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Article: Recurrent Branch Retinal Artery Occlusions Revealing Susac's Syndrome.

Kahloun, Rim / Ben Yahia, Salim / Braham, Dorra / Chebel, Saber

2021 Volume 46, Issue 1, Page(s) 50–53

Abstract: We report a case of a 28-year-old otherwise healthy female patient who presented with blurred vision in her right eye related to multiple branch retinal artery occlusions confirmed by fluorescein angiography. Investigation revealed positive antinuclear ... ...

Abstract	We report a case of a 28-year-old otherwise healthy female patient who presented with blurred vision in her right eye related to multiple branch retinal artery occlusions confirmed by fluorescein angiography. Investigation revealed positive antinuclear antibodies and an interatrial septal aneurysm on transthoracic echocardiography. The patient was treated with oral prednisolone and aspirin. Two months after her initial presentation, she developed hearing loss and tinnitus. Ophthalmological examination revealed temporal inferior and nasal inferior branch retinal artery occlusions in the left eye. Magnetic resonance imaging of the brain showed multifocal T2 hyperintense lesions in cortical and subcortical areas as well as the corpus callosum consistent with Susac's syndrome. The diagnosis of Susac's syndrome should be kept in mind in young patients presenting with multiple or recurrent retinal artery occlusions even in the absence of associated systemic symptoms to not delay appropriate management.
Language	English
Publishing date	2021-05-03
Publishing country	England
Document type	Case Reports
ZDB-ID	604820-1
ISSN	1744-506X ; 0165-8107
ISSN (online)	1744-506X
ISSN	0165-8107
DOI	10.1080/01658107.2021.1887286
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Zs.A 1784: Show issues

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Article ; Online: Cardiac and vascular complications of Behçet disease in the Tunisian context: clinical characteristics and predictive factors.

Kechida, Melek / Salah, Sana / Kahloun, Rim / Klii, Rim / Hammami, Sonia / Khochtali, Ines

Advances in rheumatology (London, England)

2018 Volume 58, Issue 1, Page(s) 32

Abstract: Background: Cardiac and vascular involvement in Behçet disease (BD), also referred as vasculo BD, is frequent. We aimed to describe clinical characteristics, predictive factors and management of vasculo BD in the Tunisian context.: Methods: We ... ...

Abstract	Background: Cardiac and vascular involvement in Behçet disease (BD), also referred as vasculo BD, is frequent. We aimed to describe clinical characteristics, predictive factors and management of vasculo BD in the Tunisian context. Methods: We retrospectively studied 213 records of all BD patients followed between January 2004 and May 2016 in the Internal Medicine Department and who fulfilled the ISGBD criteria. We described first clinical features of BD with cardiac and vascular involvement then predictive factors were studied in univariate then multivariate analysis. Results: Among the 213 patients, 64 (30%) were diagnosed as having vasculo BD. The mean age at diagnosis was 31.5 years. About 81.25% of them were males and 18.75% females. Vascular involvement associated or not with cardiac involvement was found in 64 patients (30%). Deep venous thromboses are most common (62.5%) compared with superficial ones (23.4%), pulmonary arterial thrombosis (14.1%) or aneurysms (9.4%). Cardiac involvement is ranging from pericarditis (1.6%) to intra cardiac thrombosis (3.1%) and myocardial infarction (1.6%). Predictive factors associated with cardiac and vascular involvement in BD are male gender (OR = 3.043, 95% CI = 1.436-6.447, p = 0.004), erythema nodosum (OR = 4.134, 95% CI = 1.541-11.091, p = 0.005) and neurologic involvement (OR = 2.46, 95% CI = 1.02-5.89, p = 0.043). Conclusion: Cardiac and vascular involvement in BD is frequent in the Tunisian context with a broad spectrum of manifestations ranging from vascular involvement to cardiac one. Male gender, patients with erythema nodosum or neurologic involvement are prone to develop cardiac or vascular features of BD needing therefore a close monitoring.
MeSH term(s)	Adult ; Aneurysm/epidemiology ; Aneurysm/etiology ; Behcet Syndrome/complications ; Behcet Syndrome/epidemiology ; Cardiovascular Diseases/diagnosis ; Cardiovascular Diseases/epidemiology ; Cardiovascular Diseases/etiology ; Female ; Heart Diseases/epidemiology ; Heart Diseases/etiology ; Humans ; Male ; Myocardial Infarction/epidemiology ; Myocardial Infarction/etiology ; Pericarditis/epidemiology ; Pericarditis/etiology ; Pulmonary Artery ; Pulmonary Embolism/epidemiology ; Pulmonary Embolism/etiology ; Retrospective Studies ; Risk Factors ; Sex Distribution ; Sex Factors ; Thrombosis/epidemiology ; Thrombosis/etiology ; Tunisia/epidemiology ; Venous Thrombosis/epidemiology ; Venous Thrombosis/etiology
Language	English
Publishing date	2018-10-01
Publishing country	England
Document type	Journal Article
ISSN	2523-3106
ISSN (online)	2523-3106
DOI	10.1186/s42358-018-0032-x
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Article ; Online: Ocular manifestations of emerging infectious diseases.

