Institute Hedi Rais dOphtalmologie

Tunis, Tunisia

Institute Hedi Rais dOphtalmologie

Tunis, Tunisia
SEARCH FILTERS
Time filter
Source Type

Introduction: Inflammation is one of the main mechanisms common to all forms of dry eye. Since polyunsaturated acids are known to show biological anti-inflammatory properties, the aim of this study was to evaluate the efficacy of dietary n-6 and n-3 fatty acids in patients suffering from ocular dryness. Patients and methods: One hundred and eighty-one patients diagnosed with bilateral moderate dry eye who were already treated with lachrymal substitutes were randomized in a double-blind international study to receive placebo or Nutrilarm® capsules (combination of omega-3 and omega-6), twice a day for 6 months. In all subjects, dryness feeling, overall subjective comfort, and ocular symptoms (burning, stinging, sandy and/or gritty sensation, light sensitivity, reflex tearing, and ocular fatigue) were evaluated at each visit. Furthermore, fluorescein tests (break-uptime and Oxford scheme) and lissamine green test were performed at each visit. The Schirmer test was performed at inclusion and after 6 months of treatment. Results: After 6 months of supplementation with Nutrilarm®, both the BUT scores and ocular fatigue were significantly improved when compared with placebo (P = 0.036 and P = 0.044, respectively). There was a trend in favor of Nutrilarm® in terms of the efficacy evaluated by the investigator (P = 0.061). Fewer patients experienced a feeling of severe dryness with Nutrilarm® compared with placebo after 6 months of treatment (2.5 and 9.3%, respectively), but the difference was not statistically significant. Conclusion: Oral administration of a double supplementation dietary n-6 and n-3 fatty acids present an additional therapeutic advantage in patients suffering from ocular dryness who were already treated with lachrymal substitutes. © 2011 Publié par Elsevier Masson SAS.


PubMed | Institute Hedi Rais dophtalmologie and Institute Pasteur Of Tunis
Type: Case Reports | Journal: Annales de biologie clinique | Year: 2013

In order to charaterize the Stargardt disease, the molecular exploration of the c.2041C>T mutation (ABCA4 gene) and genotype phenotype correlation in Tunisian patients, seven unrelated propositi underwent a complete ophthalmological examination. The search for the mutation was performed by a direct sequencing after a specific amplification of exon 14 of the ABCA4 gene. Baseline, the average age of propositi was 20.7 15 years and the sex-ratio was 1.3. The age of the visual impairment perception was 8.1 3.2 years. In all patients, the loss of visual acuity was bilateral and ranged from counting fingers to 3.2/10. Fundus and retinal fluorescein angiography examination showed advanced stages of the disease. The allele frequency of the c.2041C>T was 28.5% (4/14). We have reported this mutation in two patients. Their average age at onset was 5 and a half years and the disease progression was rapid with a severe visual loss after 1 and 5 years. All patients had a juvenile macular dystrophy with flavimaculatus flecks. To our knowledge, we reported for the first time the homozygous state of the c.2041C>T mutation. Among homozygous patients, the age at onset was early, the loss of visual acuity was important and the prognosis was severe. Due to the severity of the phenotype and the high rate of inbreeding, genetic counseling for healthy heterozygotes is essential.


El Matri L.,Institute Hedi Rais dOphtalmologie | Chebil A.,Institute Hedi Rais dOphtalmologie | Bouraoui R.,Institute Hedi Rais dOphtalmologie | Kort F.,Institute Hedi Rais dOphtalmologie | And 2 more authors.
Journal Francais d'Ophtalmologie | Year: 2013

Purpose: To compare the long-term safety and of intravitreal bevacizumab injections (IVB) and verteporferin photodynamic therapy (PDT) in the treatment of choroidal neovascularization (CNV) in high myopia. Methods: Review of retrospectively collected data of 60 eyes of 60 patients with high myopic choroidal neovascularization treated either with standard PDT (PDT group; n = 30) or IVB injections (IVB group; n = 30). The two groups were compared at baseline, 3, 6,12 and 24 months. Results: In the IVB group, mean best corrected visual acuity (BCVA) was significantly improved at 3 to 12 months; however, the significance was lost at 24 months. The PDT group showed an insignificant improvement at 3 and 6 months, then worsened at 12 and 24 months. Mean BCVA was better in the IVB group than the PDT group at 3, 6, 12 and 24 months. The decrease in mean central macular thickness was significantly higher in the IVB group than in the PDT group at 3, 6, 12 and 24 months. At 24 months, chorioretinal atrophy was noted in five eyes (16.6%) treated with IVB and in 22 eyes (73.3%) treated with PDT (P = 2 × 10-5). Conclusion: IVB provides significantly better BCVA than PDT for high myopic CNV over the long-term. © 2012 Publié par Elsevier Masson SAS.


