Georges Azar - Academia.edu (original) (raw)

Papers by Georges Azar

Journal of Clinical Virology, Sep 1, 2013

Herpes simplex virus type 1 (HSV-1) is a leading cause of corneal blindness. Acyclovir (ACV) cons... more Herpes simplex virus type 1 (HSV-1) is a leading cause of corneal blindness. Acyclovir (ACV) constitutes the standard treatment of HSV infections including herpetic keratitis (HK). HSV resistance to ACV is mainly described in immunocompromised patients. We describe two cases of ACV-resistant corneal HSV-1 in immunocompetent individuals with recurrent HK.

Frontiers in Medicine

ObjectiveTo evaluate the risk factors and outcomes of central retinal vein occlusion (CRVO) in yo... more ObjectiveTo evaluate the risk factors and outcomes of central retinal vein occlusion (CRVO) in young patients (< 40 years).MethodsIn this retrospective monocentric case series, we included young patients (<40 years) with CRVO. Patients’ medical files were analyzed focusing on demographic characteristics, suspected risk factors, ophthalmic work-up, visual acuity (VA), treatment, and outcomes.ResultsA total of 54 eyes of 52 patients were included. Central retinal vein occlusion was considered idiopathic in 13 patients (25%). The main risk factors identified were ocular hypertension (20.4%), inflammation (20.4%), high blood pressure (14.8%), and coagulation abnormality (11.1%). Final VA was lower in patients with high blood pressure and inflammation when compared to patients with no risk factor (p = 0.03 and 0.04, respectively). Intravitreal injections were needed in 23 eyes (42.6%) and 19 eyes (35.2%) received panretinal photocoagulation treatment.ConclusionCentral retinal vein ...

International Ophthalmology

Cornea, 2018

To describe a new and safe surgical technique of deep anterior lamellar keratoplasty (DALK) using... more To describe a new and safe surgical technique of deep anterior lamellar keratoplasty (DALK) using the femtosecond laser (FSL) and intraoperative optical coherence tomography (iOCT) for surgical management of corneal thinning and/or opacities. The technique was coined the double-docking procedure for DALK (DD-DALK). FSL-integrated iOCT was used for direct visualization and calibration to perform precise anterior lamellar and side cuts for the removal of the anterior stroma. Air was then injected in the residual posterior stroma to detach Descemet membrane [big-bubble (BB) formation]. Returning the residual posterior stroma into the docked position, a cylindrical vertical cut was made with the FSL to securely open the BB roof. Next, the stromal roof of the BB was removed with forceps leaving Descemet membrane intact, followed by a lamellar corneal graft. Anterior stroma resection, BB formation, and residual stromal resection were achieved in every case without perforation. The curved ...

Journal Français d'Ophtalmologie, 2017

Densité optique du pigment maculaire après supplémentation en lutéine et zéaxanthine grâce au mod... more Densité optique du pigment maculaire après supplémentation en lutéine et zéaxanthine grâce au module pigment du Visucam ® 200 : impact de l'état du cristallin et de la dégénérescence maculaire liée à l'âge

Journal Français d'Ophtalmologie, 2009

Symposium Franco-Libanais : Imagerie dans le glaucome 198 Causes d'erreur au cours de l'examen en... more Symposium Franco-Libanais : Imagerie dans le glaucome 198 Causes d'erreur au cours de l'examen en polarimétrie par balayage laser (SLP/GDX). Sources of error in Scanning Laser Polarimetry (SLP/GDx).

Journal Français d'Ophtalmologie, 2018

To assess the outcomes of iris fixated (IF) posterior chamber (PC) intraocular lens (IOL) versus ... more To assess the outcomes of iris fixated (IF) posterior chamber (PC) intraocular lens (IOL) versus scleral-fixated (SF) PC IOL implantation, and compare them with the results reviewed from the literature. Setting.-The study took place in the ophthalmology department of the Eye and Ear Hospital (Lebanon). Design.-This is a retrospective institutional study that collected the records of patients admitted for secondary IOL implantation between January 2007 and December 2016. Methods.-A total of 28 eyes that underwent PC IOL fixation were included, 13 of which underwent trans-scleral PC IOL fixation and 15 of which underwent iris PC IOL fixation. Data were analyzed over a period of 3 years. Results.-Of the 28 patients, 18 (64.3%) were male and 10 (35.7%) were female (mean age at intervention 36.78 ± 23.47 [standard deviation, SD] years). There were no significant intergroup differences with regard to baseline values and demographic characteristics. Trauma was the most common etiology for posterior capsule insufficiency (82.1%). The mean preoperative baseline BCVA was 0.58 ± 0.27 logMAR for SF and 0.27 ± 0.20 logMAR for IF (P = 0.07). Both groups had significant improvement in vision during the follow up period. No significant differences were noted regarding early or late postoperative complications between the two groups.

