Papers by Marie-Noelle Delyfer
Frontiers in Neurology, Mar 21, 2017
Retinal nerve fiber layer (RNFL) thickness is reduced in Alzheimer's patients. However, whether i... more Retinal nerve fiber layer (RNFL) thickness is reduced in Alzheimer's patients. However, whether it is associated with early evolution of cognitive function is unknown. Within 427 participants from the Three-City-Alienor longitudinal population-based cohort, we explored the relationship between peripapillary RNFL thicknesses and the evolution of cognitive performance. RNFL was assessed at baseline by spectral domain optical coherence tomography; cognitive performances were assessed at baseline and at 2 years, with the Mini-Mental State Examination, the Isaacs' set test, and the Free and Cued Selective Reminding Test (FCSRT). Multivariate linear mixed models were performed. The RNFL was not associated with initial cognitive performance. Nevertheless, a thicker RNFL was significantly associated with a better cognitive evolution over time in the free delayed recall (p = 0.0037) and free + cued delayed recall (p = 0.0043) scores of the FCSRT, particularly in the temporal, superotemporal, and inferotemporal segments. No associations were found with other cognitive tests. The RNFL was associated with changes in scores that assess episodic memory. RNFL thickness could reflect a higher risk of developing cognitive impairment over time.
Journal Francais D Ophtalmologie, 2018
HAL (Le Centre pour la Communication Scientifique Directe), May 1, 2016
Background: Omega-3 polyunsaturated fatty acids (PUFAs) were proposed to have potential effects a... more Background: Omega-3 polyunsaturated fatty acids (PUFAs) were proposed to have potential effects against inflammation and cancer. However, results from epidemiology studies remain inconsistent. We aimed to explore the associations of plasma PUFAs with EC recurrence and all-cause mortality. Method: Women diagnosed with endometrial cancer (EC) between 2008 and 2013 and underwent surgery at Fudan University Shanghai Cancer Center of China were recruited. Survival status was followed up through September 2017. EC recurrence and total cause deaths were identified through medical record and telephone interview. In total, 202 patients with enough plasma samples at time of surgery were included. There were 195 patients who provided baseline plasma and survival information included in the current study. Plasma omega-3 PUFAs were measured by GC-FID. Cox Proportional Hazard model adjusted for potential cofounders was used to estimate HRs and 95% CIs. Results: Median follow-up time for patients was 58 months after surgery. A total of 13 recurrences and 11 all-cause deaths, of which, 2 deaths from EC, were identified. Level of plasma EPA was higher in recurrent patients than total patients (0.78% vs 0.51%, P = 0.015). Higher plasma eicosapentaenoic acid (EPA) level trended to have positive association with EC recurrence (P-trend = 0.04), although comparing to the lowest tertile, the highest tertile of EPA level was not significantly associated with increased risk of EC recurrence (HR T3vsT1 = 6.02; 95%CI = 0.7-52.06). The association between total omega-3 PUFA and EC recurrence tended to be stronger among patients with deeper myometrial invasion (OR = 3.41; 95%CI = 1.06-10.95; P-interaction = 0.04). Conclusions: Higher plasma EPA level was significantly associated with EC recurrence. Further studies are warranted to confirm these findings.
Investigative Ophthalmology & Visual Science, Sep 26, 2016
Journal Francais D Ophtalmologie, Oct 1, 2016
Journal Francais D Ophtalmologie, Dec 1, 2015
Journal Francais D Ophtalmologie, Nov 1, 2012
To study the epidemiologic and clinical characteristics of patients with unilateral optic disc ed... more To study the epidemiologic and clinical characteristics of patients with unilateral optic disc edema diagnosed in the emergency room (ER). Retrospective observational study of all cases of unilateral optic disc edema seen in the ophthalmology ER of Bordeaux University Hospital, France, between October 1, 2008 and October 31, 2009. Fifty-two patients with unilateral optic disc edema were studied, including 61.5% women (n=32) and 38.5% men (n=20). Mean age was 53.5 years (± 22.9). Male patients were older than female (61.1 years vs 48.7 years, P=0.05). Final diagnosis was anterior ischemic optic neuropathy (27 cases), papillitis (17 cases), papilledema (three cases), and pseudoedema (two cases). No etiologies were identified for the remaining three patients. Our study discusses the diagnostic approach for patients presenting with unilateral optic disc edema; this discussion may help to improve clinical practice.
Journal Francais D Ophtalmologie, Jun 1, 2014
Journal Francais D Ophtalmologie, Oct 1, 2015
Figure 1. Œil droit après dilatation : la subluxation du complexe iques pour une baisse d’acuité ... more Figure 1. Œil droit après dilatation : la subluxation du complexe iques pour une baisse d’acuité visuelle brutale de l’œil roit depuis quelques jours. La symptomatologie s’amende orsque la patiente penche la tête face vers le sol. Aucun raumatisme oculaire récent n’est noté. Elle a pour principal ntécédent ophtalmologique une chirurgie de la cataracte ilatérale 10 ans auparavant. L’examen à la lampe à fente met en évidence à droite es dépôts de matériel exfoliatif sur le bord pupillaire et etrouve une subluxation inférieure incomplète du complexe sac capsulaire, anneau de tension de sac et implant de hambre postérieure » (Fig. 1). Les fibres zonulaires lésées ont bien visibles sur le bord supérieur du sac capsulaire, ecouvertes de matériel exfoliatif, mobiles et ondulant au ythme des mouvements oculaires. La présence de l’anneau e sac témoigne d’une probable désinsertion zonulaire perpératoire lors de la chirurgie de la cataracte.
