Eric Fortin - Academia.edu (original) (raw)
Papers by Eric Fortin
Journal of glaucoma, Jan 22, 2016
To evaluate the efficacy and safety of trabeculotomy in the treatment of pediatric uveitic glauco... more To evaluate the efficacy and safety of trabeculotomy in the treatment of pediatric uveitic glaucoma (UG). We retrospectively reviewed all cases that underwent trabeculotomy for pediatric UG at our center between 2008 and 2014. Up to 2 trabeculotomies per eye were performed in patients with medically controlled uveitis. Surgical success was defined as final intraocular pressure <22 mm Hg and ≥6 mm Hg after 1 or 2 trabeculotomies, with or without medications. Kaplan-Meier survival analyses were done. A total of 33 trabeculotomies were performed in 28 eyes of 22 patients. Diagnoses included UG associated with juvenile idiopathic arthritis (68.2%), idiopathic uveitis (22.7%), and pars planitis (9.1%). The average age at surgery was 9.8±3.7 (5 to 17) years. With a mean follow-up of 33.6±18.3 (10 to 78) months, the overall surgical success was 81.8%. The cumulative survival probability after up to 2 trabeculotomies was 0.86 (95% confidence interval, 0.71-0.93) at 12 months and 0.77 (95...
Transplantation Proceedings, 1998
Proceedings of the National Academy of Sciences, 1999
To evaluate the safety and potential therapeutic activity of humanized anti-IL-2 receptor mAb (Da... more To evaluate the safety and potential therapeutic activity of humanized anti-IL-2 receptor mAb (Daclizumab) therapy in the treatment of patients with severe, sight-threatening, intermediate and posterior noninfectious uveitis, a nonrandomized, open-label, pilot study was performed. Patients with uveitis were treated with a minimum of 20 mg of prednisone, cyclosporine, antimetabolites, or any combination of these agents were eligible. Patients were weaned off their systemic immunosuppressive agents according to a standardized schedule, while ultimately receiving Daclizumab infusions every 4 weeks. Anti-IL-2 receptor antibody therapy, given intravenously with intervals of up to 4 weeks in lieu of standard immunosuppressive therapy, appeared to prevent the expression of severe sight-threatening intraocular inf lammatory disease in 8 of 10 patients treated over a 12-month period, with noted improvements in visual acuity. One patient met a primary endpoint with a loss of vision of 10 letters or more from baseline in one eye and another patient discontinued therapy because of evidence of increased ocular inf lammation. All patients were able to tolerate the study medications without the need for dose reduction. We report effective long-term use of anti-IL-2 therapy for an autoimmune indication. These initial findings would suggest that anti-IL-2 receptor therapy may be an effective therapeutic approach for uveitis and, by implication, other disorders with a predominant Th1 profile.
JAMA: The Journal of the American Medical Association, 1997
Clinical Immunology, 1999
Linomide is a potent immunomodulator that either enhances or suppresses certain immunological pro... more Linomide is a potent immunomodulator that either enhances or suppresses certain immunological processes. Of particular interest is this compound's capacity to inhibit a variety of organ-specific autoimmune diseases. Here, we report on the effects of linomide on several immunological reactions elicited by endotoxin (LPS), both in vivo and in vitro. In rats and mice linomide inhibited the elicitation of endotoxin-induced uveitis (EIU), an acute inflammatory eye disease that develops within 24 h following footpad injection of LPS. Linomide also inhibited the production of TNF-␣ and IL-6 by LPS-stimulated rat and mouse macrophage monolayers. On the other hand, treatment with linomide significantly increased the levels of IL-1 (mice and less in rats), IL-6 (rats), and TNF-␣ (mice) in serum samples collected 2 h following injection with LPS. The increased production of proinflammatory cytokines in linomide-treated mice was also indicated by the enhanced lethal effect of LPS in these mice. The finding of elevated levels of these cytokines in animals with suppressed EIU is also in line with previous observations of an inverse relationship between EIU severity and levels of TNF-␣. Data recorded here underscore the unique capacity of linomide to both enhance and suppress the immune system.
