Central serous chorioretinopathy (CSCR) is a major cause of vision threat among middle-aged male individuals. Multimodal imaging led to the description of a wide range of CSCR manifestations, and highlighted the contribution of the choroid and pigment epithelium in CSCR pathogenesis. However, the exact molecular mechanisms of CSCR have remained uncertain. The aim of this review is to recapitulate the clinical understanding of CSCR, with an emphasis on the most recent findings on epidemiology, risk factors, clinical and imaging diagnosis, and treatments options. It also gives an overview of the novel mineralocorticoid pathway hypothesis, from animal data to clinical evidences of the biological efficacy of oral mineralocorticoid antagonists in acute and chronic CSCR patients. In rodents, activation of the mineralocorticoid pathway in ocular cells either by intravitreous injection of its specific ligand, aldosterone, or by over-expression of the receptor specifically in the vascular endothelium, induced ocular phenotypes carrying many features of acute CSCR. Molecular mechanisms include expression of the calcium-dependent potassium channel (KCa2.3) in the endothelium of choroidal vessels, inducing subsequent vasodilation. Inappropriate or over-activation of the mineralocorticoid receptor in ocular cells and other tissues (such as brain, vessels) could link CSCR with the known co-morbidities observed in CSCR patients, including hypertension, coronary disease and psychological stress.

A large series of silanes are proposed as new co-initiators for radical photopolymerization. Silanes in the presence of benzophenone, isopropylthioxanthone, camphorquinone, or dyes (Eosin) are found highly reactive and, in many cases, even better than a reference amine co-initiator (ethyl dimethylaminobenzoate (EDB)). The ability of the silanes to initiate the polymerization process under air is excellent (better than with amines), and the inhibiting effect is reduced or eliminated. An enhancement of the polymerization rates R p under air is even sometimes noted. For example, using isopropylthioxanthone/tris(trimethylsilyl)silane, R p increases by a 2-fold factor when going from a laminate to an aerated medium. The hardness and the hydrophobic properties of the coatings have also been evaluated. The reaction mechanisms are discussed on the basis of laser flash photolysis experiments. Specific reaction pathways explain the unusual behavior under air.

In this article, germanes are presented as new coinitiators for both radical and cationic photopolymerization processes. For the free radical polymerization process, the newly proposed structures are characterized by efficiencies similar or better than the reference amine. Germyl radicals are also found to be excellent initiators for free radical promoted cationic photopolymerization (FRPCP) of an epoxy resin. The associated reactivity is even better under air. V V C 2008 Wiley Periodicals, Inc. J Polym Sci Part A: Polym Chem 46: 3042-3047, 2008

Our study demonstrated clinical and statistically significant differences between idiopathic PCV and NV-AMD-related polyps that could be considered as distinct entities. Although they share some similarities, mainly the sub-RPE location, the ability to identify a specific clinical pattern suggests a more specific therapeutic approach for these two entities.

Chemically and topographically patterned surfaces have high potential as model surfaces for studying cell and bacteria responses to surface chemistry and surface topography at a nanoscale level. In this work, we demonstrated the possibility to combine pulsed plasma polymerization and UV-irradiation to obtain topographical patterns and chemical patterns perfectly controlled at microlateral resolution and sub-micrometer depth level. Biological experiments were conducted using human osteoprogenitor cells and Escherichia coli K12. Proliferation and orientation of cells and bacteria were analyzed and discussed according to the size and the chemistry of the features. This work showed interesting opposite behavior of bacteria compared to eukaryotic cells, in response to the surface chemistry and to the surface topography. This result may be particularly useful on medical implants. From a methodological point of view, it highlighted the importance of working with versatile and well-characterized surfaces before and after sterilization. It also points out the relevance and the necessity of analyzing eukaryotic cell and bacteria adhesion in parallel way.

PurposeTo evaluate the efficacy and safety of oral mineralocorticoid-receptor antagonist (MRa) therapy in three clinical presentations of nonresolving central serous chorioretinopathy (CSCR) with chronic epitheliopathy.MethodsRetrospective case series of consecutive patients with nonresolving CSCR treated with oral eplerenone or spironolactone. Treatment criteria were: persistent CSCR with subretinal fluid (SRF) lasting longer than 4 months; recurrent CSCR with SRF lasting longer than 2 months; persistent CSCR (SRF ≥ 4 months) with fundus autofluorescence gravitational tracks. Outcomes at 1, 3, and 6 months were: foveal SRF height, central macular thickness (CMT), subfoveal choroidal thickness (SFCT), best-corrected visual acuity (BCVA), and occurrence of side effects.ResultsAmong 54 eyes from 42 patients (mean age: 53 years), mean foveal SRF, CMT, and SFCT decreased significantly at 1, 3, and 6 months after treatment initiation. Mean BCVA improved significantly at 6 months. In the subgroup analysis, mean foveal SRF, CMT, and SFCT decreased significantly at 3 and 6 months in the persistent and recurrent groups. In persistent cases with tracks, a significant diminution of mean CMT and SFCT was achieved at 6 months. Treatment-related side effects were observed in 6 patients, prompting treatment discontinuation in one case.ConclusionResponse to treatment was observed in the three subgroups. In persistent CSCR with tracks the response was delayed compared with persistent and recurrent cases, suggesting that longer treatment durations would be beneficial in patients with gravitational tracks of RPE alteration.Translational RelevanceThe clinical response to oral MRa is consistent with the involvement of the mineralocorticoid pathway in CSCR pathogenesis.

The temperature-dependence of the volume and surface hydrophilicity of a series of water-swollen dense polymer brushes is measured by contact angle measurements in the captive bubble configuration, by ellipsometry, and by quartz crystal microbalance with dissipation monitoring (QCM-D). Thermoresponsive poly(N-isopropylacrylamide) (PNIPAM) and poly(di(methoxyethoxy)ethyl methacrylate) (PMEO2MA), strongly hydrophilic poly(N,N-dimethylacrylamide) (PDMA) and poly(oligo(ethylene glycol) methacrylate) (POEGMA), and weakly hydrophilic poly(2-hydroxyethyl methacrylate) (PHEMA) brushes were synthesized by surface-initiated atom-transfer radical polymerization (SI-ATRP). Conditions leading to reproducible measurements of the contact angle are first provided, giving access to the surface hydrophilicity. Volume hydrophilicity is quantified by measuring the swelling of the brushes, either by QCM-D or by ellipsometry. A model-free methodology is proposed to analyze the QCM-D data. Comparison between the acoustic and optical swelling coefficients shows that QCM-D is sensitive to the maximal thickness of swollen brushes, while ellipsometry provides an integral thickness. Diagrams of surface versus volume hydrophilicity of the brushes finally lead to identify two types of behavior: strongly water-swollen brushes exhibit a progressive decrease of volume hydrophilicity with temperature, while surface hydrophilicity changes moderately; weakly water-swollen brushes have a close-to-constant volume hydrophilicity, while surface hydrophilicity decreases with temperature. Thermoresponsive brushes abruptly switch from one behavior to the other, and do not exhibit an abrupt change of surface hydrophilicity across their collapse transition contrarily to a common erroneous belief. In general, there is no direct correlation between surface and volume hydrophilicity, because surface properties are dependent on the details of conformation and composition at the surface, whereas volume properties are averaged over a finite region within the brush.

Fluid refractory to monthly treatment with ranibizumab for neovascular age-related macular degeneration still allowed for well-maintained visual improvement, even in subfoveal location. Late fluid resolution may occur. However, refractory cysts were associated with poorer anatomical and functional outcome than subretinal fluid.