Khairallah, Moncef / Kahloun, Rim

Current opinion in ophthalmology

2013 Volume 24, Issue 6, Page(s) 574–580

Abstract: Purpose of review: Emergent and resurgent infectious diseases are major causes of systemic morbidity and death that are expanding worldwide mainly because of climate changes and globalization. Among them, specific diseases have been recently associated ... ...

Abstract	Purpose of review: Emergent and resurgent infectious diseases are major causes of systemic morbidity and death that are expanding worldwide mainly because of climate changes and globalization. Among them, specific diseases have been recently associated with ocular involvement. This review presents the ocular manifestations of selected emerging infectious diseases relevant to the ophthalmologist. Recent findings: An array of ocular manifestations, involving mainly the posterior segment, have been recently described in association with specific arthropod vector-borne diseases including rickettsioses, West Nile virus, Rift Valley fever, Dengue fever, and Chikungunya. Influenza A (H1N1) virus has also been recently associated with ocular involvement. On the contrary, with advances in laboratory testing applied to ocular fluids, new infectious agents, mainly viruses, are increasingly being found to be associated with uveitis. Summary: Emerging infectious diseases should be considered in the differential diagnosis of retinitis, chorioretinitis, retinal vasculitis, optic neuropathy, or any other ocular inflammatory condition in a patient living in or traveling back from a specific endemic area. On the contrary, ocular fluid sampling and analysis for specific new pathogens can be recommended in selected patients with uveitis of unexplained cause.
MeSH term(s)	Communicable Diseases, Emerging/diagnosis ; Diagnosis, Differential ; Eye Diseases/diagnosis ; Eye Infections/diagnosis ; Humans
Language	English
Publishing date	2013-11
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	1049383-9
ISSN	1531-7021 ; 1040-8738
ISSN (online)	1531-7021
ISSN	1040-8738
DOI	10.1097/ICU.0b013e3283654e09
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Article ; Online: Functional alterations of retinal neurons and vascular involvement progress simultaneously in the Psammomys obesus model of diabetic retinopathy.

Dellaa, Ahmed / Mbarek, Sihem / Kahloun, Rim / Dogui, Mohamed / Khairallah, Moncef / Hammoum, Imane / Rayana-Chekir, Narjess Ben / Charfeddine, Ridha / Lachapelle, Pierre / Chaouacha-Chekir, Rafika Ben

The Journal of comparative neurology

2021 Volume 529, Issue 10, Page(s) 2620–2635

Abstract: To investigate the progression of diabetic retinopathy (DR) in a new diurnal animal model, we monitored clinically the DR in Psammomys obesus (P. obesus) during 7 months using electroretinography (ERG) and imaging techniques. After the onset of DR, all ... ...

