patients with primary polycythemia (positive control groups) but not in 22 healthy bone marrow donors (negative controls) evaluated at the same time and by the same hematology laboratory. Neither conventional nor genetic diagnostic criteria for myeloproliferative disorders were observed in any patient with both RVO and an EEC at the time of diagnosis or during follow-up. CONCLUSIONS: Endogenous erythroid colony formation is frequently observed in patients with RVO independently of any detectable myeloproliferative disorder. This opens a new aspect of research on the pathophysiology of this sight-threatening disease.

PMID: 18054634 [PubMed - indexed for MEDLINE]

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Human cataract lens membrane at subnanometer resolution.

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Human cataract lens membrane at subnanometer resolution.

J Mol Biol. 2007 Nov 16;374(1):162-9

Authors: Buzhynskyy N, Girmens JF, Faigle W, Scheuring S

Human pathologies often originate from molecular disorders. Therefore, imaging technology as one of the bases for the identification and understanding of pathologies must provide views of single molecules at subnanometer resolution. Membrane proteins mediate many of life's most important processes, and their malfunction is often lethal or leads to severe disease. The membrane proteins aquaporin-0 (AQP0) and connexons form junctional microdomains between healthy lens core cells in which AQP0 form square arrays surrounded by connexons. Malfunction of both proteins results in the formation of cataract. We have used high-resolution atomic force microscopy (AFM) to image junctional microdomains in membranes from an individual human eye lens with senile cataract. Images at subnanometer resolution report individual helix-connecting loops of four amino acid residues on the AQP0 surface. We describe the supramolecular assembly and the conformational state of AQP0 in junctional microdomains, where a mixture of truncated junctional and full-length water channel AQP0 form square arrays. Imaging of microdomain borders revealed individual AQP0 tetramers and no associated connexon, indicating a lack of metabolite transport, waste accumulation, and enlarged regions of non-adhering membranes, causing cataract in this individual. This first high-resolution view of the membrane of this pathological human tissue provides insights into cataract pathology at the single membrane protein level, and indicates the power of the AFM as a future tool in medical imaging at subnanometer resolution.

PMID: 17920625 [PubMed - indexed for MEDLINE]

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Familial central retinal vein occlusion.

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Familial central retinal vein occlusion.

Eye. 2008 Feb;22(2):308-10

Authors: Girmens JF, Scheer S, Héron E, Sahel JA, Tournier-Lasserve E, Paques M

AIM: To report four cases of central retinal vein occlusion (CRVO) in a French family. PATIENTS AND METHODS: Ophthalmological examination and medical work-up of seven members of the family. RESULTS: There were four cases of CRVO in two consecutive generations. Three of them had CRVO in both eyes. Arterial hypertension was present in two, associated to glaucoma in one. Medical work-up did not reveal additional risk factors. CONCLUSIONS: We report a case of familial clustering of CRVO. Our cases combined to other cases reported in the literature provide arguments for the existence in some subjects of a genetic predisposition of CRVO. Additional case series are however needed to confirm this hypothesis.

PMID: 17173011 [PubMed - indexed for MEDLINE]

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Systemic nocardiosis mimicking an ocular relapse of giant-cell arteritis.

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Systemic nocardiosis mimicking an ocular relapse of giant-cell arteritis.

Rheumatology (Oxford). 2006 May;45(5):641-3

Authors: Héron E, Augustin P, Cervera P, Girmens JF, Généreau T, Lortholary O, Cabane J

PMID: 16531438 [PubMed - indexed for MEDLINE]

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[Heavy silicone oil as internal tamponade for retinal detachment: efficacy and tolerance]

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[Heavy silicone oil as internal tamponade for retinal detachment: efficacy and tolerance]

J Fr Ophtalmol. 2006 Feb;29(2):129-35

Authors: Scheer S, Boni S, Barale PO, Bourhis A, Bonnel S, Tuil E, Girmens JF, Buil O, Baudouin C, Laroche L, Nordmann JP, Poisson F, Warnet JM, Sahel JA