Journal of Personalized Medicine

Purpose: To determine the prevalence and characteristics of foveal hypoplasia (also called fovea ... more Purpose: To determine the prevalence and characteristics of foveal hypoplasia (also called fovea plana) in patients with Best disease using spectral-domain (SD) optical coherence tomography (OCT) and OCT-angiography (OCT-A). Design: A retrospective observational study including patients diagnosed with Best disease. Subjects and Participants: Fifty-nine eyes of thirty-two patients (fifteen females (46.9%) and seventeen males (53.1%), p = 0.9) diagnosed with Best disease were included. Patients’ eyes were categorized into two groups: Eyes with a fovea plana appearance (‘FP group’) and eyes without fovea plana appearance (‘no FP group’), based on the foveal appearance on B-scan SD-OCT. Methods and Main Outcome Measures: Cross-sectional OCT images were assessed for the persistence of inner retinal layers (IRL) and OCT-A was analyzed for the presence of a foveal avascular zone (FAZ), the size of which was determined when applicable. Results: Overall, 16 eyes (27.1%) of 9 patients had a f...

SN Comprehensive Clinical Medicine

Journal of Clinical Medicine, Apr 30, 2022

This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY

American Journal of Ophthalmology

Journal of Clinical Medicine, 2021

Background: Acute macular neuroretinopathy (AMN) is an increasingly diagnosed disorder associated... more Background: Acute macular neuroretinopathy (AMN) is an increasingly diagnosed disorder associated with several diseases. The aim of this study was to report the incidence of AMN cases diagnosed during the 2020 coronavirus disease 2019 (COVID-19) pandemic year in a French hospital, and to describe their different forms. Methods: All patients diagnosed between 2019 and 2020, in Paris Rothschild Foundation Hospital, with AMN, paracentral acute middle maculopathy (PAMM) and multiple evanescent white dot syndrome (MEWDS) were retrospectively collected using the software Ophtalmoquery® (Corilus, V1.86.0018, 9050 Gand, Belgium). Systemic and ophthalmological data from AMN patients were analyzed. Results: Eleven patients were diagnosed with AMN in 2020 vs. only one patient reported in 2019. The incidence of AMN significantly increased from 0.66/100,000 visits in 2019 to 8.97/100,000 visits in 2020 (p = 0.001), whereas the incidence of PAMM and MEWDS remained unchanged. Four (36%) of these A...

Wilderness & Environmental Medicine, 2021

Lupini beans are legume seeds of the genus Lupinus, consumed in many parts of the world. The main... more Lupini beans are legume seeds of the genus Lupinus, consumed in many parts of the world. The main species are Lupinus mutabilis, Lupius angustifolius, and Lupinus albus. The latter is commonly eaten as a snack in Mediterranean countries. The beans are very rich in alkaloids, which give them a bitter taste. One of these alkaloids was shown to cause anticholinergic effects. Lupini beans, if inadequately prepared, can cause toxicity manifesting as an anticholinergic syndrome. We present the case of a 50-y-old woman who presented with bilateral mydriasis, mouth dryness, and anxiety. We confirmed that the patient consumed partially debittered lupini beans a few hours before presentation. The rest of her physical and ophthalmic examination results were within normal limits. Her symptoms resolved without therapy within 12 h from presentation and were attributed to ingestion of incorrectly prepared lupine seeds.

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OBJECTIVE To compare the results in patients operated by partial nephrectomy (PN) and radical nep... more OBJECTIVE To compare the results in patients operated by partial nephrectomy (PN) and radical nephrectomy (RN) for renal cancers < 4 cm, between 4 and 7 cm and > 7 cm. MATERIALS AND METHODS Retrospective study including 107 patients operated for renal cancer between 1998 and 2004. Demographic characteristics, TNM stage, tumour diameter and type of surgery (PN vs RN) were recorded. The patients' current status was determined and a survival curve was constructed by the Kaplan-Meier method. RESULTS 35.2% patients were operated by PN and 64.8% were operated by RN. The mean follow-up was 45 months. No significant difference in recurrence-free survival rate was observed between patients operated by PN and RN for tumours < 4 cm (93.3% vs 92.3%, respectively, p = 0.243), or for tumours between 4 and 7 cm (100% vs 89.3%, respectively, p = 0.564) or for tumours > 7 cm (100% vs 85.5%, respectively, p = 0.218). CONCLUSION Partial nephrectomy is the standard treatment for tumours...