Abstract	To investigate the progression of diabetic retinopathy (DR) in a new diurnal animal model, we monitored clinically the DR in Psammomys obesus (P. obesus) during 7 months using electroretinography (ERG) and imaging techniques. After the onset of DR, all ERG components decreased progressively. In scotopic conditions, by 3-months of disease progression, the diabetic P. obesus displayed a significant decrease in amplitude of b-max, b-wave responses, and mixed b-waves. While mixed a-wave decreased between 4 and 7 months. Significant differences of OP2 appeared following 1 month of disease. In photopic conditions, we noticed a decrease in the a-wave at 2 months, while it took more than 5 months in b-wave amplitude. The photopic negative response (PhNR) and the i-wave amplitudes decreased following 4 and 5 months. OP1 and OP2 were the first to be altered and a significant decrease in the amplitude started after 3 months. Finally, 30 Hz-flicker and photopic S-cone were impaired after 2 and 3 months, respectively. The assessment of the eye fundus of the retina revealed an abnormal vascular architecture appeared at Months 6 and 7. In addition, we noticed exudates in the superior periphery of the retina at the same stage. The retina thickness showed a significant reduction at Month 7. Our results indicate that the clinical correlates of human DR are present in diabetic P. obesus. The depressed of ERGs, disruption of retinal architecture, and the appearance of exudates may reflect vascular and neuronal damage throughout the retina as are seen in the advanced stages of human DR.
MeSH term(s)	Animals ; Diabetes Mellitus, Experimental/pathology ; Diabetes Mellitus, Experimental/physiopathology ; Diabetic Retinopathy/pathology ; Diabetic Retinopathy/physiopathology ; Disease Models, Animal ; Disease Progression ; Electroretinography ; Gerbillinae ; Retinal Neurons/pathology
Language	English
Publishing date	2021-03-10
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	3086-7
ISSN	1096-9861 ; 0021-9967 ; 0092-7317
ISSN (online)	1096-9861
ISSN	0021-9967 ; 0092-7317
DOI	10.1002/cne.25114
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Article ; Online: Central serous chorioretinopathy, corticosteroids, and uveitis.

Khairallah, Moncef / Kahloun, Rim / Tugal-Tutkun, Ilknur

Ocular immunology and inflammation

2012 Volume 20, Issue 2, Page(s) 76–85

Abstract: Any patient with a diagnosis of central serous chorioretinopathy (CSCR) should be questioned to determine any recent corticosteroid use, as the poor visual outcome may be due to unrecognized corticosteroid use. Atypical forms of CSCR may be misdiagnosed ... ...

Abstract	Any patient with a diagnosis of central serous chorioretinopathy (CSCR) should be questioned to determine any recent corticosteroid use, as the poor visual outcome may be due to unrecognized corticosteroid use. Atypical forms of CSCR may be misdiagnosed as an inflammatory serous retinal detachment, mainly Vogt-Koyanagi-Harada disease. CSCR that develops in association with preexisting uveitis could be a challenging diagnosis as it might be misinterpreted as a worsening of the primary inflammatory condition. Failure to differentiate CSCR from retinal or choroidal inflammatory diseases may result in inappropriate use of corticosteroids, leading to exacerbation of the condition and permanent visual loss. Discontinuation of corticosteroids should be the first step in the treatment of CSCR associated with corticosteroid therapy, and the use of immunosuppressive or immunomodulatory drugs may be required to control systemic or ocular inflammatory disease. The prognosis is usually favorable, but persistent visual loss may occur.
MeSH term(s)	Adrenal Cortex Hormones/adverse effects ; Adrenal Cortex Hormones/therapeutic use ; Central Serous Chorioretinopathy/chemically induced ; Central Serous Chorioretinopathy/diagnosis ; Central Serous Chorioretinopathy/drug therapy ; Diagnostic Errors ; Female ; Humans ; Immunosuppressive Agents/therapeutic use ; Male ; Retinal Detachment/diagnosis ; Treatment Outcome ; Uveitis/chemically induced ; Uveitis/diagnosis ; Uveitis/drug therapy ; Visual Acuity/drug effects
Chemical Substances	Adrenal Cortex Hormones ; Immunosuppressive Agents
Language	English
Publishing date	2012-04
Publishing country	England
Document type	Journal Article ; Review
ZDB-ID	1193873-0
ISSN	1744-5078 ; 0927-3948
ISSN (online)	1744-5078
ISSN	0927-3948
DOI	10.3109/09273948.2011.650776
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Zs.A 4004: Show issues

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Article: Infectious optic neuropathies: a clinical update.

