Vue d’ensemble des pratiques médicales dans la DMLA exsudative en France

Massé, Hélène; Wolff, Benjamin; Bonnabel, A.; Bourhis, A.; Bats, Flore De; Gualino, Vincent; Halfon, J.; Koehrer, Philippe; Souteyrand, Georges; Streho, M.; Tick, Sarah; Zerbib, Jennyfer; Chartier, C.

doi:10.1016/j.jfo.2015.10.001

Cited by 7 publications

(4 citation statements)

References 7 publications

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“…It is interesting to note the shift of the 3 departments participating in this study towards the T&E scheme in 2/3 of the patients (65.8%), allowing reducing the therapeutic burden and travels while maintaining therapeutic efficacy. In 2014, according to a national survey of more than 4000 French ophthalmologists, only 4% of patients were injected according to a T&E regimen (Massé et al., 2016).…”

Section: Discussionmentioning

confidence: 99%

A prospective multicentre study of intravitreal injections and ocular surface in 219 patients: IVIS study

Verrecchia

Chiambaretta²,

Kodjikian

et al. 2021

Acta Ophthalmologica

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Purpose: To assess the impact of intravitreal injections (IVTI) on ocular surface of patients treated with multiple injections. Methods: Prospective, tricentric study conducted in patients treated with unilateral IVTI. An asepsis protocol with povidone-iodine was used for all patients during IVTI. The primary endpoint was the difference between the pre-IVTI Ocular Surface Disease Index (OSDI 1) score and that measured on day one (D1) post-IVTI (OSDI 2). Secondary endpoints were the evaluation of predictive factors for OSDI scores, pain assessment on D1, and the Lacrydiagâ analysis of tears from the injected eye versus contralateral eye before IVTI. Results: Two hundred and nineteen patients with a mean age of 75.9 AE 10 years were included. The mean OSDI2-OSDI1 difference was 19.2 AE 20.6 (p < 0.001). The mean noninvasive tear break-up time was 6.41 AE 4.59 seconds in the injected eye versus 7.36 AE 4.36 seconds in the contralateral eye (p < 0.001). In the multivariate analysis, the factors significantly associated with the OSDI 2 score were the OSDI 1 score (p < 0.001), the pain score on D1 (p < 0.001) the number of instilled glaucoma eye drop (p = 0.01) and a centre effect (centres 2 and 3 versus centre 1, p < 0.001). Conclusion: Our results confirm the impairment of the ocular surface and quality of life immediately after an IVTI. These results suggest 3 levels of action to improve the immediate tolerance: improving the basal status of the ocular surface, reducing the contact time with povidone-iodine that might be toxic to the surface, and improving immediate post-IVTI treatment.

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Section: Discussionmentioning

confidence: 99%

A prospective multicentre study of intravitreal injections and ocular surface in 219 patients: IVIS study

Verrecchia

Chiambaretta²,

Kodjikian

et al. 2021

Acta Ophthalmologica

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“…AMD is broadly divided into two types: dry AMD and wet AMD (33,34). Wet AMD is characterized by the formation of choroidal neovascularization mediated by vascular endothelial growth factor (VEGF) (35,36). Previous studies indicate that suppressing JNK signaling reduces choroidal VEGF expression and neovascularization in a murine model of wet AMD (37), and hypoxia-induced JNK activation promotes retinal VEGF production and pathological angiogenesis in a murine model of retinopathy of prematurity (38).…”

Section: Discussionmentioning

confidence: 99%

Activation of JNK signaling promotes all-trans-retinal–induced photoreceptor apoptosis in mice