British Journal of Ophthalmology, 1998
Archives of Ophthalmology, 2010
To estimate the annual incidence of endophthalmitis after cataract surgery from January 1, 1996, ... more To estimate the annual incidence of endophthalmitis after cataract surgery from January 1, 1996, through December 31, 2005, in Quebec, Canada. Deidentified data were obtained from an outpatient physician billing database (Quebec State Control for Health Insurance [RAMQ]) with regard to all cataract surgical procedures performed from January 1, 1996, through December 31, 2005, in Quebec. For this cohort, records of an International Classification of Diseases, Ninth Revision (ICD-9) code for endophthalmitis during the same years were requested from 2 sources: the RAMQ outpatient database and an inpatient hospital discharge database (Maintenance and Exploitation of Data for the Study of Hospitalized Patients [MED-ECHO]). Endophthalmitis after cataract surgery was assumed if it occurred within 90 days of the surgery. Risk factors were examined using chi(2) tests and logistic regression. After exclusions, 490 690 cataract surgical procedures were performed from January 1, 1996, through December 31, 2005. A total of 754 cases of endophthalmitis occurred within 90 days after surgery for an overall incidence rate of 1.5 per 1000 surgical procedures (95% confidence interval [CI], 1.4-1.7). Factors associated with endophthalmitis included age of 85 years or older (odds ratio [OR], 1.34; 95% CI, 1.06-1.70), male sex (1.44; 1.24-1.66), later year of surgery (0.94; 0.92-0.97), and region of cataract surgery, because regions 6 (2.21; 1.91-2.55) and 9 (4.00; 2.48-6.43) had higher rates compared with all other regions. Reasons that explain the apparent decrease in endophthalmitis, especially in 2005, should be explored and further research performed to understand why certain patients and regions have higher risks of endophthalmitis after cataract surgery.
Canadian Journal of Ophthalmology / Journal Canadien d'Ophtalmologie, 2009
Objective: To report 4 cases of recurrent anterior uveitis occurring 1-11 months after trabeculec... more Objective: To report 4 cases of recurrent anterior uveitis occurring 1-11 months after trabeculectomy with mitomycin C. Design: Observational case series. Participants: Four patients in whom recurrent uveitis developed after trabeculectomy with mitomycin C, followed at Maisonneuve-Rosemont Hospital in Montreal, Quebec. Methods: Retrospective review of the medical records. Results: One to 11 months after trabeculectomy with mitomycin C, noninfectious, recurrent anterior uveitis developed in 4 patients with no prior history of uveitis. Topical and intravitreal corticosteroids were effective in reducing acute inflammation, yet 2 patients went on to have chronic anterior uveitis. Conclusions: Recurrent anterior uveitis presenting later than 3 weeks postoperatively may be associated with trabeculectomy with mitomycin C. It should be included in the differential diagnosis of a nonresolving blebitis.
Journal of glaucoma, Jan 22, 2016
To evaluate the efficacy and safety of trabeculotomy in the treatment of pediatric uveitic glauco... more To evaluate the efficacy and safety of trabeculotomy in the treatment of pediatric uveitic glaucoma (UG). We retrospectively reviewed all cases that underwent trabeculotomy for pediatric UG at our center between 2008 and 2014. Up to 2 trabeculotomies per eye were performed in patients with medically controlled uveitis. Surgical success was defined as final intraocular pressure <22 mm Hg and ≥6 mm Hg after 1 or 2 trabeculotomies, with or without medications. Kaplan-Meier survival analyses were done. A total of 33 trabeculotomies were performed in 28 eyes of 22 patients. Diagnoses included UG associated with juvenile idiopathic arthritis (68.2%), idiopathic uveitis (22.7%), and pars planitis (9.1%). The average age at surgery was 9.8±3.7 (5 to 17) years. With a mean follow-up of 33.6±18.3 (10 to 78) months, the overall surgical success was 81.8%. The cumulative survival probability after up to 2 trabeculotomies was 0.86 (95% confidence interval, 0.71-0.93) at 12 months and 0.77 (95...
Transplantation Proceedings, 1998
Proceedings of the National Academy of Sciences, 1999
To evaluate the safety and potential therapeutic activity of humanized anti-IL-2 receptor mAb (Da... more To evaluate the safety and potential therapeutic activity of humanized anti-IL-2 receptor mAb (Daclizumab) therapy in the treatment of patients with severe, sight-threatening, intermediate and posterior noninfectious uveitis, a nonrandomized, open-label, pilot study was performed. Patients with uveitis were treated with a minimum of 20 mg of prednisone, cyclosporine, antimetabolites, or any combination of these agents were eligible. Patients were weaned off their systemic immunosuppressive agents according to a standardized schedule, while ultimately receiving Daclizumab infusions every 4 weeks. Anti-IL-2 receptor antibody therapy, given intravenously with intervals of up to 4 weeks in lieu of standard immunosuppressive therapy, appeared to prevent the expression of severe sight-threatening intraocular inf lammatory disease in 8 of 10 patients treated over a 12-month period, with noted improvements in visual acuity. One patient met a primary endpoint with a loss of vision of 10 letters or more from baseline in one eye and another patient discontinued therapy because of evidence of increased ocular inf lammation. All patients were able to tolerate the study medications without the need for dose reduction. We report effective long-term use of anti-IL-2 therapy for an autoimmune indication. These initial findings would suggest that anti-IL-2 receptor therapy may be an effective therapeutic approach for uveitis and, by implication, other disorders with a predominant Th1 profile.