Kahloun, Rim / Abroug, Nesrine / Ksiaa, Imen / Mahmoud, Anis / Zeghidi, Hatem / Zaouali, Sonia / Khairallah, Moncef

Eye and brain

2015 Volume 7, Page(s) 59–81

Abstract: Different forms of optic neuropathy causing visual impairment of varying severity have been reported in association with a wide variety of infectious agents. Proper clinical diagnosis of any of these infectious conditions is based on epidemiological data, ...

Abstract	Different forms of optic neuropathy causing visual impairment of varying severity have been reported in association with a wide variety of infectious agents. Proper clinical diagnosis of any of these infectious conditions is based on epidemiological data, history, systemic symptoms and signs, and the pattern of ocular findings. Diagnosis is confirmed by serologic testing and polymerase chain reaction in selected cases. Treatment of infectious optic neuropathies involves the use of specific anti-infectious drugs and corticosteroids to suppress the associated inflammatory reaction. The visual prognosis is generally good, but persistent severe vision loss with optic atrophy can occur. This review presents optic neuropathies caused by specific viral, bacterial, parasitic, and fungal diseases.
Language	English
Publishing date	2015-09-28
Publishing country	New Zealand
Document type	Journal Article ; Review
ZDB-ID	2587460-3
ISSN	1179-2744
ISSN	1179-2744
DOI	10.2147/EB.S69173
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Article ; Online: Parinaud's oculoglandular syndrome revealing subclinical Rickettsia conorii infection.

Abroug, Nesrine / Khairallah-Ksiaa, Imen / Kahloun, Rim / Khochtali, Sana / Zaouali, Sonia / Khairallah, Moncef

International ophthalmology

2015 Volume 35, Issue 5, Page(s) 717–719

Abstract: The purpose of this study was to report a case of Parinaud's oculoglandular syndrome associated with subclinical Rickettsia conorii infection. We report a case of a 66-year-old male patient presented with unilateral persistent granulomatous ... ...

Abstract	The purpose of this study was to report a case of Parinaud's oculoglandular syndrome associated with subclinical Rickettsia conorii infection. We report a case of a 66-year-old male patient presented with unilateral persistent granulomatous conjunctivitis in the left eye and an ipsilateral preauricular lymphadenopathy without associated systemic features. Laboratory evaluation showed a positive indirect immunofluorescence antibody test for R. conorii. The patient received a 2-week course of oral doxycycline, with subsequent complete resolution of all his symptoms. Rickettsial disease should be considered in the differential diagnosis of oculoglandular syndrome with or without associated systemic symptoms in any patient living in or returning from a specific endemic area.
MeSH term(s)	Aged ; Anti-Bacterial Agents/therapeutic use ; Boutonneuse Fever/complications ; Humans ; Male ; Ocular Motility Disorders/etiology ; Rickettsia conorii/isolation & purification
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2015-10
Publishing country	Netherlands
Document type	Case Reports ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	800087-6
ISSN	1573-2630 ; 0165-5701
ISSN (online)	1573-2630
ISSN	0165-5701
DOI	10.1007/s10792-015-0094-2
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Zs.A 1479: Show issues

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Article ; Online: Swept-Source Optical Coherence Tomography Angiography in West Nile Virus Chorioretinitis and Associated Occlusive Retinal Vasculitis.