INTRODUCTION: To evaluate the tolerance and efficacy of heavy silicone oil as internal tamponade for retinal detachment surgery. PATIENTS AND METHODS: Sixty-six eyes requiring heavy silicone oil for retinal detachment, with at least 1 month follow-up, were retrospectively studied. Preoperative status, surgical technique, tolerance, and anatomical and functional results were analyzed from the patient's file. Indications for heavy silicone injection were inferior retinotomy or inferior retraction in 65% of cases. PVR grade C was present in at least 63% of cases. Retinotomy was performed in 45% of cases. An exchange procedure was performed versus DKline in 65% of cases. Mean follow-up was 7 +/- 4 months. RESULTS: At the end of follow-up, 59% of eyes had a completely reattached retina, 32% without internal tamponade. Another surgery was necessary in 54% of cases. During follow-up, mean intraocular pressure was normal, and there was a significant intraocular inflammation in three cases (4.5%). In seven cases of the 44 ablations of heavy silicone oil, an adherence of residual bubbles was present. Redetachment occurred after ablation for anatomical success in 41% of cases. BCVA was better than 0.05 (20/400) in 54% of cases at the end of follow-up. CONCLUSION: Heavy silicone was well tolerated and seems not to be pro-inflammatory in our study. It is a good alternative to standard silicone for inferior retinotomy and inferior breaks without PVR. It is not a treatment of inferior retraction, and is not a long-term internal tamponade. During the ablation of heavy silicone oil, adherence of residual bubbles is possible, in which case a coaxial light or an endoillumination could be needed during ablation.

PMID: 16523153 [PubMed - indexed for MEDLINE]

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Decreased venous tortuosity associated with resolution of macular edema after intravitreal injection of triamcinolone.

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Decreased venous tortuosity associated with resolution of macular edema after intravitreal injection of triamcinolone.

Retina. 2005 Dec;25(8):1099-101

Authors: Paques M, Krivosic V, Girmens JF, Giraud C, Sahel J, Gaudric A

PMID: 16340544 [PubMed - indexed for MEDLINE]

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Dilation of the minor arterial circle of the iris preceding rubeosis iridis during retinal vein occlusion.

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Dilation of the minor arterial circle of the iris preceding rubeosis iridis during retinal vein occlusion.

Am J Ophthalmol. 2004 Dec;138(6):1083-6

Authors: Paques M, Girmens JF, Rivière E, Sahel J

PURPOSE: To report in four patients with retinal vein occlusion the presence of biomicroscopically visible circulation in the minor arterial circle of the iris, preceding rubeosis iridis in two cases. DESIGN: Retrospective observational case series. METHODS: Four patients with ischemic type of central or hemi-central retinal vein occlusion seen at a single center. RESULTS: Dilation of the minor arterial circle remnants with biomicroscopically visible circulation was observed in four eyes of four adult patients with severe retinal ischemia secondary to retinal vein occlusion and preceded the occurrence of anterior segment neovascularization in two cases. CONCLUSION: In patients with ischemic retinal vein occlusion, the clinical finding of a dilation of the minor arterial circle may indicate the necessity of a closer follow-up to make a timely decision on panretinal photocoagulation.

PMID: 15629321 [PubMed - indexed for MEDLINE]

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Treatment of von Hippel-Lindau retinal hemangioblastoma by the vascular endothelial growth factor receptor inhibitor SU5416 is more effective for associated macular edema than for hemangioblastomas.

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Treatment of von Hippel-Lindau retinal hemangioblastoma by the vascular endothelial growth factor receptor inhibitor SU5416 is more effective for associated macular edema than for hemangioblastomas.