Chebil A.,Institute Hedi Rais dOphtalmologie | Maamouri R.,Institute Hedi Rais dOphtalmologie | Ben Abdallah M.,Institute Hedi Rais dOphtalmologie | Ouderni M.,Institute Hedi Rais dOphtalmologie | And 2 more authors.
Journal Francais d'Ophtalmologie | Year: 2015

Purpose. - To measure macular choroidal thickness (CT) using spectral domain optical cohe-rence tomography (OCT) in high myopic eyes with primary angle-open glaucoma (POAG), and toinvestigate whether the choroid is thinner in these eyes compared to high myopic eyes withoutglaucoma.Patients and methods. - We conducted a cross-sectional study of forty-eight eyes with highmyopic glaucoma matched with 48 highly myopic eyes without glaucoma by age, central cor-neal thickness and axial length (AL). OCT scans were performed with the spectral domain OCT(Topcon 2000). The subfoveal CT was measured between the Bruch membrane and the internalaspect of the sclera. Results. - In the subgroup without glaucoma, matched with the subgroup with glaucoma(P = 0.57), by age, central corneal thickness (P = 0.33) and AL (P = 0.10), the mean subfovealCT was 96.32 μm ± 39.56 μm. In the subgroup with glaucoma, the mean subfoveal CT was50.44 μm ± 16.36 μm. The comparison between the two subgroups found a statistically signifi-cant difference in subfoveal CT (P < 10-4).Conclusions. - Foveal choroidal thickness is reduced in highly myopic eyes with glaucoma. Thechoroidal thinning can be a useful parameter for the diagnosis and the follow-up of highlymyopic patients with glaucoma. © 2015 Elsevier Masson SAS. All rights reserved.


Chebil A.,Institute Hedi Rais dOphtalmologie | Kort F.,Institute Hedi Rais dOphtalmologie | Bouraoui R.,Institute Hedi Rais dOphtalmologie | Youssef N.B.,Institute Hedi Rais dOphtalmologie | Matri L.E.,Institute Hedi Rais dOphtalmologie
Journal Francais d'Ophtalmologie | Year: 2010

The complex immunological effects of interferon and ribavirin therapy in hepatitis C virus may also exacerbate or trigger the development of autoimmunity. A rare case of Vogt-Koyanagi-Harada disease associated with ribavirin and interferon-alpha treatment for chronic hepatitis C infection is presented. The potential role of interferon and/or ribavirin therapy is discussed. Physicians should be aware of the association between interferon-alpha 2a and ribavirin use for hepatitis C infection and the development of Harada disease. This severe ophthalmological complication requires close follow-up of hepatitis C virus-infected patients on interferon-alpha treatment. © 2010 Elsevier Masson SAS. All rights reserved.


PubMed | Institute Hedi Rais dophtalmologie
Type: Case Reports | Journal: Journal francais d'ophtalmologie | Year: 2010

The complex immunological effects of interferon and ribavirin therapy in hepatitis C virus may also exacerbate or trigger the development of autoimmunity. A rare case of Vogt-Koyanagi-Harada disease associated with ribavirin and interferon-alpha treatment for chronic hepatitis C infection is presented. The potential role of interferon and/or ribavirin therapy is discussed. Physicians should be aware of the association between interferon-alpha 2a and ribavirin use for hepatitis C infection and the development of Harada disease. This severe ophthalmological complication requires close follow-up of hepatitis C virus-infected patients on interferon-alpha treatment.