Liao

Cai

Feng

et al. 2020

Journal of Biological Chemistry

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Disrupted clearance of all-trans-retinal (atRAL), a component of the visual (retinoid) cycle in the retina, may cause photoreceptor atrophy in autosomal recessive Stargardt disease (STGD1) and dry age-related macular degeneration (AMD). However, the mechanisms underlying atRAL-induced photoreceptor loss remain elusive. Here, we report that atRAL activates c-Jun N-terminal kinase (JNK) signaling at least partially through reactive oxygen species production, which promoted mitochondria-mediated caspase- and DNA damage-dependent apoptosis in photoreceptor cells. Damage to mitochondria in atRAL-exposed photoreceptor cells resulted from JNK activation, leading to decreased expression of Bcl2 apoptosis regulator (Bcl2), increased Bcl2 antagonist/killer (Bak) levels, and cytochrome c (Cyt c) release into the cytosol. Cytosolic Cyt c specifically provoked caspase-9 and caspase-3 activation and thereby initiated apoptosis. Phosphorylation of JNK in atRAL-loaded photoreceptor cells induced the appearance of γH2AX, a sensitive marker for DNA damage, and was also associated with apoptosis onset. Suppression of JNK signaling protected photoreceptor cells against atRAL-induced apoptosis. Moreover, photoreceptor cells lacking Jnk1 and Jnk2 genes were more resistant to atRAL-associated cytotoxicity. The Abca4−/−Rdh8−/− mouse model displays defects in atRAL clearance that are characteristic of STGD1 and dry AMD. We found that JNK signaling was activated in the neural retina of light-exposed Abca4−/−Rdh8−/− mice. Of note, intraperitoneal administration of JNK–IN-8, which inhibits JNK signaling, effectively ameliorated photoreceptor degeneration and apoptosis in light-exposed Abca4−/−Rdh8−/− mice. We propose that pharmacological inhibition of JNK signaling may represent a therapeutic strategy for preventing photoreceptor loss in retinopathies arising from atRAL overload.

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“…The exudative form is characterized by an invasive neovascularization of the choroid, Bruch's membrane, RPE and retina, which contributes, in combination with GA, to a progressive vision loss. This neovascularization [42] is mediated by the overexpression of the vascular endothelial growth factor (VEGF) as well as by local inflammatory cytokines, such as tumor necrosis factor-alpha (TNF-alpha) (Figure 10) [43][44][45]. Indeed, in healthy eyes, VEGF plays a physiological role in the development and trophic maintenance of the Today, no therapeutic options can be proposed to patients to slow down the atrophic AMD progression.…”

Section: Clinical Specificities Of the Exudative Amd Form (Wet-amd)mentioning

confidence: 99%

Recent Advances in Age-Related Macular Degeneration Therapies

et al. 2022

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Age-related macular degeneration (AMD) was described for the first time in the 1840s and is currently the leading cause of blindness for patients over 65 years in Western Countries. This disease impacts the eye’s posterior segment and damages the macula, a retina section with high levels of photoreceptor cells and responsible for the central vision. Advanced AMD stages are divided into the atrophic (dry) form and the exudative (wet) form. Atrophic AMD consists in the progressive atrophy of the retinal pigment epithelium (RPE) and the outer retinal layers, while the exudative form results in the anarchic invasion by choroidal neo-vessels of RPE and the retina. This invasion is responsible for fluid accumulation in the intra/sub-retinal spaces and for a progressive dysfunction of the photoreceptor cells. To date, the few existing anti-AMD therapies may only delay or suspend its progression, without providing cure to patients. However, in the last decade, an outstanding number of research programs targeting its different aspects have been initiated by academics and industrials. This review aims to bring together the most recent advances and insights into the mechanisms underlying AMD pathogenicity and disease evolution, and to highlight the current hypotheses towards the development of new treatments, i.e., symptomatic vs. curative. The therapeutic options and drugs proposed to tackle these mechanisms are analyzed and critically compared. A particular emphasis has been given to the therapeutic agents currently tested in clinical trials, whose results have been carefully collected and discussed whenever possible.

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Vue d’ensemble des pratiques médicales dans la DMLA exsudative en France

Cited by 7 publications

References 7 publications

A prospective multicentre study of intravitreal injections and ocular surface in 219 patients: IVIS study

A prospective multicentre study of intravitreal injections and ocular surface in 219 patients: IVIS study

Activation of JNK signaling promotes all-trans-retinal–induced photoreceptor apoptosis in mice

Recent Advances in Age-Related Macular Degeneration Therapies

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