Am J Ophthalmol. 2003 Jul;136(1):194-6

Authors: Girmens JF, Erginay A, Massin P, Scigalla P, Gaudric A, Richard S

PURPOSE: To test the efficacy of the novel vascular endothelial growth factor (VEGF) receptor inhibitor SU5416, in a case of refractory von Hippel-Lindau (VHL) retinal hemangioblastoma (RHB). DESIGN: Interventional case report. METHODS: Patient included in a multicenter phase II trial. A 30-year-old woman presenting with VHL disease and multiple RHB on her only eye, refractory to conventional treatments, had decreased visual acuity due to cystoid macular edema (CME). SU5416 was administered intravenously for 7 months. Best-corrected visual acuity (BCVA) and macular thickness were measured by optical coherence tomography. RESULTS: Under treatment, the size of the RHB did not change, but CME improved significantly. Best-corrected visual acuity rose from 20/40 to 20/25. However, CME recurred after the end of the treatment. CONCLUSION: The VEGF receptor inhibitor SU5416 failed to reduce the size of RHB but was very effective for the associated CME.

PMID: 12834696 [PubMed - indexed for MEDLINE]

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Persistence of fundus fluorescence after use of indocyanine green for macular surgery.

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Persistence of fundus fluorescence after use of indocyanine green for macular surgery.

Ophthalmology. 2003 Mar;110(3):604-8

Authors: Tadayoni R, Paques M, Girmens JF, Massin P, Gaudric A

PURPOSE: To investigate the possible persistence and characteristics of infrared fluorescence of the fundus for several months after surgery with intraocular injection of indocyanine green (ICG). DESIGN: Interventional, noncomparative, prospective case series. PARTICIPANTS: Seventeen patients operated on in our department with ICG injection into the vitreous cavity, who gave prior informed consent. METHODS: After standard three-port pars plana vitrectomy and posterior vitreous detachment, 0.1 to 0.2 ml of an ICG solution at a concentration of 2.5 mg/ml was injected through a 5- micro m sterile filter over the posterior pole and left in place for 3 minutes. The stained internal limiting membrane was then peeled off. Patients had postoperative infrared fundus photographs at each consultation in our department. Follow-up ranged from 1 to 7 months. Visual acuity and any unexpected event were also recorded. MAIN OUTCOME MEASURES: Postoperative infrared fluorescence of the fundus. RESULTS: The day after surgery, no green ICG staining of the fundus was visible on biomicroscopy. However, infrared photography showed diffuse fluorescence of the fundus. At 1 and 3 postoperative months, infrared fundus photography showed an intensely fluorescent optic nerve disc. In patients with macular hole, the center of the macula also exhibited faint granular fluorescence. At 6 months postoperative or later, only the optic disc remained fluorescent, but the fluorescence was far less intense than at 3 months. Infrared photographs of the fellow eyes exhibited no fluorescence. Visual acuity improved or was unchanged compared with preoperative vision in 16 eyes and decreased by 1 line in 1 eye. CONCLUSIONS: After intraoperative use of ICG for macular surgery, fluorescence of the optic disc and of the macular center after macular hole surgery persisted for months in all cases. ICG may accumulate in the macular pigment epithelium and optic nerve, raising the problem of the as yet unknown pharmacokinetics of ICG after intravitreous administration and of its long-term safety.

PMID: 12623830 [PubMed - indexed for MEDLINE]

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[Peripheral retinal neovascularization and sarcoidosis: two case reports]

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[Peripheral retinal neovascularization and sarcoidosis: two case reports]

J Fr Ophtalmol. 2002 Mar;25(3):303-7

Authors: Girmens JF, Fajnkuchen F, Badelon I, Chaine G

Peripheral retinal neovascularization occurs in approximately 10% of cases of sarcoidosis. Its pathogenesis is unknown, but it probably results from retinal ischemia and/or inflammation. In cases of peripheral retinal neovascularization associated with sarcoidosis, sickle cell disease should be considered, even if sarcoidosis is histologically proved: new vessels seen in sickle cell disease and sarcoidosis may have a very similar pattern. We present two cases with histologically proven sarcoidosis who developed peripheral neovascularization: the first one had no associated disease and new vessels were likely to be related to sarcoidosis; in the second case, hemoglobin electrophoresis revealed hemoglobin SC, and provided diagnosis of sickle cell hemoglobinopathy.

PMID: 11941257 [PubMed - indexed for MEDLINE]

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