Khairallah, Moncef / Kahloun, Rim / Gargouri, Salma / Jelliti, Bechir / Sellami, Dorra / Ben Yahia, Salim / Feki, Jamel

Ophthalmic surgery, lasers & imaging retina

2017 Volume 48, Issue 8, Page(s) 672–675

Abstract: A 65-year-old man with diabetes and a history of fever of unknown origin 2 weeks earlier complained of sudden decreased vision in the left eye. The patient was diagnosed with bilateral West Nile virus (WNV) chorioretinitis associated with occlusive ... ...

Abstract	A 65-year-old man with diabetes and a history of fever of unknown origin 2 weeks earlier complained of sudden decreased vision in the left eye. The patient was diagnosed with bilateral West Nile virus (WNV) chorioretinitis associated with occlusive retinal vasculitis in the left eye. Swept-source optical coherence tomography angiography (SS-OCTA) of the left eye showed extensive, well-delineated, hypointense non-perfusion areas and perifoveal capillary arcade disruption in the superficial capillary plexus, as well as larger non-perfusion areas, capillary rarefaction, and diffuse capillary network attenuation and disorganization in the deep capillary plexus. OCTA may be a valuable tool for noninvasively assessing occlusive retinal vasculitis associated with WNV infection. It allows an accurate detection and precise delineation of areas of retinal capillary nonperfusion in both the superficial and deep capillary plexuses. [Ophthalmic Surg Lasers Imaging Retina. 2017;48:672-675.].
MeSH term(s)	Aged ; Antibodies, Viral/immunology ; Chorioretinitis/diagnosis ; Chorioretinitis/virology ; Choroid/pathology ; Diagnosis, Differential ; Eye Infections, Viral/diagnosis ; Eye Infections, Viral/virology ; Fluorescein Angiography/methods ; Fundus Oculi ; Humans ; Male ; Retina/pathology ; Tomography, Optical Coherence/methods ; West Nile Fever/diagnosis ; West Nile Fever/virology ; West Nile virus/immunology
Chemical Substances	Antibodies, Viral
Language	English
Publishing date	2017--01
Publishing country	United States
Document type	Case Reports ; Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2701167-7
ISSN	2325-8179 ; 2325-8160
ISSN (online)	2325-8179
ISSN	2325-8160
DOI	10.3928/23258160-20170802-11
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Zs.A 756: Show issues

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Article ; Online: OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY IN PATIENTS WITH BEHÇET UVEITIS.

Khairallah, Moncef / Abroug, Nesrine / Khochtali, Sana / Mahmoud, Anis / Jelliti, Bechir / Coscas, Gabriel / Lupidi, Marco / Kahloun, Rim / Ben Yahia, Salim

Retina (Philadelphia, Pa.)

2017 Volume 37, Issue 9, Page(s) 1678–1691

Abstract: Purpose: To describe optical coherence tomography angiography (OCTA) findings in eyes with Behçet uveitis (BU) and to compare these findings with those of fluorescein angiography (FA).: Methods: Prospective, comparative, cross-sectional study. ... ...

Abstract	Purpose: To describe optical coherence tomography angiography (OCTA) findings in eyes with Behçet uveitis (BU) and to compare these findings with those of fluorescein angiography (FA). Methods: Prospective, comparative, cross-sectional study. Patients presenting with clinically active BU involving the posterior segment were evaluated using FA, spectral domain optical coherence tomography (SD-OCT), and OCTA. Optical coherence tomography angiograms were reviewed and analyzed. Foveal avascular zone areas and vessel densities were also reported. Results: Twenty-five patients (44 eyes) were included. Perifoveal microvascular changes were more frequently observed on OCTA than on FA (95.5 vs 59.1%; P < 0.001). Disruption of the perifoveal capillary arcade, areas of retinal capillary nonperfusion/hypoperfusion, and perifoveal capillary abnormalities, including rarefied, dilated, or shunting vessels were observed more frequently using OCTA than FA (40.9 vs 25%; P = 0.039, 86.4 vs 34.1%; P < 0.001, and 84.1 vs 36.4%; P < 0.001, respectively). Areas of retinal capillary nonperfusion/hypoperfusion were more frequently observed in the deep than in the superficial capillary plexus (81.8 vs 63.6%; P = 0.039). Capillary abnormalities and disorganization of the normal architecture of the capillary network were more frequent in the deep than in the superficial capillary plexus (P < 0.001). Foveal avascular zone area was not significantly larger in eyes with BU than in control group in both the superficial and the deep capillary plexuses (0.4 vs 0.34 mm; P = 0.23 and 0.72 vs 0.53 mm; P = 0.053, respectively). Capillary vessel density was significantly lower in eyes with BU than in control group in the deep capillary plexus (13.7 vs 17.2 mm 21; P = 0.004). Conclusion: OCTA allows better visualization and characterization of perifoveal microvascular changes than FA in eyes with active BU. The deep capillary plexus seemed to be more severely involved than the superficial capillary plexus.
Language	English
Publishing date	2017-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	603192-4
ISSN	1539-2864 ; 0275-004X
ISSN (online)	1539-2864
ISSN	0275-004X
DOI	10.1097/IAE.0000000000001418
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Article ; Online: SWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY IN RICKETTSIAL RETINITIS.