Journal Francais D Ophtalmologie, May 1, 2017
Journal Francais D Ophtalmologie, Apr 1, 2017
Ophthalmic Research, 2020
To describe the use of eye care services among adults treated for diabetes from 2008 to 2017 in t... more To describe the use of eye care services among adults treated for diabetes from 2008 to 2017 in the French population. Methods: We used a random representative sampling of the French national health insurance database. Participants were adults treated for diabetes. Data regarding visits to ophthalmologists, eye examination procedures, and medical treatments were extracted using reimbursement codes. Cross-sectional analyses of eye care claims were per
Investigative Ophthalmology & Visual Science, Apr 11, 2017
The purpose of this study was to describe vitreomacular adhesion (VMA), diagnosed with spectral-d... more The purpose of this study was to describe vitreomacular adhesion (VMA), diagnosed with spectral-domain optical coherence tomography (SD-OCT), its risk factors, and its association with AMD in a population-based study of French elderly subjects. METHODS. Six hundred twenty-two of 624 (99.7%) participants of the Alienor study (Bordeaux, France), ‡75 years of age, had gradable SD-OCT scans of the macula in at least one eye. VMA was defined as visible perifoveal vitreous separation with remaining vitreomacular attachment and unperturbed foveal morphologic features. Late AMD was classified from retinal color photographs, SD-OCT, and ophthalmologic history. Early AMD was classified from retinal photographs and defined by the presence of large drusen and/or reticular drusen and/or pigmentary abnormalities. RESULTS. The prevalence of VMA was 15.8%, decreased with age (18.1% in subjects 75 to 84 years of age versus 8.9% after 85 years of age), and was higher in men than women (20.6% vs. 12.8%). VMA also tended to be less frequent in eyes with a history of cataract surgery (odds ratio [OR] ¼ 0.66, P ¼ 0.05), after adjustment for age and sex. No associations of VMA with other risk factors (cardiovascular risk factors, dietary intake of omega-3 fatty acids, lifetime ultraviolet radiation exposure, major AMD genetic polymorphisms) were found. After multivariate adjustment, VMA was not significantly associated with early or late AMD (OR ¼ 1.14, P ¼ 0.70 and OR ¼ 0.78, P ¼ 0.51 for early and late AMD, respectively). CONCLUSIONS. VMA was visible on SD-OCT in 16% in this sample of elderly French subjects but was not associated with AMD. Prospective studies of the associations of VMA with AMD are needed.
Journal Francais D Ophtalmologie, Apr 1, 2008
Interest in macular pigment has been growing since it was first identified 200 years ago. Because... more Interest in macular pigment has been growing since it was first identified 200 years ago. Because of its antioxidant properties and putative protection against age-related macular degeneration (AMD), clinical, experimental, and epidemiologic studies have attempted to show a positive correlation between the high density of macular pigment and low risk for macular degeneration. Since the two main components of macular pigment, lutein and zeaxanthin, cannot be endogenously synthesized, oral supplementation may be an efficient means to increase macular pigment density. However, the ideal dosage for such supplementation remains to be determined, since absorption varies greatly from one subject to another. Hence, reliable quantitative measurement of macular pigment density is necessary before any beneficial effects of oral supplementation on AMD occurrence can be demonstrated; then at-risk subjects who would require such supplementation can be targeted. Several techniques can be used to measure macular pigment density noninvasively in vivo. Psychophysical methods are the most commonly used. They include heterochromatic flicker photometry and Raman spectroscopy. Heterochromatic flicker is the most widely used method and seems to be the easiest and least costly. However, because it requires very good cooperation from patients and a good grasp of the instructions, it is probably the least reliable and reproducible method. Raman spectroscopy, on the other hand, requires less cooperation on the part of the patient. Subjects are asked to overlap a blue disc and a red polka-dot pattern to ensure proper alignment of the eye. Since these instructions are simpler than those for heterochromatic flicker photometry, this technique is more reliable. Overall, the data obtained are more objective because they are based on the analysis of a signal emitted after an argon laser excitation of the macular pigment. Nevertheless, data are closely related to pupil diameter. Finally Raman spectroscopy requires expensive equipment. Physical methods are based on retinal excitation by an incident light and the analysis of the reflected signal obtained. These methods are mainly represented by autofluorescence measurement and fundus reflectance. These two techniques differ in the wavelength used in the incident light, because the reflected signal is itself related to the amount of incident light absorbed by retinal structures. Both techniques allow rapid and objective measurement of spatial distribution of macular pigment. The software of the modified Scanning Laser Ophthalmoscope (Heidelberg, Germany) further creates a density map image after digital subtraction of the log reflectance data obtained at two different wavelengths. Physical methods require little cooperation from patients and could be considered the most objective and high-performance technique available today. However, the instruments are still expensive and therefore cannot be widely used in clinical practice.