JAMA: The Journal of the American Medical Association, 1997
Clinical Immunology, 1999
Linomide is a potent immunomodulator that either enhances or suppresses certain immunological pro... more Linomide is a potent immunomodulator that either enhances or suppresses certain immunological processes. Of particular interest is this compound's capacity to inhibit a variety of organ-specific autoimmune diseases. Here, we report on the effects of linomide on several immunological reactions elicited by endotoxin (LPS), both in vivo and in vitro. In rats and mice linomide inhibited the elicitation of endotoxin-induced uveitis (EIU), an acute inflammatory eye disease that develops within 24 h following footpad injection of LPS. Linomide also inhibited the production of TNF-␣ and IL-6 by LPS-stimulated rat and mouse macrophage monolayers. On the other hand, treatment with linomide significantly increased the levels of IL-1 (mice and less in rats), IL-6 (rats), and TNF-␣ (mice) in serum samples collected 2 h following injection with LPS. The increased production of proinflammatory cytokines in linomide-treated mice was also indicated by the enhanced lethal effect of LPS in these mice. The finding of elevated levels of these cytokines in animals with suppressed EIU is also in line with previous observations of an inverse relationship between EIU severity and levels of TNF-␣. Data recorded here underscore the unique capacity of linomide to both enhance and suppress the immune system.
British Journal of Ophthalmology, 1998
Archives of Ophthalmology, 2010
To estimate the annual incidence of endophthalmitis after cataract surgery from January 1, 1996, ... more To estimate the annual incidence of endophthalmitis after cataract surgery from January 1, 1996, through December 31, 2005, in Quebec, Canada. Deidentified data were obtained from an outpatient physician billing database (Quebec State Control for Health Insurance [RAMQ]) with regard to all cataract surgical procedures performed from January 1, 1996, through December 31, 2005, in Quebec. For this cohort, records of an International Classification of Diseases, Ninth Revision (ICD-9) code for endophthalmitis during the same years were requested from 2 sources: the RAMQ outpatient database and an inpatient hospital discharge database (Maintenance and Exploitation of Data for the Study of Hospitalized Patients [MED-ECHO]). Endophthalmitis after cataract surgery was assumed if it occurred within 90 days of the surgery. Risk factors were examined using chi(2) tests and logistic regression. After exclusions, 490 690 cataract surgical procedures were performed from January 1, 1996, through December 31, 2005. A total of 754 cases of endophthalmitis occurred within 90 days after surgery for an overall incidence rate of 1.5 per 1000 surgical procedures (95% confidence interval [CI], 1.4-1.7). Factors associated with endophthalmitis included age of 85 years or older (odds ratio [OR], 1.34; 95% CI, 1.06-1.70), male sex (1.44; 1.24-1.66), later year of surgery (0.94; 0.92-0.97), and region of cataract surgery, because regions 6 (2.21; 1.91-2.55) and 9 (4.00; 2.48-6.43) had higher rates compared with all other regions. Reasons that explain the apparent decrease in endophthalmitis, especially in 2005, should be explored and further research performed to understand why certain patients and regions have higher risks of endophthalmitis after cataract surgery.
Canadian Journal of Ophthalmology / Journal Canadien d'Ophtalmologie, 2009
Objective: To report 4 cases of recurrent anterior uveitis occurring 1-11 months after trabeculec... more Objective: To report 4 cases of recurrent anterior uveitis occurring 1-11 months after trabeculectomy with mitomycin C. Design: Observational case series. Participants: Four patients in whom recurrent uveitis developed after trabeculectomy with mitomycin C, followed at Maisonneuve-Rosemont Hospital in Montreal, Quebec. Methods: Retrospective review of the medical records. Results: One to 11 months after trabeculectomy with mitomycin C, noninfectious, recurrent anterior uveitis developed in 4 patients with no prior history of uveitis. Topical and intravitreal corticosteroids were effective in reducing acute inflammation, yet 2 patients went on to have chronic anterior uveitis. Conclusions: Recurrent anterior uveitis presenting later than 3 weeks postoperatively may be associated with trabeculectomy with mitomycin C. It should be included in the differential diagnosis of a nonresolving blebitis.