Kahloun, Rim / Jelliti, Bechir / Ksiaa, Imen / Ben Amor, Hager / Zaouali, Sonia / Lupidi, Marco / Ben Yahia, Salim / Khairallah, Moncef

Retinal cases & brief reports

2017 Volume 13, Issue 4, Page(s) 348–351

Abstract: Purpose: To report optical coherence tomography angiography findings in a patient with rickettsial retinitis.: Methods: A 29-year-old man complaining of acute blurring vision in the right eye associated with Rickettsia conorii infection underwent a ... ...

Abstract	Purpose: To report optical coherence tomography angiography findings in a patient with rickettsial retinitis. Methods: A 29-year-old man complaining of acute blurring vision in the right eye associated with Rickettsia conorii infection underwent a comprehensive ocular examination, fluorescein angiography, spectral-domain optical coherence tomography, and swept-source optical coherence tomography angiography. Results: Funduscopy showed two large areas of retinitis in the inferior macula along the distribution of the inferotemporal artery with associated retinal hemorrhages, retinal edema, and serous retinal detachment. Fluorescein angiography showed early hypofluorescence and late staining of white retinal lesions and associated adjacent retinal vascular leakage and optic disc hyperfluorescence. Optical coherence tomography angiography showed hypointense dark areas in the superficial capillary plexus and larger hypointense areas in the deep capillary plexus, outer retina, and choriocapillaris layer. The patient was treated with doxycycline and prednisone. Six weeks after presentation, retinal changes seen at the acute phase had resolved, leading to mild residual retinal pigment epithelial changes. Fluorescein angiography showed retinal capillary nonperfusion within areas of resolved retinitis. Spectral-domain optical coherence tomography findings included inner retinal atrophy, intraretinal cysts, and disruption of ellipsoid zone and interdigitation zone. Swept-source optical coherence tomography angiography showed well-delineated hypointense greyish areas of retinal capillary nonperfusion in both the superficial and deep capillary plexuses. Visual field testing revealed the presence of a corresponding paracentral defect. Conclusion: Optical coherence tomography angiography may be a valuable noninvasive imaging technique for detecting and analyzing occlusive complications associated with rickettsial retinitis.
MeSH term(s)	Adult ; Antibodies, Bacterial/analysis ; Eye Infections, Bacterial/diagnosis ; Eye Infections, Bacterial/microbiology ; Fluorescein Angiography/methods ; Fundus Oculi ; Humans ; Male ; Retina/pathology ; Retinitis/diagnosis ; Retinitis/microbiology ; Rickettsia/immunology ; Rickettsia Infections/diagnosis ; Rickettsia Infections/microbiology ; Tomography, Optical Coherence/methods ; Visual Acuity
Chemical Substances	Antibodies, Bacterial
Language	English
Publishing date	2017-06-13
Publishing country	United States
Document type	Case Reports ; Journal Article
ISSN	1937-1578
ISSN (online)	1937-1578
DOI	10.1097/ICB.0000000000000603
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