Retina-the Journal of Retinal and Vitreous Diseases, 2019
Purpose: To study the associations of subfoveal choroidal thickness with vascular risk factors an... more Purpose: To study the associations of subfoveal choroidal thickness with vascular risk factors and age-related macular degeneration. Methods: Two hundred sixty-one participants of the Alienor study had gradable enhanced-depth imaging optical coherence tomography scans of the macula and available data on vascular and genetic risk factors (assessed through face-to-face interview and fasting blood samples) and age-related macular degeneration status (assessed from retinal photographs and optical coherence tomography). Subfoveal choroidal thickness was measured manually on one horizontal scan passing through the fovea. Results: In a multivariate mixed linear model, subfoveal choroidal thickness was independently associated with age greater than 80 years (221.77 mm, P = 0.02), axial length (221.77 mm, P , 0.0001), heavy smoking ($20 pack-years: 224.89 mm, P = 0.05), fasting blood glucose higher than 7 mmol/L (253.17 mm, P = 0.02), and lipid-lowering treatment (+18.23, P = 0.047). After multivariate adjustment for age, sex, axial length, and vascular and genetic risk factors, subfoveal choroidal thickness was thinner in eyes with central hyperpigmentation (245.39 mm, P = 0.006), central hypopigmentation (244.99 mm, P = 0.001), and central pigmentary abnormalities (244.50 mm, P = 0.001), but not in eyes with late agerelated macular degeneration (218.05 mm, P = 0.33) or soft drusen. Conclusion: These findings indicate a relationship between vascular risk factors and choroidal thinning and suggest an early involvement of the choroid in the pathogenesis of age-related macular degeneration.
Investigative Ophthalmology & Visual Science, Jul 30, 2011
PURPOSE. Previous studies have suggested a lower risk for agerelated maculopathy (ARM) in subject... more PURPOSE. Previous studies have suggested a lower risk for agerelated maculopathy (ARM) in subjects with high dietary intake of long-chain omega-3 polyunsaturated fatty acids (PUFA). The authors report the associations of ARM with past dietary intakes in French elderly subjects. METHODS. The Alienor Study is a population-based epidemiologic study on nutrition and age-related eye diseases performed in residents of Bordeaux 73 years of age and older. Six hundred sixty-six subjects (1289 eyes) with complete data were included in the analyses. ARM was classified from retinal photographs taken in 2006 to 2008 in five exclusive stages: late neovascular ARM (n ϭ 21 subjects, 29 eyes); late atrophic ARM (n ϭ 19 subjects, 33 eyes); large soft indistinct drusen and/or reticular drusen and/or large distinct drusen with pigment abnormalities (early ARM2, n ϭ 67 subjects, 100 eyes); large soft distinct drusen alone or pigment abnormalities alone (early ARM1, n ϭ 119 subjects, 163 eyes); and no ARM (n ϭ 440 subjects, 964 eyes). Dietary intakes were estimated from a 24-hour dietary recall performed by dieticians (2001-2002). Associations were estimated using logistic Generalized Estimating Equation. RESULTS. After multivariate adjustment, subjects with high intake of long-chain omega-3 PUFA showed a decreased risk for early ARM1 (odds ratio [OR], 0.83; 95% confidence interval [95% CI], 0.71-0.98; P ϭ 0.03) and late neovascular ARM (OR, 0.26; 95% CI, 0.08-0.83; P ϭ 0.02). Associations with late atrophic ARM were in the same direction but did not reach statistical significance (OR, 0.74; 95% CI, 0.52-1.06; P ϭ 0.10). Overall, high intakes of long-chain omega-3 PUFA were associated with reduced risk for late ARM (OR, 0.59; 95% CI, 0.39-0.88; P ϭ 0.01). CONCLUSIONS. These results confirm a decreased risk for ARM in subjects with high intake of long-chain omega-3 PUFA.
Current Developments in Nutrition
Background: Macular edema (ME) results from hyperpermeability of retinal vessels, leading to chro... more Background: Macular edema (ME) results from hyperpermeability of retinal vessels, leading to chronic extravasation of plasma components into the retina and hence potentially severe visual acuity loss. Current standard of care consists in using intravitreal injections (IVI), which results in a significant medical and economic burden. During diabetic retinopathy (DR) or retinal vein occlusion (RVO), it has recently been shown that focal vascular anomalies (capillary macro-aneurysms, also termed TelCaps-for telangiectatic capillaries) may play a central role in the onset, early recurrence and/or persistence of ME. Since targeted photocoagulation of TelCaps may improve vision, identification and photocoagulation of TelCaps may represent a way to improve management of ME. Objective: The Targeted Laser in (Diabetic) Macular Edema (TalaDME) study aims to evaluate whether ICG-guided Targeted Laser (IGTL), in association with standard of care by IVI, allows reducing the number of injections ...
Investigative Ophthalmology & Visual Science, 2013
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Papers by Marie-Noelle Delyfer