British Journal of Ophthalmology, 2021

AimsTo determine the incidence and risk factors of cystoid macular oedema (CMO) following desceme... more AimsTo determine the incidence and risk factors of cystoid macular oedema (CMO) following descemet membrane endothelial keratoplasty (DMEK) with or without combined cataract surgery (triple-DMEK).MethodsWe reviewed the records of patients who underwent DMEK surgery alone or triple-DMEK performed at the Rothschild Foundation Hospital (Paris, France) between January 2019 and March 2020. Patients with pre-existing CMO observed on the preoperative macular optical coherence tomography (OCT) were excluded. Spectral-domain OCT was performed in patients with postoperative visual impairment. Data regarding comorbidities, intraoperative characteristics and postoperative treatments or complications were collected and analysed. Univariate and multivariate analyses were performed.ResultsTwenty three of 246 eyes (9.36%) developed clinically significant (cs)-CMO after DMEK. Triple-DMEK was not associated with a higher risk to develop CMO (12.2% in DMEK alone and 6.1% in triple-DMEK). Pseudophakic ...

Journal of Neuro-Ophthalmology, 2020

L eber hereditary optic neuropathy (LHON) is a mitochondrial genetic disease characterized by bil... more L eber hereditary optic neuropathy (LHON) is a mitochondrial genetic disease characterized by bilateral, painless, subacute visual failure that develops during young adult life (1). It is a mitochondrial genetic disease with a maternal pattern of inheritance. Identifying the mutations is important not only in respect to the diagnosis but also as different LHON mutations result in variations of severity and recovery rate in the affected individuals. Ninety-five percent of LHON cases are associated with 1 of 3 primary mutations: m.3460G.A, m.11778 G.A, and m.14484T.C with defect in the mtDNA (mitochondrial DNA) respiratory chain complex I subunit genes MTND1, MT-ND4, and MT-ND6 (mitochondrially encoded NADH:ubiquinone oxidoreductase core subunit 1,4, and 6). However, there are many reports about new primary and potential mtDNA mutations associated with LHON from different parts of the world. A genotype–phenotype correlation depending on the mutated gene and the type of pathogenic variant has been discussed in different articles (2). In this report, we discuss the case of 2 young Lebanese patients with LHON who were found to have 2 novel mutations: m.14568G.A/C.T and m.7299A.G (Table 1).

Clinical Nutrition ESPEN, 2021

BACKGROUND & AIMS Choroidal thickness can undergo considerable variations in response to diff... more BACKGROUND & AIMS Choroidal thickness can undergo considerable variations in response to different substances. The aim of this study was to assess the change in choroidal thickness after the ingestion of taurine and caffeine contained in the Red Bull energy drink. METHODS Enhanced Depth Imaging - Spectral Domain Optical Coherence Tomography was used to measure subfoveal choroidal thickness (SFCT) variations in healthy volunteers at several time points after drinking a Red Bull can (25 cl). RESULTS Forty eyes of 20 volunteers were enrolled. A significant reduction in SFCT (-14 μm, p < 0.0001) occurred at 1 h after the Red Bull intake, and was even more important (-20.14 μm, p < 0.0001) in eyes with particularly thick choroids (≥ 395 μm). SFCT measurements at 4 h were comparable to baseline. CONCLUSIONS A concomitant ingestion of caffeine and taurine can induce a transient choroidal thinning that is more marked in eyes with thick choroids. REGISTRATION NUMBER OF CLINICAL TRIAL NCT02856256.

Graefe's Archive for Clinical and Experimental Ophthalmology, 2021

To investigate the clinical profile and visual outcomes of infectious endophthalmitis in children... more To investigate the clinical profile and visual outcomes of infectious endophthalmitis in children at a single tertiary hospital in France, and propose an evidence-based protocol for management. This is a retrospective monocentric study that involved children with a history of endophthalmitis between January 2008 and January 2020. The clinical characteristics, etiology, microbiological spectrum from aqueous/vitreous tab, anatomical and visual outcomes, and management were analyzed. The Fischer and chi-square tests were used in the statistical evaluation. Twenty-six children were eligible for inclusion. The mean patients age at presentation was 4.2 years (range, 8 days–14.3 years). With regard to etiology, patients were divided into posttraumatic group (n = 7 (26.9%)), postoperative group (n = 15 (57.7%)), endogenous group (n = 3 (11.5%)), and infectious corneal ulcer group (n = 1 (3.9%)). Time-to-onset of symptoms was highest in children ≤ 3 years old and in the postoperative subgroup who had at least one glaucoma procedure. Microbiology results showed growth in 12/26 (46.2%). The most common microorganism identified was Streptococcus pneumoniae (5/12 (41.7%)). The antibiotic regimen varied depending on age, organism, and sensitivities. The final visual outcomes were 20/200 or better in 11/26 (42.3%) eyes, and 13/26 (50.0%) eyes had no light perception. Twelve of twenty-six (46.2%) eyes ended up with phthisis bulbi. Pediatric endophthalmitis is a rare but devastating condition with poor visual prognosis, requiring prompt recognition and treatment. Despite aggressive management with antibiotics and vitrectomy, the visual prognosis is generally poor. A protocol for management with an adapted systemic antibiotic therapy is proposed in order to improve outcomes.