PubMed | Institute Hedi Rais dophtalmologie
Type: Journal Article | Journal: Journal francais d'ophtalmologie | Year: 2016

Best vitelliform macular dystrophy is the second most frequent hereditary maculopathy, with bilateral involvement and juvenile onset. It is clinically characterized by bilateral deposits of lipofuscin-like autofluorescent material in the subretinal space, with a typical phenotypic manifestation taking the form of a vitelliform macular lesion evolving gradually into more advanced stages. The purpose of our study was to describe fundus autofluorescence patterns and OCT findings in three patients (6 eyes) with several stages of Best vitelliform macular dystrophy. Optical coherence tomography (OCT) has become the first imaging technique to order when confronted with a hereditary maculopathy suggesting Best disease. Fundus autofluorescence combined with OCT allow for better diagnosis and management, which are necessary for any genetic analysis.


Chebil A.,Institute Hedi Rais dophtalmologie | Charfi H.,Institute Hedi Rais dophtalmologie | Largueche L.,Institute Hedi Rais dophtalmologie | El Matri L.,Institute Hedi Rais dophtalmologie
Journal Francais d'Ophtalmologie | Year: 2016

Best vitelliform macular dystrophy is the second most frequent hereditary maculopathy, with bilateral involvement and juvenile onset. It is clinically characterized by bilateral deposits of lipofuscin-like autofluorescent material in the subretinal space, with a typical phenotypic manifestation taking the form of a vitelliform macular lesion evolving gradually into more advanced stages. The purpose of our study was to describe fundus autofluorescence patterns and OCT findings in three patients (6 eyes) with several stages of Best vitelliform macular dystrophy. Optical coherence tomography (OCT) has become the first imaging technique to order when confronted with a hereditary maculopathy suggesting Best disease. Fundus autofluorescence combined with OCT allow for better diagnosis and management, which are necessary for any genetic analysis. © 2016 Elsevier Masson SAS


PubMed | Institute Hedi Rais dophtalmologie
Type: Comparative Study | Journal: Journal francais d'ophtalmologie | Year: 2013

To compare the long-term safety and of intravitreal bevacizumab injections (IVB) and verteporferin photodynamic therapy (PDT) in the treatment of choroidal neovascularization (CNV) in high myopia.Review of retrospectively collected data of 60 eyes of 60 patients with high myopic choroidal neovascularization treated either with standard PDT (PDT group; n=30) or IVB injections (IVB group; n=30). The two groups were compared at baseline, 3, 6,12 and 24 months.In the IVB group, mean best corrected visual acuity (BCVA) was significantly improved at 3 to 12 months; however, the significance was lost at 24 months. The PDT group showed an insignificant improvement at 3 and 6 months, then worsened at 12 and 24 months. Mean BCVA was better in the IVB group than the PDT group at 3, 6, 12 and 24 months. The decrease in mean central macular thickness was significantly higher in the IVB group than in the PDT group at 3, 6, 12 and 24 months. At 24 months, chorioretinal atrophy was noted in five eyes (16.6%) treated with IVB and in 22 eyes (73.3%) treated with PDT (P=210(-5)).IVB provides significantly better BCVA than PDT for high myopic CNV over the long-term.


PubMed | Institute Hedi Rais dophtalmologie
Type: Journal Article | Journal: Journal francais d'ophtalmologie | Year: 2015

To measure macular choroidal thickness (CT) using spectral domain optical coherence tomography (OCT) in high myopic eyes with primary angle-open glaucoma (POAG), and to investigate whether the choroid is thinner in these eyes compared to high myopic eyes without glaucoma.We conducted a cross-sectional study of forty-eight eyes with high myopic glaucoma matched with 48 highly myopic eyes without glaucoma by age, central corneal thickness and axial length (AL). OCT scans were performed with the spectral domain OCT (Topcon 2000). The subfoveal CT was measured between the Bruch membrane and the internal aspect of the sclera.In the subgroup without glaucoma, matched with the subgroup with glaucoma (P=0.57), by age, central corneal thickness (P=0.33) and AL (P=0.10), the mean subfoveal CT was 96.32 m 39.56 m. In the subgroup with glaucoma, the mean subfoveal CT was 50.44 m 16.36 m. The comparison between the two subgroups found a statistically significant difference in subfoveal CT (P<10(-4)).Foveal choroidal thickness is reduced in highly myopic eyes with glaucoma. The choroidal thinning can be a useful parameter for the diagnosis and the follow-up of highly myopic patients with glaucoma.

Loading Institute Hedi Rais dOphtalmologie collaborators
Loading Institute Hedi Rais dOphtalmologie collaborators